Infectious diseases is a fascinating and rapidly changing specialty which offers the opportunity to see a wide range of patients, combine laboratory and clinical skills and spend time in research or working abroad in specialist centres. Particular challenges include the emergence of new diseases, and the increasing problems associated with antimicrobial resistance.
The training programme has recently been revised and all infection trainees will spend two years on a combined infection training (CIT) programme, with one year predominantly ID-based and one year spent attached to the microbiology laboratory and clinical consult rounds. This is followed by higher specialist training for a further three years in either ID/general medicine or ID/microbiology or ID/virology.
Infectious diseases involves in-patient work based in regional specialist ID Units, managing patients with a range of complex conditions including community acquired infections, returning travellers, TB, HIV, bone and joint infections and multi-drug resistant infections. Advice and consultation are provided for the management of nosocomial infections, antimicrobial stewardship and infections in immunocompromised patients.
Out-patient work includes travel-related conditions, tropical medicine and specialist clinics in HIV, TB, viral hepatitis and bone and joint infections. There is increasing use of out-patient antimicrobial therapy (OPAT) services.
The specialty will suit trainees who want to be challenged, who enjoy the interface between clinical and laboratory medicine and are keen on research. A large proportion of trainees go on to complete research projects leading to higher degrees and diplomas. Research and additional specialist experience is actively encouraged by the specialty advisory committee.
Medical microbiology is a varied and evolving specialty, involving all aspects of infection. It was formerly a very laboratory-based role, overseeing the diagnostic work, interpreting results and providing telephone advice to clinicians.
Increasingly it is more clinical and diverse, providing a rewarding mix of lab work, ward consults about cases of complex or serious infection, advising on how to control the spread of infection in hospitals and the community, infection-focused ward rounds and multidisciplinary meetings with many other specialties (including intensive care, haemato-oncology, orthopaedics), and the chance to take a lead role in developing new infection services such as OPAT (outpatient parenteral antibiotic treatment).
There is obvious overlap with infectious diseases, and it is possible to do dual training in both specialties; some centres have merged their microbiology and infectious diseases departments into combined departments of infection.
Clinical virology is an exciting specialty which is rarely out of the news and will appeal to those wishing to get involved in the interface between clinical work and research and development alongside an expanding clinical role.
The training programme provides an opportunity to be involved in a stimulating mix of clinical work, laboratory liaison, research, development and teaching. Clinical virologists concentrate on the diagnosis and management of patients with viral infections. Rapid diagnosis using molecular based tests, monitoring resistance to antiviral drugs, managing outbreaks of respiratory, gastrointestinal and other infections and learning the principles of laboratory diagnostic methods in a specialty that has always embraced new technologies are major parts of the job.
In addition, there is an opportunity to be involved in the management of patients with chronic viral infections such as HIV and hepatitis B and C, respiratory virus infections, congenital and perinatal infection and latent viral infections in immunocompromised patients, particularly transplant recipients.
In recent years, newly emerging virus infections have added to the breadth of interest and the skills required of the specialist virologist. Virology is important in the context of public health through input into surveillance and immunisation programmes. Laboratory and clinical research have traditionally been strong in this specialty; trainees wishing to obtain a higher degree will be actively encouraged.
For further information:
The Royal College of Pathologists, 21 Prescot St, 4th Floor, London E1 8BB
Phone: 020 7451 6700 Web: http://www.rcpath.org
UK Clinical Virology Network: http://www.clinicalvirology.org
There are a small number of training posts in tropical medicine. The training programme and curriculum is identical to that for infectious diseases. Trainees will need to train at a recognised centre for tropical medicine (London, Liverpool or Birmingham) and will complete the course for the diploma in tropical medicine.
In addition one year must be spent training abroad at a recognised centre. Most tropical medicine specialists will end up in academic positions, working abroad or overseeing collaborations between UK and tropical centres. Research is actively encouraged.
Joint specialty training
It's possible for two CCTs to be obtained as well as one CCT in an individual infection specialty. Joint programmes are available across the combinations listed in the diagram below and will require one additional year of training, but may not be available in all areas.
At the time of application candidates can be in competition for all available posts across all four infection specialties. They will be able to preference their preferred CCT single specialty or joint specialties during the recruitment process.
Combined infection training (CIT)
The first two years, ST3 and ST4, have a common combined infection training programme in all four specialties. After the two Combined Infection Training years the four specialties have their own separate two year higher specialty training programmes leading to a CCT in that particular specialty.
All four specialty training programmes include both clinical management of patients with infections and laboratory diagnostic experience. Most trainees undertake research leading to an MD or PhD degree at some point in training.
Infection training - trainee characteristics
Infection specialties will particularly suit trainees who enjoy:
a great variety of clinical presentations
the challenge of making the correct diagnosis
Working/training in an ST3 infection specialty training post
Training in the infection specialties is particularly interesting and unlike many medical specialties infection specialties are not confined to a single organ or system. Infections can present in many different ways, in patients of all ages and backgrounds. Combined infection training offers a broad training in the diversity of infection diagnosis and management in a range of clinical settings, both outside and inside the infectious diseases unit, and includes time learning laboratory skills and antimicrobial and infection control management.
