Internal Medicine Training

 

The Internal Medicine (IM) Stage 1 curriculum was approved by the GMC on 8 December 2017 and will replace Core Medical Training (CMT) from August 2019. Internal Medicine Training (IMT) will form the first three years of post-foundation training and, for the main specialties supporting acute hospital care, an indicative 12 months of further Internal Medicine Training will be integrated flexibly with specialty training in a dual programme.

 

Further information will be added in due course.

 

Curriculum - Internal Medicine Training 

 

 

Mersey

 

Welcome to Internal Medicine Training

There are two Programme Directors for Internal Medicine Training (IMT) covering the Mersey, Cheshire and Isle of Man zone of HEENW. Our role is to ensure that the training you are given in all core medical specialties is of high quality and well-coordinated. Each year you will each be trained by a number of Consultant Physicians, skilled not only in their own fields but also in supporting education for medical trainees. You will also discover that you receive very valuable training from non-consultant grade doctors, senior trainees and senior nursing staff during your placements.

You may well have dealings with both Training Programme Directors during your time in IMT, but each hospital Trust will be covered primarily by one of us and this person should be your first point of contact if you need our input with anything.

In all your posts you will have both clinical supervisors and educational supervisors. The latter will meet with you regularly for appraisal and supervision of training, although we rely on you to instigate the meetings. We expect a high level of commitment from you in your role as adult learners taking, responsibility to ensure that you progress with your training at a satisfactory rate.

Apart from ourselves and those you will work closely with in your Trusts, there is a further supportive network of medical educationalists who can help you if necessary, including the College Tutors and Directors of Medical Education in each of your Trusts.

The Mersey IMT programme offers excellent training which will provide the breadth and depth of medical expertise you require before embarking on more specialised training, provided you use your opportunities wisely.

 

Good luck!

Training Programme Directors 

                                                                                            


Dr Nadine Carroll                                                                                              Dr Rob Egdell

Nadine.Carroll@rlbuht.nhs.uk                                                                            Robin.egdell@nhs.net

Royal Liverpool and Broadgreen NHS Trust                                                      East Cheshire NHS Trust

 

IMT Zonal Administrator - Mersey, Cheshire and Isle of Man 

Nicola Moffitt

nicola.moffitt@hee.nhs.uk

Regatta Place, Brunswick Business Park, Liverpool

Key Contacts

Postgraduate Dean - Professor Jane Mamelok

Head of School of Medicine - Dr John Anderton

Associate Head of School - Professor James Barrett

Associate Head of School - Professor Rosemary Morgan

IMT Education Lead - Dr Paul Walker

HR Lead - Jayne Ashton

College Tutors

Wirral - Dr Simon Whittingham-Jones

Clatterbridge Cancer Centre - Dr Joanne Cliffe

Royal Liverpool - Dr Dushyant Sharma

Liverpool Heart and Chest - Dr Archana Rao

Aintree - Dr Dan Komrower and Dr Gurinder Tack

Walton Centre - Dr Dinesh Damodoran

Countess of Chester - Professor Anand Prakash

Leighton - Vacant

Macclesfield - Dr Jo Gallagher and Dr Imran Ansari

Nobles - Dr John Thomas

Southport - Dr Beth Glackin

Warrington - Dr Amir Baluwala

Whiston - Dr Karen Short and Dr Katie Clarke 

Educational Supervisor


  • Educational supervisor is also usually your Clinical supervisor in first post of the year
  • Educational supervisor stays the same all year even if you move site
  • New clinical supervisor with each post i.e. second and third posts
  • You should have a sit-down meeting (Induction Appraisal) with your clinical supervisor in the first 2-3 weeks of the post.

Before the Meeting:

  • Sign educational, health and probity agreements
  • Fill in induction appraisal form (save not submit)
  • Fill in a PDP
  • Fill in ALS details in Certificates section
  • Take along your ALS certificate to the appraisal so dates can be verified
  • Arrange next meeting!


