Clinical pharmacology & therapeutics (CPT) is an exciting and tremendously varied specialty; the core role of a clinical pharmacologist is to improve the care of patients through safe and effective use of medicines.
This wide remit combines clinical practice with development and implementation of new therapies, training and teaching of current and future prescribers, and promotion of evidence-based therapeutics through local and national policy.
In most centres, training in general internal medicine (GIM) will be offered alongside that in CPT, leading to a dual CCT in CPT & GIM. Combinations with other medical specialities are available in some centres.
Following training in the core CPT curriculum, trainees undertake training in one of four advanced specialist area modules: Hypertension; Clinical Toxicology; Clinical Trials; or Research.
CPT - trainee characteristics
CPT has a broad remit and so will appeal to trainees with a wide range of interests and skills. It will particularly suit trainees who are:
- seeking variety
- keen to work with a measure of independence
Plus, training in clinical pharmacology provides time for critical appraisal, analysis and academic development, which is not always available in other specialties.
Summary of the specialty
It is currently an excellent time to consider CPT as a career. Clinical pharmacologists make a vital contribution to the health of patients and the wealth of the NHS, providing unparalleled generalist and specialist expertise across the breadth of its services.
Significant progress has been made in improving the UK’s academic expertise in clinical pharmacology through the Medical Research Council’s and the Wellcome Trust’s initiatives, and in improving prescribing practice through the British Pharmacological Society’s collaborative project with MSC Assessment: the Prescribing Safety Assessment.
CPT is the only medical specialty focusing on the safe, effective, and economic use of medicines. It is a diverse and wide-ranging discipline that plays an essential role across multiple areas of the NHS, contributing to its organisational objectives and, most importantly, improving patient outcomes and experiences.
Clinical pharmacologists make a particularly valuable contribution to the NHS in areas including:
- Providing specialist and generalist patient care in hospitals (including paediatrics) and other settings, using their expertise in the use of medicines to improve outcomes and prevent avoidable harm
- Leading clinical toxicology services and the National Poisons Information Service
- Advising on all aspects of medicines policy and management including regulation, health economic assessments, prescribing guidance, and formulary management in order to optimise the clinical and cost-effective use of medicines – for every £1 of investment, clinical pharmacology has delivered savings of £10 to the NHS
- Providing education and training for undergraduates and postgraduates to ensure doctors have the appropriate skills to prescribe safely and effectively
- Working with industry and supporting the UK’s life sciences sector to enhance the development of innovative new medicines and improve the use of current medicines
- Bringing innovation to the NHS through experimental medicine by designing early phase clinical trials, establishing NHS clinical research facilities, and providing overarching clinical support
The work programme of a consultant in CPT varies greatly depending on the employer and the primary work setting.
Some brief information on these areas is given below (click on the relevant heading):
Academic clinical pharmacologists are usually employed by a university on a clinical academic contract with time divided between academic work and clinical practice, eg as a 50-50 split.
The academic career path after CCT is senior lecturer, reader, then professor. Academic work includes research and teaching according to individual and departmental interests.
Alongside the substantive university contract, academics in CPT usually have an honorary consultant contract with an associated NHS trust.
Their clinical practice includes general medicine with or without a sub-specialty interest, such as cardiovascular risk management, toxicology, airways disease, epilepsy or gastroenterology.
They often have a role in medicines management as described for NHS consultants.
NHS consultants in CPT deliver a clinical service in general (GIM) and acute medicine; although sometimes CPT is combined with paediatrics or general practice. The workload for CPT consultants with GIM accreditation includes acute medical intaking, ongoing care of medical inpatients and running outpatient clinics.
Many CPT consultants have a sub-specialty interest, eg cardiovascular risk management, toxicology, airways disease, epilepsy or gastroenterology.
Clinical pharmacologists practise the specialty of CPT in the NHS through local contribution to medicines management. Some CPT consultants may also lead provision of a 'medicines information service' to local prescribers, usually with the support of a clinical pharmacist.
Many NHS CPT consultants will also have a strong research emphasis to their work, that will contribute to knowledge about drug actions and their clinical usage and play an important role in the planning and delivery of undergraduate teaching in therapeutics.
Some clinical pharmacologists at consultant level are employed within the pharmaceutical industry, and are involved in the development of new drugs and clinical trials in patients.
Some of these hold joint appointments with academic units or trusts - a trend that may grow in the future.
The pharmaceutical industry, as well as drug regulatory bodies, has a particular interest in recruiting trained clinical pharmacologists.
At a national level, CPT consultants frequently occupy senior positions within bodies involved in drug regulation. Some of these are full time posts and other positions are held in addition to academic or NHS posts. These include:
- National Institute for Health and Care Excellence (NICE)
- Medicines and Healthcare products Regulatory Agency (MHRA)
- Commission on Human Medicines
- Pharmacovigilance schemes.
In addition to this, the National Poisons Information Service is run almost exclusively by NHS clinical pharmacologists.
