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Applying to internal medicine

An overview of the process for applying to internal medicine.

Presently (2018 application round) the application process for internal medicine (IM) has two rounds, with the majority of applicants appointed via round 1. Application is via an online system (Oriel) and applications are longlisted (checked against eligibility criteria), shortlisted (scored via a self-assessment of the scoring section of the application) and it’s expected that all shortlisted applicants will be interviewed at one of a number of interview centres.

The interview process reviews the self-assessed score as well as looking at clinical and ethical scenarios with the interviewers. Around the time of the interview, applicants will be asked to rank all jobs that they are interested in. A final score is then calculated from the interview and application form to then match applicants to their ranked jobs. Round 2 follows a very similar pattern to round 1. Application to IM training is described on the CT1 recruitment website and any changes to the process will be found there.

Application processes may be more complicated for doctors from a non-EU background or for those that did not complete the UK Foundation Programme. For further information regarding these and similar issues, please see the CT1 recruitment website.


Do I need to apply straight from the Foundation Programme?

Although most applicants to IM training have gone through the UK Foundation Programme, this isn’t a requirement. Many trainees elect to take time out following the Foundation Programme for a number of reasons, and coming back to apply for IM training a year or two (or more) later is perfectly acceptable. Indeed, some trainees pursue alternative career paths before deciding to become a physician. For more information, please see the CT1 recruitment website.

Do I have to have MRCP(UK) to apply for Internal Medicine stage 1 training?

Some candidates choose to sit the written parts of MRCP (MRCP part 1 and part 2 written) and even PACES, prior to applying for Internal Medicine stage 1. However, MRCP or indeed any part of the examination is not required for entry into IM stage 1.

Any completed parts of the MRCP are likely to show suitability and commitment to specialty, which is assessed in station 1 of the interview, but having said that, there are many successful candidates who have not completed any parts of the MRCP qualification.

Do I have to have MRCP(UK) to apply for higher specialty (ST4+) physicianly training?

While most physicians have done MRCP(UK), some specialties (eg clinical genetics) also enable you to apply from other routes, such as from paediatrics. However, you will need to have completed your exams and spent some time in acute medicine. This varies with specialties, and not every specialty will enable this. You can read more about this on the ST3 recruitment website.

How can I improve my application score?

The most useful advice is to know the application scoring process and to look at it early! This can be viewed via the CT1 recruitment website. Some domains, such as undergraduate and postgraduate degrees or qualifications, are very difficult to modify – but others, like presentations, publications, teaching and leadership experience or QI work, can be improved with a little time and effort. Remember, you only get one score for each domain and so having moderate achievements in many domains is often better than fantastic achievements in just one domain.

What other routes are available to become a consultant physician?

Not everyone who becomes a consultant physician does so via the formal training routes. Everyone is different and also has different circumstances and priorities. Of ultimate importance is that you have the knowledge, skills and attributes to be a safe and effective consultant. There is the possibility to gain experience in a specialty via a non-training route, or via having part of your experience in training and then to demonstrate your competence via a Certificate of Eligibility for Specialist Registration (CESR) to the GMC. This process costs money, and is also somewhat dependent on the specialty.

For some specialties, it is very difficult to gain all the skills required to be a consultant outside of a training pathway. Furthermore, the CESR route often takes longer and there is less security than following a training pathway. However, for some, this route fits their circumstances. The best way of doing this is by getting an e-portfolio and mapping your experience to the curriculum of the specialty in question.