One of the main attractions of renal medicine (often referred to as 'nephrology') is the spectrum of renal disease and fascinating disease processes.
The speciality requires close interactions with all other medical specialities and joint patient management.
There are plenty of research opportunities, from disease processes to drug development, dialysis technology to transplant immunology.
Renal medicine - trainee characteristics
Training in renal medicine will appeal to candidates who are:
- self-directed
- inquisitive
- need variety
- able to work with a measure of independence.
Working/training in an ST3 renal medicine post
Renal medicine provides good medical training and opportunity for a wide range of research and practical procedures.
Breadth of practice
It is a tremendously varied specialty, covering areas such as vasculitis, immunology, cardiovascular disease, diabetes, acute kidney injury, fibrotic conditions; or the rare and interesting tubular or hereditary disease; as well as the dialysis technology and transplantation.
Renal physicians are uniquely placed to synthesize the diverse problems of renal patients and often do genuinely provide healthcare from 'cradle to grave'.
Renal medicine has a strong professional association basis, committed to guideline development, comparative audit, research and training needs.
Dual training
In most cases training in general internal medicine (GIM) will be offered alongside renal medicine, leading to a dual CCT in renal medicine and GIM.
In some centres, it may be possible to undertake dual training in renal medicine and intensive care medicine. Additional guidance can be found on the Faculty of Intensive Care Medicine's website.
Increasing challenge
It is currently a challenging time in renal medicine. The advance in medical therapy has enabled us to treat more complex patients with renal failure.
Dialysis and transplantation are both high-cost therapies. Renal physicians have the pivotal role in leading and delivering high standard of care, ranging from prevention and education to maintenance, and finally end-of-life care.
Most renal service is based on a 'hub and spoke' model, which means a lot of consultants working together in one centre, providing services to other centres.
Some renal physicians (nephrologists) will have a part-time commitment because of demands from academia and/or the family.
A typical nephrologist will usually lead three/four clinics per week and supervise a dialysis unit, and some may have sessions for practical procedures.
Most consultants would also have a research, teaching, supervisory or organisational commitment.
Medical Care
Find out more about renal medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
Further information
General / application queries
For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Specialty Recruitment Office via email at [email protected].
Renal medicine is devolved into four clusters. Applications are assessed by the lead region to which they have been devolved, therefore please contact the lead region for any queries regarding this specialty.
| Renal medicine 2020 ST3 R1 - regional contact details by cluster | ||
|---|---|---|
| Clustered regions | Lead region | Contact details |
|
East of England London and KSS Wessex |
London and KSS | |
|
East Midlands North East North West West Midlands Yorkshire & the Humber |
North West | |
|
South West (Peninsula) South West (Severn) Thames Valley Wales |
South West (Severn) |
General enquiries - [email protected] Fitness to practise queries - confidential - [email protected] |
| Scotland | Scotland | http://www.scotmt.scot.nhs.uk/contact-us/hospital-specialty-recruitment-contacts.aspx |
Eligibility
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.
Cascadable application model
This specialty uses the cascadable application model. If you apply to this specialty you will be required to give (up to) four preferences of regions on your application form, ranked in order of preference.
Once your application is confirmed as eligible, in shortlisting you will be allocated to a region for interview based on the score awarded to your application and subsequent ranking, your regional preferences and the interview capacity available at each region.
Your application will be allocated to your first-choice preference region if possible; if the region has reached capacity with higher-scoring applicants, it will instead be cascaded to your second-choice; if that is also full, it will then be cascaded to your third-choice; and so on.
Most applicants are allocated to their first choice and normally either none or only a few cascaded to a lower preference. In a small number of cases, usually where an applicant only preferences one or two regions, an applicant will not be shortlisted. Information on the outcome of shortlisting from previous years is available in the document library.
Regional clusters
It is normal for regions to join together for recruitment purposes, forming amalgamated regional ‘clusters’. A candidate applying to any such cluster can consider posts available across all constituent regions within the cluster. Details of the regional clusters can be found on the 'Who do I Contact?' tab.
