Internal Medicine Training (IMT) is the core level training for all the un-coupled medical specialties (e.g. cardiology, gastroenterology, nephrology etc.) in the UK. A trainee in this programme rotates through various specialities and achieves the competencies of becoming a medical registrar. In a way, IMT is the door to all higher specialisation in any particular medical specialty.

Core Medical Training (CMT) has been replaced by  Internal Medicine Training (IMT) starting from August, 2019.

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 should look at the full person specifications for Internal Medicine Training (IMT) here.

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.

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

For up-to-date timeline always check IMT recruitment website.

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

Providing proof of all these without ever working in the UK can be difficult, 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 pressurised 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

There is no “Internal Medicine Consultant” in the UK. The IMT training is making you competent to become a medical registrar and passing MRCP along with it is a part of the training. After that comes further specialisation in your chosen specialty.

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.

This video explains the overall training pathway for doctors in the UK

Frequently Asked Questions

How long is the entire medical training in the UK? How long will it take to become a medical consultant?

I will refer you to the info-graphic above. 3 years of IMT and 4 years of higher specialty training – so it takes a minimum of 7 years to become a specialist/consultant in any medical specialty. But you can add years to it, if you do an MD or PhD while you are in the training as out of programme.

How much an internal medicine trainee (IMT) earn?

IMT 1 an 2 gets paid as CT1/ST1 grade and IMT3 gets paid as ST3 grade. To know more numbers please check this video – A doctor’s pay in the UK. And yes, you get paid, you don’t have to pay for the training.

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

You need to have 1 year of fully registered 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 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.

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!

64 thoughts on “Internal Medicine Training (IMT) in the UK”

  1. Hey, thanks a ton for the information.
    How competitive is the internal medicine training for non EU residents?

  2. Hello Dear Ibreez and Ibrahim,
    I was wondering if you could help me with my query, I have accepted an offer for IMT but I have only received an email from ORIEL so far stating about the change in my application status. Is there a formal letter that I should expect? Also Should I be getting in touch with anyone else? I have to apply for a new COS as I am currently a trust grade doc and will be moving to a totally different region.
    Or anything else I could possibly be doing to prepare for the new job ?

    Many Thanks
    Kind Regards

    1. If your application status has changed to “Offer accepted” then everything is in order. I received an official email from the deanery with a subject “IMT Training Programme Offer Letter” with a letter attached which stated the dates, hospital and rotation details. And visa department of my deanery also contacted me to provide more info so that they could apply for my CoS.

      Congratulations, btw. Well done!

      1. Thank you for the response, it is a much-needed relief indeed. I am super grateful to both of you for the kind of dedication you put in to help the IMGs . I know how difficult and busy the medical rotations are but you still manage time, perhaps I could be of some help some day. Hats off to you for your mentoring and leadership skills.
        Forever indebted
        Many Thanks
        Kind Regards

  3. For my post internship experience, I’ve worked for 7 months in A&E in my home country and intend to finish another 5-6 months in the UK so that it adds up to a year. However, those 7 months weren’t a contuous stretch and I took breaks of 1-2 months twice. Will that still count?

    1. The breaks were part of your one employment? or you changed jobs and there was breaks in between?

    1. You can study as much as you want in your time or in your study leave. If you are asking whether there is chance or opportunity to study while working at the same time, yes, there is. You will have to make your own schedule.

  4. After FY2 training, before entering IMT, how can I ensure I stay in the same geographical location as it is not easy for my partner and my family to relocate

  5. Hi Ibreez and Ibrahim! Thanks for the well laid out information. It’s been very helpful. I had a question regarding imt group 1. I have ten months of clinical experience post internship after my national overseas registration. However,after the ten month period I enrolled towards an academic post grad degree(recently completed). Withstanding complete GMC registration(process ongoing) I am hoping to apply for IMT in the August 21′ cycle. My main queries here are: 1) if I complete 2 more months in my home country now, to fulfill the one year clause; would that be alright or is one year in straight continuity required? 2) If I were to have my crest form signed nationally by relevant supervisors as per form instructions; can I still join fy2 in August for a few months while I also apply for IMT in the August cycle(in the case my IMT app is rejected on the basis of having no uk experience; I can have an ongoing future safety net by being in a fy2 position starting August 21′. Is that potentially allowed?). Kindly feel free to add any further tips you think might be useful in my case.( I also have non registeration experience of 1.5 years-not including internship; however I doubt that would be helpful by technical grounds ).Thanks so much for the guidance. Kind Regards.

    1. Hello, we are glad that our website was helpful.
      1) Yes, a non-UK clinical work after being fully registered will also be counted towards that 12 months experience. Make sure to explain your experiences in the oriel application. And, continuous 12 months in not required.
      2) Applying for a non-training job while your training job is in the pipeline is not a problem. But remember you can’t apply for FY2 Standalone and IMT1 at the same time because if you are eligible to apply for IMT1, you are not eligible for FY2 standalone. But a non-training job can be applied.
      3) For August 2021 intake the application will be in this November 2020 so after you have applied for the training, keep applying for non-training jobs as well. But if an offer comes up do not say yes, until you know the outcome of your training application.

