Acute internal medicine

Doctors in acute internal medicine (AIM) assess, investigate, diagnose and manage the care of patients with conditions that have developed quickly, exhibit severe symptoms and may be life-threatening.

This page provides useful information on the nature of the work, the common procedures/interventions, associated specialties and other roles that may interest you.

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Watch the above video where Dr Hannah Skene MBChB, FRCP(Edin), MMedSci, SFHEA talks about her career as a consultant in AIM.

Nature of the work

Much of the work involves the immediate care of patients around the time of their admission to hospital and the initial diagnosis and treatment for up to 72 hours of all acutely presenting medical ailments. It also includes the provision of ambulatory (outpatient) care.

The spectrum of clinical problems is wide, so trainees become experts in acute aspects of all medical specialties, and gain excellent practical procedure skills. AIM trainees and consultants interact daily with colleagues from the emergency department, critical care and many other medical specialities.

An acute medical unit (AMU) is often busy and bustling and hosts a mixture of clinical pathologies and patients of all ages – it is often described as the acute care hub of the hospital.

      There's a wide range of clinical work within the specialty. Trainees will develop expertise and skills in:

Acute internal medicine was formally recognised as a specialty in 2009, having previously been a subspecialty of general internal medicine.

“Acute physicians need to have excellent clinical acumen, with a solid grounding in all medical specialties”. Consultant acute physician, Chelsea and Westminster Hospital.

Read Hannah’s story

Common procedures/interventions

These procedures are often needed within the first 24 hours of hospital admission. Trainees also have an opportunity to gain experience in ultrasound during their respiratory and cardiology rotation.

Associated specialties

The development of specialist skills is a mandatory part of training in the specialty. Some trainees will choose to learn a practical procedure such as echocardiography, while others will gain qualifications in management, leadership or education, and some will become involved in medical research.  The requirement to develop an additional skill or qualification is a key element of the curriculum.

AIM is distinct from emergency medicine (A&E), although specialist acute physicians should work in close collaboration with specialists in emergency medicine. There is also a close relationship with critical care, and some trainees in this field will choose AIM as their ‘base’ specialty, before acquiring dual qualification by CCT or certification with critical care medicine.

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