Making the correct diagnosis often involves considerable detective skill in history-taking, physical examination and interpretation of laboratory data.
Treating serious infections in acutely ill patients is very satisfying, because the vast majority of patients make an excellent recovery, and this is increasingly true for many patients with chronic infections.
Before entering ST3, core experience in a broad range of specialties is desirable; prior experience of any of the infection specialties is useful but not essential.
Many infection specialty consultants work in teaching hospitals with access to specialised investigations and many pursue research interests.
The increasing number of infection related consultant posts is evidence of the wider recognition of the distinctive clinical value of the various infection disciplines.
Given the growing numbers of patients with HIV and tuberculosis, the widespread use of immuno-suppressive treatments, increasing transplantation numbers, breakthroughs in hepatitis management, and the importance of healthcare-associated infections and management of antimicrobial prescribing, there has never been a better time to become an infection specialist. Changes in laboratory practice have meant that medical virologists and microbiologists not only have access to increasingly sophisticated diagnostics but also have clinical roles alongside infectious diseases and tropical medicine colleagues.
Find out more about combined infection training and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
- NHS health careers - infectious diseases
- NHS health careers - medical microbiology and virology
- NHS health careers - tropical medicine
- JRCPTB specialty page and curriculum - ID and TM
- RCPath specialty page - MM
- RCPath specialty page - MV
- RCP(London), Specialty spotlight - infectious diseases
- ST3 CIT 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 combined infection training in 2019 is London and South East (LaSE) Recruitment:
|London and KSS Recruitment|
|ST3/general queries||General enquiries - https://lasepgmdesupport.hee.nhs.uk/support/tickets/new?form_1=true|
|Fitness to practise/Disability/GIS queries - confidential||https://lasepgmdesupport.hee.nhs.uk/support/home#4|
For general queries relating 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].
This specialty uses the standard ST3 eligibility criteria, and does not accept candidates from any alternative training routes.
Please visit the am I eligible? section of this website for further information.
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 North West region. 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 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.
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 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 this station 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 quality improvement.
Upon arrival at station 3, you will need to give a presentation on the following topic, for no more than three minutes:
'An interesting recent development / research finding, relevant to infection specialties (including infectious diseases, medical microbiology, medical virology or tropical medicine)'
When preparing your presentation, please bear in mind the points below:
Clarity & relevance most important - Select a topic that is relevant to infection specialties, and which you can present with clarity. This is more important than trying to impress by choosing a subject that is esoteric or complex. It should be relevant to your application where possible.
No aids/resources provided - 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.
Three minute time limit - Your presentation must last for no more than three minutes. Please note that you will be stopped after three 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 also be taken into consideration.
Once your presentation is finished (interviewers will stop you at the three minute-mark), interviewers will discuss it with you and ask further questions relating to the items you raise and any further points.
This discussion will take place for approximately another three minutes.
Quality improvement discussion
Once your presentation and the subsequent discussion is finished, you will then move onto a general discussion on the subject of quality improvement.
No specific preparation will be required of you here, however we would advise undertaking some general preparation. For example, you may wish to review what quality improvement is and how this can be applied to healthcare to improve outcomes. As quality improvement is a mandatory part of core medical training, you may wish to review work you have previously undertaken.
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 quality improvement.
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|
|Quality improvement||/ 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.|
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.
Training in an infection specialty is particularly interesting and varied because it combines both the clinical and laboratory skills of making diagnoses with the satisfaction of effective treatment for a wide range of common serious infections in both acutely and chronically ill patients.
There are four separate infection specialties: infectious diseases (ID), medical microbiology (MM), medical virology (MV) and tropical medicine (TM). To find out more about each of the specialties click on the pop-out boxes below.
Round 1 Interview dates & post numbers
CIT parent specialties: Where information is known about the specialty(ies) in which an NTN post will eventually specialise - general internal medicine ( GIM ), infectious diseases ( ID ), medical microbiology ( MM ), medical virology ( MV ), tropical medicine ( TM ), this will be indicated.
|Region||NTN posts||LAT posts*||Interview date(s)|
|East Midlands||1 (MM)||n/a||
|East of England||4 (ID/MM=1; ID+MM=1; MM=2)||n/a|
London and KSS
3 (ID/MM=1; ID/MV=1; ID/GIM=1)
5 (MM=1; ID/MM=1; ID/MV=1; ID/GIM=2)
|North West †||
2 (ID/GIM=1; ID/MM=1)
5 (ID/GIM=1; ID/MM=3; ID=1)
|Yorkshire & Humber||
10 (MM=1; MM/ID=7; ID/GIM=2)
|Scotland**||18 (MM=1; MM/ID=12; ID/GIM=2; MV/ID=3)||0|
4 (MM=3; ID/MM=1)
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