Clearing
As the main round draws to a close this specialty can implement a period of national clearing, should any vacancies remain. Further information can be found in the clearing section.
Round 2
If participating in round 2, this specialty will use the single centre recruitment model, whereby the specialty will nominate a particular region to act as lead for the round and host all interviews with applications made nationally; the lead region will be confirmed in the lead up to the start of the round.
Flexible portfolio training
This specialty will be participating in the ‘flexible portfolio training’ scheme. This protects one day a week (or 20% time equivalent across the year) for the trainee to engage in project work that will aid their professional development in one of four pathways; medical education, clinical informatics, quality improvement or research. 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.
Interview content
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.
Evidence checking
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.)
Scenario considerations
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.
This station will feature assessment of an ethical scenario, and discussion of a question on the subject of professionalism & governance.
Ethical scenario
As with the clinical scenario at station 2, this takes the form of a hypothetical situation, described briefly in text form, details of which will be given to you before arriving at the station.
This scenario focuses less on a clinical situation, and deals more with consideration of the moral, ethical, legal (etc.) issues which may arise in a particular situation.
The first area of assessment here will be your suggested reponses to the ethical scenario during discussion, as well as your knowledge of the different considerations required.
Professionalism & governance
Following the ethical scenario will be discussion of professionalism & governance.
This discussion will be prompted by a short question (often a single sentence) provided by interviewers. This will be given verbally by interviewers once ethical scenario discussion is finished.
This section of the interview is designed to assess your demonstration and understanding of professionalism and governance in a given situation.
Familiarise yourself with Good Medical Practice
Please note - assessment at station 3 is underpinned by the principles of GMC Good Medical Practice.
Establishing appointability
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 three 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 falls 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 or two 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 | |
| Station 1 | ||||
| Evidence | / 5 | / 5 | x1.6 | / 16 |
| Suitability for specialty | / 5 | / 5 | x1.2 | / 12 |
| Station 2 | ||||
| Clinical scenario | / 5 | / 5 | x1.6 | / 16 |
| Communication mark | / 5 | / 5 | x0.8 | / 8 |
| Station 3 | ||||
| Professionalism | / 5 | / 5 | x1.6 | / 16 |
| Ethical scenario | / 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.
Round 1
| Year | Apps. | NTN posts |
LAT posts |
Total posts |
Comp. | Unique* |
| 2019 | 139 | 61 | 3 | 64 | 2.2 | 51% |
| 2018 | 107 | 69 | 6 | 75 | 1.4 | 50% |
| 2017 | 105 | 67 | 4 | 71 | 1.5 | 48% |
| 2016 | 110 | 84 | 3 | 87 | 1.3 | 54% |
| 2015 | 102 | 65 | 25 | 90 | 1.1 | 43% |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
Round 2
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
| 2018 | 44 | 25 | 3 | 28 | 1.6 |
| 2017 | 29 | 27 | 2 | 29 | 1.0 |
| 2016 | 29 | 26 | 1 | 27 | 1.1 |
| 2015 | 31 | 32 | 10 | 42 | 0.7 |
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 & posts
| Region | NTN posts | LAT posts* | Interview date(s) |
|---|---|---|---|
| London and KSS (lead) |
(London) 0-13 |
N/A |
London |
|
(Kent, Surrey, Sussex) 0-2 |
N/A | ||
| East of England | 3-6 | N/A | |
| Wessex † | 1-3 | N/A | |
| East Midlands |
1 |
N/A |
Manchester |
| North East † | 1-3 | N/A | |
| North West (lead) |
(Mersey) 0-2 |
N/A | |
|
(North Western) 0-2 |
N/A | ||
| West Midlands | 0-2 | N/A | |
| Yorkshire & Humber | 5-7 | N/A | |
| South West (lead) | 2 | N/A |
Bristol 31 March 2020 |
| Thames Valley | 4 | N/A | |
| Wales | 2 | 0 | |
| Scotland** (lead) | 6 | 3 |
Glasgow 1 April 2020 |
*English LATs
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