IMT Training Pathway

The specialties have been split into two groups which follow different training pathways:


IM1 - Three four-month posts mostly, including Geriatric Medicine

IM2 - Critical Care/Out patient and Ambulatory Care

Posts: 6 months/3 months 3 months (Critical Care)

IM3 - A supported Registrar year

Greater involvement in the Acute Unselected Take

Expected to “lead” the unselected take

MRCP (UK) before the end of IMT3 


Will only be placed in NW hospitals where there is support from a more senior medical registrar



The IMT Decision Aid can be found here


Procedural Skills Training Videos


Information regarding procedural training videos can be accessed here

The password can be gained by emailing the IMT Zonal Administrator


IMT Induction Booklet

IMT Induction Booklet - can be viewed here

 

Study Leave


All information regarding study leave should be accessed here

The study leave process must be followed even if youa re attending the course on your day off and require funding

A full-time trainee is eligible for 30 days.  Any trainee who trains at LTFT receives study leave days pro rata

You must apply for study leave to attend Regional Teaching half-days or the QI Showcase and it is vital to ensure that you are able to attend by asking your supervising Consultant for patient safety.  Study leave is discretionary

Five days are taken off the 30-day allowance for regional teaching

Always use this study leave form here

Trust HR Department


       Organise rotas
       Need to know if you are off sick as does your Consultant
       Sickness – if you miss more than 2 weeks work in one year you may need additional training time in IMT (although cases will be considered individually)
       Absences section in the e portfolio
       They collate leave requests although consent for leave dealt with departmentally
       Annual leave = 27 days per year.
       Plan ahead – minimum 6 weeks notice

Lead Employer - Health, Work and Wellbeing


       Health assessments and immunisation
       Counselling
       Psychiatric and psychological and health support
       Health education and promotion
       You can self-refer
       Website: https://sharedservices.sthk.nhs.uk/health-work-and-wellbeing/
       Email: Well.being@sthk.nhs.uk
       Telephone: 0151 290 4070

Raising Concerns


If you have any concerns regarding any aspect of your training you should raise them immediately


Locally first - Trust:

  • Educational Supervisor
  • Director of Medical Education
  • Medical Education Manager
  • Guardian of Safe Working
  • Guardian of Safe Speaking

School of Medicine:

  • Training Programme Director or IMT Zonal Administrator

Revalidation


All information regarding revalidation can be accessed here

  • The Postgraduate Dean is the Responsible Officer for all trainees, including those out of programme and on statutory leave
  • Trainee revalidation is via the ARCP process
  • Completed ARCPs – outcomes 2 or 3 usually lead to a positive recommendation for revalidation
  • Deferral of revalidation sometimes happens and is not detrimental
  • Every trainee must complete and submit a form R as part of the ARCP every year


IMT Teaching Programme

Morning sessions will run from 9.30am-12.30pm, with registration 9-9.30am. Unless stated, afternoon sessions will run from 2-5pm with registration 1.30-2pm.  The programme will be updated shortly.

 

Chester - Education Centre

Friday 20 September 2019

1.30 - 5pm

Topic TBC
Arrowe Park - Lecture Theatre, Education Centre

Friday 11 October 2019

9 - 12noon

Topic TBC

Crewe

Wednesday 23 October 2019

Registration 1.30.  Start 2 - 5pm

Topic TBC
Southport

Monday 25 November 2019

2 - 5pm

The Pregnant Patient
Aintree
Warrington
Aintree - Lecture Theatre, Clinical Science Building

Thursday 19 March 2020

1.30 - 5pm

Haematology
RLUH - Lecture Theatre, Education Centre

Tuesday 17 December 2019

9.00 - 1.00

Acute Medicine

Dr Vicky Price

QI  Showcase
Whiston
LHCH
WCNN

 

August

Post PACES Trainees will also benefit from the Broadgreen Acute/General Medicine Programme (SpR GIM Programme) (Contact Dr Sid McNulty).

 

All Trainees should attend their local Trust Education sessions (Contact College Tutor).

 

Royal College of Physicians – Mersey Regional Office

Teach-ins

The Mersey RCP office runs a monthly teach-in programme at the Liverpool Medical Institution on the first Tuesday of the month (excluding January and August). Attendees can book a place online at www.rcplondon.ac.uk from 2 weeks before the teach-in. Registration is from 6 – 6.30 pm. The teach-in starts at 6.30pm and closes at 8.30 pm. There is no charge to attend.

 

Each teach-in focuses on a different medical specialty and aims to provide an update on advances in clinical practice for doctors in training.

 

 

Contact Mersey@rcplondon.ac.uk for more information.

 

Mock PACES Examination


The Mersey RCP office runs 1 or 2 Mock PACES examinations each diet. The cost to take part is £100.00 per candidate.

 

The aim is to test candidates’ ability to demonstrate in a clinical setting the knowledge, skills and attitudes appropriate for a physician who is eligible to take PACES and is completing Core Medical Training.

 

The mock PACES examination consists of five clinical stations moving round each station at regular timed intervals until they have completed the cycle. Run in accordance with MRCP(UK) regulations to give real-life experience of examination conditions, it will provide candidates with an opportunity to reflect on their strengths and weaknesses under the pressure of close observation and to identify common and repeated simple mistakes which can be easily corrected.

