The Ultimate Guide to Internal Medicine Training (IMT) 2027

Have you ever sat in a medical handover, exhausted following 12 hours of extinguishing fires across the hospital, and listened to the conversation between medical trainees thinking “I have no idea what is happening”?

You’re not alone.

Internal Medicine Training (IMT) is the 3-year UK programme that aims to turn you from that dumbstruck foundation trainee into the legendary medical registrar – a hardened veteran of the acute take, master of the dumping grounds, wizard of the wards.

The “Internal Medicine Trainee” badge on your lanyard may still draw raised eyebrows from colleagues who had only just gotten their head around Core Medical Training (CMT), but with a transition to IMT in 2019, there’s still confusion over what an IMY1-3 is.

In this ultimate guide to internal medical training, we will walk you through what the training programme is, the curriculum and what life as an IMT is like.

Updated October 2026 against the JRCPTB IMT ARCP decision aid (August 2026 update) and the 2027 recruitment pages. For the 2027 application changes - the 5-point IMT-only bonus removed, presentations max 8, publications max 6, and the Medical Training (Prioritisation) Act applying at shortlisting and offers - see our IMT application scoring guide.

IMT in a Nutshell

IMT is a 3-year core training program for UK junior doctors, preparing trainees for life as a medical registrar and beyond. Internal medicine UK training comes after the completion of foundation training and leads to higher medical speciality training (ST4+).

You may have heard rumours about life as a core medical trainee. Claims of endless service provision. Frustrations about the day-to-day Groundhog Day of an SHO. Difficulties finding an opportunity to learn.

While unprecedented demand on NHS services means that the 2019 overhaul of medical training doesn’t fix all these problems, the new program aims to address some areas of frustration.

IMT replaced Core Medical Training (CMT) in 2019 and is designed to give medical trainees the opportunity to dual CCT with Internal Medicine – meaning a group 1 speciality consultant can partake in the acute medical take.

The new programme also brought about changes to reduce the “tick-box” portfolio burden, provide support in the transition to becoming a medical registrar, and increase exposure to outpatients, intensive care, and geriatrics.

Internal Medicine UK Training lasts between 2 and 3 years, depending on which speciality you choose to enter. You don’t have to choose how long you will stay in the program when you start – it’s a decision you can make in your second year (IMY2).

Medical trainees who apply to train in group 1 specialities, which dual CCT with the speciality and general internal medicine, must complete all 3 years. Those who wish to apply to group 2 specialities may leave after 2 years and will go on to attain a single CCT in their chosen specialities.

Internal Medicine Training is a hospital-based medical training program. At least 2 years of the 3-year program must be ward-based, though the new programme also requires outpatient clinic experience throughout all three years.

IMT medical rotations are made up of hospital-based inpatient specialities, outpatient-based medical specialities, and intensive care. Geriatrics is a mandatory placement, and most out-of-hours work will be focused on the acute medical take (though the dreaded ward cover will also rear its ugly head depending on your trust).

By the end of IMY2, trainees will be expected to take on the role of the medical registrar, albeit with more supervision than ST4+ equivalent registrars. In their IMY3 year, they will be expected to take leadership roles in ward work, the acute take, and resuscitation teams.

During training, you will be taught to perform procedures including chest drain, central lines, and lumbar puncture. Regular teaching will be delivered by the training deanery, including mandatory simulation sessions.

Trainees are expected to pass MRCP(UK) Part 1 by the end of IMY1 and the full diploma by the end of IMY2 to obtain a standard ARCP outcome - the JRCPTB decision aid states "Failure to pass Part 1 at end of IMY1 or full MRCP by the end of IMY2 will affect ARCP outcome." Compared to CMT, this provides some leniency to those who haven’t passed the MRCP by year 2.

You will be allowed to continue their progression without passing MRCP by year 3 (with potential changes to their training and timeline of completion dictated by their deanery), whereas CMTs of old ended up missing out on a ST3 posts due to missing MRCP passing deadlines.

After completion of 3 years of training (2 years for group 2 specialities), trainees are expected to apply for higher speciality training.

Application for IMT is done online via the Oriel application system, with applicants scored on categories including publications, teaching experience, and quality improvement projects. Your application score will determine whether you are invited to interview. IMT medical interviews are de-centralised, with your interview score turned into a ranking that determines whether you receive your preferred placement.

Trainees can apply for less than full-time training (LTFT) for circumstances that satisfy category one, category two, or category three conditions. You will not need to apply to specific LTFT posts and can make the decision to apply for LTFT during your training. LTFT trainees may apply to work at between 50% and 80% of full-time equivalent, including out-of-hours work.

Category three LTFT, which allows LTFT training for any personal reason, was piloted from 2017/18 and rolled out to all postgraduate specialties from August 2022. Any resident doctor can apply for LTFT, though approval "will be dependent upon exigencies of the service" and must be agreed with the training deanery.

Should I Do IMT?

If you love the buzz of managing acutely unwell patients and the idea of becoming a medical detective, then internal medicine training might be right for you. If you don’t love any of those things… it might also be for you.

Ultimately IMT can be a 3-year love affair or just a means to an end – it depends on what you want to get out of it on the other side.

Thus, the main reason for applying is so you can apply for your higher medical speciality of choice on completion of the programme. Even if you’re not pumped to spend 2-3 more years on the wards, you might just need to put your head down and get to the other side in the best position you can.

On the other hand, core medical training can also be an amazing opportunity to equip yourself with the skills to deal with whatever comes through your door. The journey from a lowly foundation doctor can be challenging, but the reward of becoming the go-to medical advice hotline brings some satisfaction.

With the ageing population, an overstretched health system, and a trend toward super-specialised consultants, core medical training aims to equip consultants with the skills to deal with a broad range of medical conditions and provide more holistic patient care.

You may relish the challenge if you enjoy:

• Clinical problem solving
• Team-based hospital environments
• Hands-on ward-based procedural skills
• Attention to detail when examining and investigating patients
• Managing both chronic conditions and acutely unwell patients
• Leading teams day-to-day and during emergencies
• Working closely with most other specialities

Another important factor to consider when deciding whether to pursue medical training is work-life balance. Whether you’re planning to continue working as a medical registrar or to apply to a group 2 speciality, weekends and nights will feature in your rota.

Major changes from CMT to IMT

Core Medical Training (CMT) was the post-foundation training programme for medics prior to 2019, leading on to ST3 higher medical speciality applications. It’s no secret that Core Medical Training had a reputation problem. Core medical trainees were often disillusioned with the tick-box nature of CMT, and a sizeable chunk of CMTs required extra time to complete their training or pass exams before becoming a medical registrar.

Another reason for the change from CMT was that, with increasing specialisation and sub-specialisation of medicine, deaneries were concerned that newly qualified consultants might not be able to provide holistic care to an ageing population with increasingly complex health needs.

In August 2019 UK core medical training was overhauled. Core Medical Training (CMT) became Internal Medicine Training (IMT) and was extended from 2 to 3 years duration. The extra year of training was used to give trainees (who don’t leave after the second year for group 2 specialities) a chance to work as a medical registrar with an increased level of supervision.

This change was also designed to increase the number of consultants with a general internal medicine CCT who could partake in the acute medical take.

With the new core training programme, medical training is designed to better prepare the trainee for life as a medical registrar and beyond – though it’s yet to be seen whether old grievances will continue despite changes to the programme.