Internal Medicine Training (IMT) in the UK

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Internal medicine training UK

If you haven’t heard already,  Core Medical Training (CMT) has been replaced by  Internal Medicine Training (IMT) starting from August, 2019.

CMT was the first part of specialty training in many medicine specialties. It was a 2 year program. Now, however, it has been replaced by IMT, which can be either 2 years or 3 years of internal medicine training, depending on which specialty you want to pursue.

Which specialties will require IMT?

The medical specialties have been divided into two groups. Group 1 specialties are the one which support the acute hospital care and Group 2 specialties are the one which provides primarily non-acute, out-patient based services.

Group 1 Medical Specialties

The following specialties will require 3 YEARS of IMT completion before you can apply for them:

  • Acute Internal Medicine
  • Cardiology
  • Clinical Pharmacology & Therapeutics
  • Endocrinology & Diabetes Mellitus
  • Gastroenterology
  • Genitourinary Medicine
  • Geriatric Medicine
  • Infectious Diseases (except when dual with Medical Microbiology or Virology)
  • Neurology
  • Palliative Medicine
  • Renal Medicine
  • Respiratory Medicine
  • Rheumatology

Group 2 Medical Specialties

The following specialties will require 2 YEARS of IMT completion before you can apply for them:

  • Allergy
  • Audiovestibular Medicine
  • Aviation & Space Medicine
  • Clinical Genetics
  • Clinical Neurophysiology
  • Dermatology
  • Haematology
  • Immunology
  • Infectious Diseases (when dual with Medical Microbiology or Virology)
  • Medical Oncology
  • Medical Ophthalmology
  • Nuclear Medicine
  • Paediatric Cardiology
  • Pharmaceutical Medicine
  • Rehabilitation Medicine
  • Sport and Exercise Medicine.

Clinical Oncology, Medical Microbiology, Medical Virology and Occupational Medicine will also recruit trainees who have completed the first two years of internal medicine training.

Person specifications for IMT


  • MBBS or equivalent medical qualification


  • Be eligible for full registration with, and hold a current licence to practice from, the GMC at the intended start date (usually August of the year applied)
  • Have evidence of achievement of foundation competences (now called Certificate of Readiness to Enter Specialty Training) , in the three and a half years preceding the advertised post start date for the round of application (usually August of the year) via:
    • Current employment in a UKFPO-affiliated foundation program, OR
    • 12 months medical experience after full GMC registration (or equivalent post licensing experience), and evidence to commence specialty training in the form of a Certificate of Readiness to Enter Specialty Training.

You can find the full specifications on the IMT website.

The 12 months experience required must not only be from the UK. Your medical experience back in your home country will also be counted. Certificate of Readiness to Enter Specialty Training was previously knows as alternate certificate of foundation competence. The form for 2020 can be found here.

When is the time to apply for IMT?

This question can be answered from two perspectives. 

  • Literally, when (as in dates) the application rounds open?
  • When in your career should you opt for IMT?

IMT application rounds

Round 1 timetable

If you have the eligibility to apply in round 1, the following timetable is for you:

Round 2 timetable

When in your career should you opt for IMT?

Specialty training is not a race. You should grow into this steadily. You should be able to participate in all aspects of your career advancement as you work in the NHS.

That being said, if you notice the selection criteria for IMT, it also contains the following:

  • Clinical skills
  • Academic skills
    • Research & audit
    • Teaching
    • Presentation
  • Personal skills
    • Communication skills
    • Management & leadership
    • Team involvement
    • Organisation & planning
    • Values
  • Probity
  • Commitment to specialty

You can’t possibly think to prove or support all of these without ever working in the UK, but that doesn’t mean you can’t apply directly without having worked in the UK.

So, the best time in your career to apply for IMT would be after working in the NHS as a non-training doctor for at least 6 months – 1 year. Keep in mind that this is not a hard and fast rule.

Do it when you have ticked off a lot of the selection criteria and you feel ready that you have the total understanding about how the healthcare in the NHS works. Don’t feel pressurized into directly joining a training post without prior NHS exposure just because you feel you are lagging behind.

The one book you need to study cover to cover in order to prepare for training interviews is the Medical Interviews: A comprehensive guide to CT, ST, and Registrar Interview Skills.

Further training after IMT

As mentioned already, IMT will be followed by another selection process to get into either Group 1 or Group 2 medical specialties. That training will start from ST3/4 level depending on the specialty.

medical training in the UK

To have a better understanding about the whole training pathway in all the specialties in the UK: Specialty (or GP) training (residency) in the UK.

Frequently Asked Questions

I have just my internship experience. Can I apply for IMT?

You need to have 2 years of experience (1 year of internship plus 1 year more) by the intended start date of the IMT post. Just completing internship and then applying for IMT will not be possible.

Does the 1 year post internship have to be in the UK?

No. You can have completed 1 year back home as well. You could even do 6 months back home and 6 months in the UK. It just needs to add up to 1 year by the start date of your IMT post.

Should I join IMT without NHS experience?

This is up to you. Some feel they can adjust to the UK healthcare system fairly quickly and that they will have no issues directly joining a training post, but if you don’t feel that you are comfortable doing that, you can work for some time in a non training post and then apply for training.

Is the training the same across all regions?

Yes. There is a standard of training that is maintained, no matter if you are training in Wales, Scotland, England, or Northern Ireland.

How will IMT differ from CMT?

IMT will be a 3 year program (versus 2 year for CMT), which will deliver the following improvements:
-Supported transition to medical registrar role
-More structured program with mandatory training in geriatric medicine, critical care, and outpatient
-Longer placements in IMY3 to provide more continuity in training
-Simulation based learning
-Additional time to gain MRCP, if needed

How will IMY3 differ from ST3?

The new program will better prepare trainees for the role of medical registrar. There will be a critical progression at the end of the second year (IMY2) to ensure trainees have the required capabilities and are entrusted to ‘step up’ to the medical registrar role in IMY3.

When do I need to decide if I want to apply for a Group 1 or 2 specialty?

Trainees will be appointed to a 3 year IMT and then training program directors will discuss the career options in front of you to help you decide and plan further. You can choose to leave the program after IMY2 whether or not you are successfully appointed to to a Group 2 specialty, or stay and complete IMY3.

Can I complete all 3 years of IMT and still apply for a Group 2 specialty?

Yes. You are still eligible to apply for Group 2 specialties and you can complete all 3 years as it would give you flexibility to apply for any specialty.

Is it very competitive?

It is not as competitive as certain core training, but you can get a better idea from the following:

imt competition ratio round 2

I want to apply only in (region). How competitive is it?

region fill rates imt 2019

I still have a lot of questions!

It’s totally understandable. Please head over to our forum to start a topic: Internal Medicine Training (IMT) or join the group Internal Medicine Training for IMGs!

We hope you’ve understood now how the IMT works and when best it would be for you to apply. If ever you have any questions or confusion you’d like to clear up, please don’t hesitate to ask any question you may have in the above forum!

Good Luck!

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