New internal medicine curriculum

Book and Laptop

The UK Shape of Training steering group was formed to work collaboratively with stakeholders to understand and interpret the recommendations outlined in the Shape of Training report and develop a strategy for implementation.

In response to the report's recommendations, the Joint Royal Colleges of Physicians Training Board (JRCPTB) has developed the first stage of a new internal medicine curriculum to support a model of training which will comprise first three years post-foundation training via a single certificate of completion of training, (CCT) or dual CCT route.

This will replace the current core medical training (CMT) programme and has received approval from the General Medical Council (GMC) for implementation in August 2019.

Find out more about the new curriculum using the jump links below.

Implementation

The JRCPTB has put in place a full implementation plan to support the move from core medical training to the proposed new curriculum and supporting training models. This plan involves a phased approach which will minimise the disruption to service.

Phase 1

2018
Implementation planning
 
JRCPTB will attend regional implementation planning meetings/events and provide resources to support heads of schools (HoS) (for example, slide set and FAQs)
 
2018/2019
Training for supervisors and trainees
JRCPTB will develop training materials and train a core faculty to cascade training to key roles and trainees
2019/2020

First year of IM1 

(replacing CT1)

No further CMT recruitment

Existing CT2 enter last year of CMT training

Evaluation of first year of IM stage 1
2020/2021

First year of IM2 (replacing CT2) 
IM1 progress to IM2

Phase 2

2021/2022

First year of IM3 and new curricula for group 2 specialties

Training the trainers
No further recruitment into ST3 in group 1 specialties. 
IM2 progress to IM3 or exit to enter group 2 specialties at ST3

2022/2023

First year of IM stage 2 training and new curricula for group 1 specialties

Training the trainers
Trainees exiting IM3 enter ST4 group 1 specialty plus IM stage 2 training

Phase 3

2023/2024 onwards
Assimilation of trainees on previous curricula 

Trainees to transition to new curricula in accordance with transition plan agreed with GMC

Monitoring and evaluation

Considerations for employers

The heads of schools of medicine will be responsible for implementing training programmes to deliver the new curriculum and will be holding a series of regional and national interactive workshop sessions will take place in 2018.

The JRCPTB will be encouraging heads of schools to ensure that employers are represented at these sessions. Therefore, this is an opportunity for employers to provide input into the design of clinical placements to ensure that they are deliverable at on operational level, and within the limits of your existing educational infrastructure and service demands.

Clinical placements

Flexibility will allow programmes to continue with four month placements in IM1 and IM2 but the move towards longer placements, for example six months, may allow for better rota planning and development opportunities, as well as helping doctors to integrate in to teams better and provide more cohesion. 

Employers need to provide input in the design of new clinical placements to ensure that they are deliverable at on operational level and within the limits of your existing educational infrastructure and service demands.

Employers may need to consider how these new arrangements will impact on the generic work schedules of existing CT1 and 2 doctors transitioning onto the new curriculum.

Training the trainer

The curriculum has 14 competencies in practice (CiPs) which outline the key generic and professional capabilities, expected of a fully trained physician. These are more reflective of employer and patient’s needs and will ensure a continuous progression in capability and reduction in the level of supervision required to enable the trainee to undertake increasing responsibility for the acute medical take. 

As such, trainees will be assessed on the attainment of generic and specialty specific capabilities as opposed to the amount of time they have spent in a programme.

The JRCTPB will oversee the development of training packages for the different training roles, the training of core faculty and cascade training to clinical and educational supervisors who will be supervising IM stage 1 trainees and assessing them against the new CiPs.

Training arrangements

The curriculum has been updated to reflect broader specialty training, including more generic and transferable capabilities.

Trainees in IM1 will require exposure to acute care (via unselected take) but with a concentration upon continuing in-patient care with responsibilities in general medical and geriatric medical wards.

Trainees in IM2 will need to continue to gain exposure to acute care (via unselected take) but with greater training opportunities in Ambulatory Care and medical out-patient management.

Trainees in IM3 will require greater involvement in the acute unselected take and training opportunities in medical high dependency units (mHDU) and medical admission units (AMU). They will be expected to lead the unselected take and provide support for IM1 & IM2 trainees as well as other staff involved in the take (for example, foundation trainees, GP trainees, ACCS trainees and others).

Employers will need to consider how current training arrangements can be coordinated to meet the requirements of the new IM stage 1 curriculum.

Read the report in full, or contact programme manager Khalida Wilson for further information.

 

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