      1. Dear Ibrahim, Thank you for your reply. I was also wondering my post registeration experience is in surgery and I want to apply for imt? Is that an issue potentially? Does the clinical experience have to be in medicine and allied . Thanks so much

  6. Alisha Rafeek

    I would like to know, if I have completed one year of internship from India and then want to pursue IMT in UK, can I apply directly for an IMT post or should I be doing FY2 first and then move onto IMT?

    1. And mentioned in the article, you need a CREST from signed in order to apply for IMT. You may need to work in the UK to get that signed.
      If you have worked in India after your internship and done all the things mentioned in the CREST form (and have documentary evidence to prove that) and find a consultant willing to sign that off for you, only then you can directly think about starting in a training post. Provided you get selected via the application and interview process.
      Still we advise against it, as getting into a training in a big commitment. Stepping into that without having a first-hand experience in a new healthcare system is almost sure way of dissatisfaction.

  7. Papani Sruthika

    I wanted to know if we need to clear any exam to start IMT for imgs and if so what is the exam called?

  8. Pingback: Working in Intensive Care Unit (ICU) in the NHS | Road to UK

  9. Nissar Bankur

    Hi I am currently working as a JCF in haematology for the last 3 months. Just signing the CREST form will be enough to apply for imt or I should have an e-portfolios together with it ? Thank you for your help guys.

  10. Hello
    If someone couldn’t clear round 1 IMT then can he or she apply for round 2 IMT??
    Also when filling preferences, all the hospitals in the UK are there in preference list ??

    1. What do you mean by “Couldn’t clear”? Didn’t get in?
      Yes, the unsuccessful applicants in round 1 can apply in round 2.
      And yes, all the hospitals in the UK who have opening slots for IMT trainees will be there in your preferences in round 1. But in round 2 you will only have the slots that hadn’t filled in round 1.

      1. Couldn’t clear means did not get selected for IMT when results are posted on 9th March, in that scenario can a person apply in round 2?

        1. is there any specific limitation about how many times a candidate can apply for training if not selected?

  11. Mushfiquzzaman Dipto

    Who can sign my “Certificate of Readiness to Enter Specialty Training” form? Can my Bangladeshi supervisor sign it? If yes then what should be my supervisor’s qualification/degree? If no then what should be done?

    1. The following individuals can sign your competency form:
      GPs (in the UK)
      Clinical Directors
      Medical Superintendents
      Academic Professors
      Locum Consultants with CCT/CESR
      After the update of the CREST form in 2020 you can see that several sections, for example 4.5, 4.6 is more related to working in a developed healthcare system, like the NHS. Having said that, it is quite difficult to get the entire thing convincingly signed outside the UK.
      You need to work as a non-training doctor in the UK and gain those equivalent competencies and get that CREST signed from your UK Supervising Consultant.

  12. I am an IMG with more than 4 years experience working as a medical officer both in the Philippines and currently, in Maldives. I am applying for GMC registration through the PLAB route and was planning to join the WAST program in the northwestern territories. I just read about this IMT program, am I also eligible to apply for this program? If so, what are the steps that I should take, if for example I choose to take a non-training post for 1 year first to better adjust to the NHS system?

  13. Hello I m Dr Omar Farook from Bangladesh .I completed my MBBS in 2014 then completed my 1 year internship in 2015.Since then I have been working in an ICU in Dhaka for the last 3 years.By this time I have done Mrcp part 1 .Now I am interested for IMT training. Please let me know whether I will allowed or not .Is there any other requirements ?I am not GMC registered.Planning to take my IELTS next month.please let me know.I am extremely interested to do IMT training.

    1. Have you read the above post? It talks about eligibility and scopes of IMT training in detail already.

    1. Soon. Please understand we are also working in the NHS and the blog updates as and when we can. Making a new content in which I am not directly committed, involves a lot of data gathering and vetting process.
      Have you looked at what already is available: Training in Surgical Specialties

  14. Orzo Raj Shrestha

    As an IMG, will I be able to apply for IMT in round 1? And if yes, what is this immigration criteria?

    1. No you would not be eligible unless you already had a settled visa status (ie citizenship or spousal visa).

  15. So if understood correctly, the Certificate of Readiness to Enter Specialty Training is the foundation we need signed by FY2, right?

  16. Like if I want to enter cardiology, is it possible for me to apply for IMT in round 1? If not will it be available in Round2 ? What kind of preparation I need to do in order to success for my application before and after working in NHS?

    1. You can’t apply in round 1 if you do not fill the immigration criteria. Doesn’t matter what you want to do after IMT.
      As mentioned in the post, take part in all the selection criteria check-boxes and collect proof of those in your portfolio.

    1. Curriculum wise it will remain very similar. But IMY3 is added for extra time to train further and complete MRCP if needed.

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