Find out more about CPT and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
- For personal accounts of careers in CPT (including 'day-in-the-life'-style accounts), please visit the British Pharmacological Society website
- NHS health careers
- JRCPTB specialty page and curriculum
- RCP (London), Specialty spotlight - clinical pharmacology and therapeutics
- ST3 CPT person specification
- Developing physicians on RCP Medical Care
Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for clinical pharmacology and therapeutics in round 1 2019 is West Midlands.
|Health Education West Midlands|
|Postal address||Health Education West Midlands
St Chad's Court
213 Hagley Road
|email address||[email protected]|
For general queries reloating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Physician Specialty Recruitment Office via email at [email protected].
Please be aware that clinical pharamcology and therapeutics also accepts applicants from anaesthestics, emergency medicine, general practice and paediatric training routes, who may not have the MRCP(UK) examination nor all IMT competences.
Non-physician applicants must have obtained the basic specialty professional examination relevant to their training pathway prior to the start of ST3 training, in addition to specific clinical experience and competences. Therefore applicants must have one of the following:
- Physician training (eg CMT) - MRCP(UK) Part 1 at time of application; full MRCP(UK) by required deadline
- Paediatric training - full MRCPH diploma by required deadline
- General practice - full MRCGP at time of application
- Anaesthetics training - FRCA (Primary) at time of application; full FRCA by required deadline
- Emergency medicine training - MCEM (Part A) at time of application; full MCEM by required deadline.
Please view the CPT person specification for information about the experience and competency required and the deadlines for when this must be achieved.
Medical trainees please view the standard eligibility criteria as detailed in the am I eligible? section.
Dual accreditation with general internal medicine
Although it is possible to apply for CPT from a non-medicine training pathway without core medicine competences, including the MRCP(UK), in most cases CPT programmes will be dual accredited with general internal medicine (GIM). GIM requires core medical competence and therefore non-medicine applicants will not be eligible.
Consequently, if you are interested in CPT training and do not meet the requirements for GIM, prior to applying you are advised to contact the training programme director at the region(s) in which you are considering working to find out if it will be possible for a single accredited CPT programme to be offered.
National single centre model
This specialty uses the single centre recruitment model.
You will not be required to give any preferences of particular regions when completing your application; you are applying purely for the specialty at that stage.
Later on, you will be required to give preferences of the available posts – at that point, you can opt to be considered for as many (or as few) post vacancies available nationally as you wish.
Lead region and single centre interviews
The specialty will nominate a particular region to act as lead for the round; this region is shown under the 'Who do I contact?' tab above. This lead region will review all applications, liaise with all candidates, host interviews, verify assessments, and make offers on behalf of all regions nationally.
Your application will be handled solely by the lead region throughout the entire round, up to the point where you receive and accept an offer; after which it will be transferred to the region where the post is based for pre-employment checks.
All interviews will be held at this lead region although the clinicians making up the interview panel will be drawn from a national background – ie not just from the host region.
Flexible portfolio training
New for 2019, this specialty will be participating in the ‘flexible portfolio training’ scheme, in the West Midlands, North West and North East regions. This protects one day a week (or 20% time equivalent across the year) for the trainee to work within clinical informatics that will aid their professional development. This is an opportunity to acquire and develop key skills and engage in meaningful project work, in a different environment, alongside time in training that will be the springboard to a consultant career.
Further details about the scheme, and the regions where this is available can be found by visiting the website https://www.rcplondon.ac.uk/projects/flexible-portfolio-training or by emailing [email protected]
It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal. You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last reviewed.
You will spend approximately 15 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the clinical pharmacology & therapeutics interview will be approximately 55-60 minutes.
For details of how scores are awarded at interview, and weighting that is applied subsequently, please see the scoring page of this website.
Click on the relevant stations below for more information on the content of the interview.
Please note that this is subject to change, and will be confirmed by the date of interview.
This is where your application form and training to date will be reviewed. This will include checking the documentation you have brought along to ensure all content on your application form is correct.
Normally your evidence folder will have been reviewed by the interviewers immediately prior to your arrival in the station. They will be:
• Checking that your achievements in your evidence folder match that claimed on your application form.
• Considering your career progression to date.
• Identifying areas about which they may wish to question you during the interview.
Areas for assessment
The two main aspects of discussion here, on which you will be assessed, will be your suitability for and commitment to ST3 training in the specialty, and your achievements and engagement with training and learning to date.
Scoring at the station
It is important to recognise that the scores awarded to you at this station will not purely be about your achievements, as this already contributes towards the scoring via your application form. Interviewers will be deciding upon scores via a combination of factors, for example: your responses to the questions asked, the breadth and quality of your achievements and your career progression.
Prior to arriving at station 2 you will be given a clinical scenario to review. Upon arrival at the station you will be asked questions relating to this scenario.
The clinical scenario will be relatively brief (two/three sentences), so once you have read this, the remainder of the pre-station time will allow you to undertake some short preparation (just mental preparation - this does not mean making notes, etc.).
