Internal Medical Training (IMT)

IMT is an exciting and challenging training programme which will certainly make you a better clinician but you will need perseverance, dedication and resilience to complete it. In this article, we discuss IMT and hope it will help you decide whether it is the correct programme for you.

Overview of IMT

IMT is a programme which pushes you to develop your clinical knowledge and skills and incorporates study time (days for revision for exams and taking exams, procedural skills days, and simulation skills days) into the training programme. It is tough and can be mentally challenging but if medicine is what you would like to do then it should be a worthwhile experience. By completing either 2 years of IMT (and then joining a group 2 speciality training programme) or 3 years of IMT (and then entering a group 1 speciality training programme) you will have the opportunity to apply for a number of different medical speciality training programmes.

Why do IMT

Whilst being a medical doctor is one of the most busiest and demanding jobs in the entire hospital, medicine remains a popular choice that allows you to see more and do more for your patients, providing the satisfaction of turning around acutely sick patients. If you like variety, are able to manage uncertainty and keep calm under extreme pressure, then an internal medical training (IMT) programme may be for you.

I chose to do internal medicine training as I enjoy intellectual challenges and I wanted to experience a variety of medical specialties. I am also passionate about taking a holistic patient-centred approach and this is core to general medicine.

An internal medicine training programme is an excellent training programme that equips you with the required skill set and broad knowledge base for a career in inpatient hospital medicine. The programme allows you to rotate and experience several medical specialities that you may not otherwise have. This is a great advantage if you enjoy medicine but are unsure as to what speciality you want to specialise in as you can take more time in training before setting foot into a speciality.  By the end of training (3 years), you will be known as the infamous ‘medical registrar’ who is charged with leading most medical emergencies. You’ll also be the dynamic action-orientated problem, solver. At this point, you can choose to single or dual specialise. Note – group 2 specialities allow you to leave for a single CCT after 2 years of IMT.

Images of timeline from JRCPTB:

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How to build your portfolio

As with other specialities, you’ll score well if you have publications, prizes, leadership roles, complete audit cycles/ quality improvement projects and if you have additional (postgraduate) degrees. If you are interested in IMT I would definitely recommend doing a medicine-orientated audit during your foundation years. I’d also focus on completing two cycles of one audit rather than doing separate audits. For maximal points – try to get this presented (oral presentation ideally) at a national conference. Publications are always looked upon favourably and a medical one is going to give you a big tick. If you can, try to get first or joint co-authorship – you’ll score highly. Doing taster days during your foundation years will give you something to talk about during your application/interview process and will allow you to explore the medical speciality you are interested in. Extracurricular activities that include leadership roles and teaching medical students will also give brownie points.  Although not necessary, and only if you want to, you could sit the MRCP 1 (and even MRCP2). If you’re about to apply and don’t have any of the above, don’t panic! As long as you demonstrate a genuine passion and are able to form links between your portfolio and internal medicine, you’ll be just fine. The IMT recruitment website is a great place to look to see how you should build your portfolio.

This is a very useful page which explains the scoring system for IMT application in detail: https://www.imtrecruitment.org.uk/recruitment-process/applying/application-scoring

The application process

You apply via Oriel as per other specialities however IMT holds an advantage in that there is no need to sit any exams. You are scored according to your portfolio but are also assessed on your commitment to internal medicine. Your application score is used to shortlist you for interviews. Once shortlisted, you’ll be invited to book an interview (from my understanding these run from January to March). The interview normally consists of 2-3 panel members who are generally consultant physicians. My interview was conducted online with 3-panel members (2 were consultant physicians who led the interview). I was asked questions about my portfolio, and reasons for applying to IMT and then had a clinical scenario presented to me. Interviews have a similar format and after the first clinical scenario candidates are asked to hand over the patient to a senior colleague and then face/discuss ethical scenarios. Communication skills and professionalism are assessed throughout the interview. You are scored individually by both panel members. I would highly advise that you practice for the interview with a senior colleague/consultant and run through possible scenarios prior to your interview. Your final score consists mostly of your interview score and parts of your application score. You are then able to rank jobs throughout the country.

More detail on the IMT interview can be found here: https://www.imtrecruitment.org.uk/recruitment-process/interview/interview-structure-and-content

Useful Resources 

The internal medicine recruitment website is very helpful in understanding what you will be scored on (https://www.imtrecruitment.org.uk)

I would use the Oxford cheese and onion book to prepare for interviews.

Written by Dr Samra Yasin

IMT1 Doctor

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