Acute Internal Medicine
Acute Internal Medicine involves the assessment and management of patients with acute conditions that may be life-threatening. Acute Medicine differs from Emergency Medicine in that it focuses on medical problems, with specialists therefore having more responsibility for ongoing care.
The Royal Society of Medicine offers a range of events for different acute specialties, including Acute Internal Medicine – see a full list on our Events page>>
Entry Route into Acute Internal Medicine
Applicants need to have completed the two-year Foundation Programme before they are eligible to apply for the core training programme at ST1 level. There is a choice of two pathways for core training:
Trainees should have gained their full membership of the Royal College of Physicians (MRCP) before applying for entry to ST3.
Job Progression as an AIM Specialist
The training programme for Acute Medicine takes a minimum of six years to earn a single CCT. At ST3, trainees can dual the CCT with General Internal Medicine. Consequently, this will increase the length of the training programme to seven years.
Trainees can apply for consultant positions six months before obtaining their CCT, and there are opportunities to work in management as a clinical lead, or a clinical or medical director. There are also formal opportunities to become involved in the education and training of junior doctors by working as
- a director of medical education overseeing postgraduate medical training,
- a training programme director responsible for the education of trainee doctors in the local region, or
- an associate dean responsible for managing the training programme.
Academic AIM Roles
Trainees interested in an academic career can apply for an academic clinical fellowship. Alternatively, trainees can continue the ST clinical training programme after ST4 level.
Competition for Acute Internal Medicine Posts
In 2017, the competition ratio at ST3 was 1.9 in the first round, with 238 applications for 125 NTN posts, with 24% of applicants applying for AIM only. In the second round, the competition ratio was 1.4, with 95 applications for 68 NTN posts.
In December 2017, there were
- 336 consultants,
- 8 associate specialists,
- 55 speciality doctors,
- 3 staff grades,
- 371 speciality registrars,
- 299 core trainees,
- 159 F2 trainees, and
- 226 F1 trainees.
Salaries in Acute Internal Medicine
The salary for NHS consultants ranges from £76,000 to £102, 500, and for speciality doctors from £37,500 to £70,000. The salary for doctors in training ranges from £26,350 to £45,750.
A Day in the Life of an Acute Medicine Specialist
Most AIM specialists work in acute medical units, but may also see patients in emergency departments and inpatient wards. Some AMUs have an ambulatory care facilities or rapid access outpatient clinics. GPs at these facilities may therefore see patients in ambulatory care.
Daily work includes reviewing new admissions, and liaising with other specialists to decide whether patients need to be admitted or discharged. The work is fast-paced and intense. Consequently, there are many opportunities to perform a variety of practical procedures – such as central venous catheter insertion, echocardiography, and insertion of pleural drains. AMUs are open 24 hours a day for 365 days a year, and as a result AIM doctors and most consultants are often on-call, including weekend work.