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved. Some points to consider when reviewing the scenario and preparing for discussion are:
what steps you would take
any potential treatments possible
any further information you would gather
how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario
You should also take into account any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
One mark will be awarded to you based on your suggestions and responses to the clinical scenario. The second mark will be on the communication skills you display.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers at the station.
At station 3, you will be asked to give a presentation, which you are expected to prepare in advance on a given subject (see below). This will be followed by discussion of your presentation between you and the interviewers; and then a general discussion regarding research and academic medicine.
Upon arrival at station 3, you will need to give a presentation on the following topic, for no more than five minutes:
'An interesting recent development / research finding, relevant to clinical pharmacology & therapeutics'
When preparing your presentation, please bear in mind the points below:
- Clarity & relevance most important - The major purpose of this station is to assess communication skills. Thus you should select a topic that is relevant to CPT, and which you can present with clarity. This is more important than trying to impress by choosing a subject that is esoteric or complex. The topic should be relevant to your application where possible.
- No aids/resources - There will be no projectors or laptops for PowerPoint, no OHPs, flip-charts, etc. You are welcome to use prompts on small cards, but these should be for your own use only, and should not be given out as hand-outs.
- Five minute time limit - Your presentation must last for no more than five minutes. Please note that you will be stopped after five minutes so as to allow further discussion to take place, so try and get your main points across before then. At the same time, bear in mind that interviewers will be assessing the level, depth and content of your presentation, as well as expecting some structure.
Interview nerves will be taken into consideration.
Once your presentation is finished (interviewers will stop you at the five minute-mark), interviewers will discuss it with you and ask further questions relating to the items you raise and any further points.
Research & academic medicine discussion
Once your presentation and the subsequent discussion is finished, you will then move onto a general discussion on the subject of research and academic medicine.
No specific preparation will be required of you here, and you will not receive data in advance as you did with the presentation and clinical scenario.
However, we would advise undertaking some general preparation. For example, familiarising yourself with the process by which medical research takes place and progresses, from initial setup to report; as well as any areas of research that interest you, and the challenges, benefits, costs, etc. of research more broadly.
Areas for assessment
The first area for which you will receive a score at station 3 will be your presentation and its accompanying discussion; and the second is on your knowledge, awareness and understanding of medical research.
Station 3 will last for 15 minutes in total. As noted, the presentation should last for no more than five minutes. The remaining 10 minutes will be split between the presentation discussion and the research/academic medicine discussion as is required.
There is some flexibility in division of these 10 minutes, so interviewers will move on from one subject to the next as appropriate, rather than imposing an absolutely strict time limit.
Appointable - automatic
If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.
Not appointable - automatic
If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.
If four or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.
Should your interview assessment fall under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable.
Appointability subject to panel decision
In the event that your 12 interview scores contain one, two or three marks of 2/5 (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.
The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.
Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.
Review vs automatic status
Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.
Total score calculation
After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.
Please note that this is subject to change, and will be confirmed by the date of interview.
|Int. 1||Int. 2||Weighting||Max score|
|Evidence||/ 5||/ 5||x1.6||/ 16|
|Suitability for specialty||/ 5||/ 5||x1.2||/ 12|
|Clinical scenario||/ 5||/ 5||x1.6||/ 16|
|Communication mark||/ 5||/ 5||x0.8||/ 8|
|Presentation / Research||/ 5||/ 5||x1.6||/ 16|
|Research / Academic||/ 5||/ 5||x1.2||/ 12|
|Raw interview score||/ 60|
|Interview score (including weighting)||/ 80|
|Short-listing (app form)||/ 80||x0.25||/ 20|
|Overall assessment score||/ 100|
As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.
To this end, we have published data dating back to 2013 (where this is available), based around four main areas:
Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.
Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.
Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.
Post fill rates - the number of posts filled by region.
We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.
|Year||Apps.|| NTN |
| LAT |
| Total |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
|Year||Apps.||NTN posts||LAT posts||Total posts||Comp.|
|2017||Did not participate in round 2|
Provisional post numbers
Specialty vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts.
It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.
Numbers subject to change
Please be aware that it is not uncommon for vacancy numbers to change throughout the round.
More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. On average post numbers rise between 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.
It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.
Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.
Round 1 interview dates and posts
|Region||NTN posts||LAT posts*||Interview date(s)|
20 March 2019
|East of England||0||n/a|
London and KSS
Kent, Surrey & Sussex
|North East †||3||n/a|
|North West †||
|West Midlands (lead) †||1||n/a|
|Yorkshire & Humber||0||n/a|
Please note, English regions do not recruit to LAT posts.
**Scotland post numbers
If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish deaneries is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.
Please note that whilst we endeavour to keep the Physician ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.
† Regions taking part in flexible portfolio training
Trainees will be able to preference posts with or without the 'flexible portfolio training' option where available. For further information on the scheme, and the distribution of regions to each pathway, please visit https://www.rcplondon.ac.uk/projects/flexible-portfolio-training