Acute internal medicine

Doctors working in acute internal medicine assess, investigate, diagnose and manage patients with conditions that exhibit severe symptoms that develop quickly and may be life-threatening. 

You’ll care for patients as they first arrive at hospital, making an initial diagnosis and providing treatment for up to 72 hours. 

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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.

Life in acute internal medicine 

You’ll work as part of the acute medical unit, which is often very busy. You’ll treat patients of all ages with a wide range of clinical problems and interact with numerous colleagues including consultants, emergency department staff, critical care and other medical specialists. 

You’ll regularly perform: 

  • lumbar puncture 
  • paracentesis – puncture of the wall of a body cavity (for example chest or abdomen) to drain off excess fluid or to obtain diagnostic material 
  • pleural aspiration – insertion of a small needle into the space between the lungs and the chest wall to remove fluid that has accumulated around the lung 

Your exposure to a broad range of clinical problems will give you experience in all aspects of acute medical specialties and practical procedure skills. 

You’ll gain experience in: 

  • managing acute presentation of medical illness promptly 
  • managing medical patients in an in-patient setting 
  • developing new patient pathways to maximise safe, effective care in the community where feasible 
  • providing leadership skills within an acute medical unit 
  • developing multi-professional systems to promote optimal patient care 
  • the care of patients requiring more intensive levels of care than would be generally managed in a medical ward, usually gained from experience within a critical care unit 

How much can I earn? 

You’ll first earn a salary when you start your foundation training after medical school.  Find out details of current salary ranges for foundation and specialty training, SAS doctors and consultants on the 'Pay for doctors' page. 

How about the benefits? 

  • make a difference 
  • flexible and part-time working 
  • high income early in your career   
  • work anywhere in the world   
  • excellent pension scheme 
  • good holiday entitlement 
  • NHS discounts in shops and restaurants 

Must-have skills 

  • excellent communication skills to manage a wide range of relationships with colleagues, and patients and their families  
  • emotional resilience, a calm temperament and the ability to work well under pressure  
  • teamwork and the capacity to lead multidisciplinary teams  
  • problem-solving and diagnostic skills  
  • outstanding organisational ability and effective decision-making skills  
  • first-class time and resource management for the benefit of patients  

Entry requirements 

Your first step is medical school. Typically, you’ll need excellent GCSEs and three A or A* passes at A level including chemistry for a five-year undergraduate degree in medicine. Many medical schools also ask for biology and others may require maths or physics.   

If you already have a degree, you could study for a four-year postgraduate degree in medicine.  

You’ll need to pass an interview and admissions test. You’ll be asked to show how you demonstrate the NHS values such as compassion and respect.  

Some medical schools look to recruit a mix of students from different backgrounds and geographical areas, so your educational and economic background and family circumstances could be considered as part of your application. 

What are my chances of starting a career in acute internal medicine? 

There are approximately 504 doctors working in acute internal medicine in NHS, England. In 2020, there were 510 applications for 94 specialty training posts.  

How to become a doctor in acute internal medicine 

After medical school, you’ll join the paid two-year foundation programme where you’ll work in six placements in different settings.  

After your foundation programme, you can apply for paid specialty training to become a doctor in acute internal medicine, which will take a minimum of six years.  

You may be able to train part time, for example for health reasons or if you have family or caring responsibilities. 

Where a career as a doctor working in intensive care medicine can take you 

You’ll be required to development specialist skills as part of your acute internal medicine training. You can choose to specialise in a practical procedure such as echocardiography or gain qualifications in management, leadership or education.  

You’ll also have opportunities to be involved in medical research. 

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