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Training and development (AIM)

The approved postgraduate training programme for AIM is available from the GMC.

The full training programmes for AIM lasts a minimum of six years for single CCT and seven years for dual CCT. Selection takes place before entry to ST1 (after the foundation programme) and again before entry to specialty training ST3 in AIM. A significant proportion of the trainees in AIM are training less than full time.

You will need to complete core training after your two-year foundation programme. Core training has a choice of two pathways:

• core medical training (CMT), which is a two-year programme
• the acute care common stem in acute medicine (ACCS), which is a three-year programme

The consensus among acute specialists is that both pathways are equally valid but that those doing ACCS usually gain more critical care exposure early in training.

Entry at ST3 level requires full membership of the Royal College of Physicians (MRCP).

At ST3, many trainees will choose to dual CCT with General Internal Medicine which increases the training time by approximately one year. Trainees should seek advice from their Training Programme Director about whether they should seek a single or dual CCT.

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 new curriculum.

The JRCPTB has detailed information on Acute Internal Medicine.

Detailed entry requirements and all essential and desirable criteria are listed in the person specification 2017 for acute internal medicine (ACCS) CT1 or ST3.  

All 2017 person specifications can be found on the NHS specialty training website. Please note that these documents are updated every year in the autumn before the recruitment round opens.

This information is correct at the time of writing. Full and accurate details of training pathways are available from medical royal colleges or the GMC.

Getting in tips

It is important to develop your practical skills and interest in acute internal medicine as early as you can. This will also give you valuable experience to add to your CV.

Whether you're a medical student, foundation trainee or doing your core specialty training, there's information below to help you. 

• Medical students

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  • join your university medical society
  • attend conferences for medical students – this will give you an opportunity to network and meet your future colleagues
  • get involved with the GMC (General Medical Council). Medical students can participate in visits to medical schools as part of the GMC’s quality assurance process
  • consider joining the specialist society for your chosen specialty as a student member, eg the Society for Acute Medicine
  • consider becoming a student member of the BMA, the trade union and professional association for doctors. The BMA also provides careers advice
  • make your specialty decisions in good time so that you can test it out before committing yourself, eg by using hospital visits and clinical placements arranged as part of your course to ask questions and observe people at work
  • choose the topic of your supervised research project carefully to test out your thinking

• Foundation trainees

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  • remember your first priority is to demonstrate that you have developed the personal, learning, clinical, practical and management skills needed by all doctors
  • think laterally when applying for rotations – vacancies may not be available in AIM so apply for a rotation in a related field
  • talk to your clinical and educational supervisors about particular areas of interest to explore
  • use full placements to experience specialties that you might be interested in or apply for taster experiences if you can’t get a placement
  • talk with your peers about their career ideas and experiences – you may be able to help each other
  • listen to information and advice from more experienced doctors but make your own decisions
  • taking part in a clinical audit is important for your development as a doctor but you may be able to choose an audit project related to a specialty that interests you
  • ensure your Foundation e-portfolio has plenty of medical evidence and that this is kept properly up-to-date
  • try to gain teaching and management experience
  • look at competition ratios (ie the number of applicants to places) critically. Find out what is happening this year and spot any regional differences in competition ratios
  • view the careers resources on the foundation programme website
  • write case reports and make presentations with an acute medicine focus

• Core and specialty trainees

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  • ensure a good grounding in general internal medicine
  • join the Society for Acute Medicine and get help with navigating your way through specialty training
  • speak to consultants about what the role is like
  • read as much information as you can on the websites of relevant professional bodies
  • question your own perceptions and possible negative stereotypes of the specialty
  • impress interviewers by showing that your interest in the specialty is intrinsically motivated - that you are drawn to the work and not just attracted to it because you admire someone you have shadowed 
  • be prepared to move to where the vacancies are
  • continue to develop your practical and academic expertise
  • undertake a research project
  • try to get some of your work published and present at national and international meetings
  • join or start a journal club to critically evaluate academic research
  • teach junior colleagues
  • take on any management opportunities you are offered