 

Previous attendees to the mock PACES examinations have found them very useful in their exam preparations.

 

The next date will be Tuesday 15 October in Aintree Hospital.  Those that are interested can send an email to Mersey@rcplondon.ac.uk 

 

RCP Updates in Medicine


The Mersey RCP office runs a Regional Update in Medicine and an Acute Medicine Update each year. These are 1 day conferences attracting 5 CPD points.

 

The programme is relevant to doctors in training.

Contact Mersey@rcplondon.ac.uk for more information.

 

Courses and Events

Forthcoming relating to the RCP - Mersey Region can be found on their website here.

Core/Mandatory Courses and Meetings


For Internal Medicine Training the courses/training identified in the table below are recommended.

 

  • The ALS course is mandatory to ensure you are always up to date.
  • We need you to attend 70% of the Regional IMT Teaching and poor attendance can result in a poor outcome at the ARCP. 
  • The other courses identified are largely related to obtaining the MRCP exam. Look under ‘Courses and events’ for details.
  • Each Trust will have its own study leave rules and funding limits. You should arrange your study leave with those guidelines in mind.

 

General (Internal) Medicine (IMT1+2/ST1+2)

 

Year of Training Description of Event Frequency Comments
To avoid expiry ALS To keep up to date -
Every Year IMT monthly Regional Teaching x10/year (must attend at least 70%) -
Depending on progress towards MRCP MRCP part 1 course - Desirable
MRCP part 2 course - Desirable Desirable
PACES course - Desirable Desirable
Ongoing LMI Evening teaching Sessions Monthly

Desirable

(can count towards annual teaching requirements in CMT)

IMT2/ST2 Teaching Course Once Desirable
Ongoing RCP Regional Update in Medicine Meeting Annually

Desirable

(can count towards annual teaching requirements in CMT)

 

Further information


Training in the Isle of Man

Those of you training in, or wishing to train, in the Isle of Man should watch this informative video filmed by Mark Roberts at the Medical Education Centre in Nobles

https://youtu.be/At_SpqA1V2I

 

North Western

 

Training Programme Directors

 

South Cumbria and Lancshire Sector

Dr Simon Howell

simon.howell@lthtr.nhs.uk

Royal Preston Hospital

 

North Sector

Dr Andrew Robinson

andrew.robinson@srft.nhs.uk

Salford Royal Hospitals NHS Foundation Trust

 

South Sector

Dr Pippa Newton

pippa.newton@uhsm.nhs.uk

University Hospital of South Manchester

 

Overview of Programme

The CMT programme builds on the traditional excellence of SHO training in medicine in the North West region, including the larger training programmes previously centred at Hope Hospital, Manchester Royal Infirmary, North Manchester General Hospital, Royal Preston Hospital and Wythenshawe Hospital.

 

The training programme is run in three zones (Lancashire and Cumbria Zone; Greater Manchester North & West Zone; and Greater Manchester Central, South & East Zone) to afford proximity of placement hospitals for all trainees.

 

The two-year CMT programme delivers training based upon the JRCPTB CMT curriculum, with the majority of posts involving both district general hospital and teaching hospital placements.

 

There is a wide range of training paths affording experience in the main medical specialties. These training paths also afford the possibility of individual focus with choice suiting differing career specialty plans.

 

General Description of Rotation

The three programme zones, while providing the same high standards, each offer differing flavours of training. There are four trusts with seven sites in Lancashire and Cumbria; four trusts and seven sites in Greater Manchester North & West; and six trusts and sites in Central Manchester South & East.

 

Successful applicants are asked to express a preference between the different training tracks, to suit individual interests and career plans. Allocation to tracks is on the basis of expressed preference and interview score.

 

Each zone has 24 training paths, involving six four-month placements. These placements will involve at least one year in the main medical sub-specialties (geriatric medicine [care of the elderly], chest medicine, endocrinology/diabetes, gastroenterology, and cardiology).

 

Each path will provide 16-20 months of acute medical experience, with at least eight months of unselected acute medical 'take'. The majority of trainees will be based in one site for each year of the programme.

 

Each training path will allow a sub-specialist training focus for at least one four-month placement. This will be either cardiology, haematology, intensive care, liver unit, neurology, oncology, renal medicine, rheumatology, specialist chest medicine, infectious diseases, or palliative medicine.

 

Educational Opportunities

CMT curriculum-based protected teaching programmes are in place for CT1 and CT2 trainees, building on the mature individual trust and multi-trust teaching programmes already in place. Skills Training Days are provided separately for CT1 and CT2 level trainees.

 

There is an active and successful NW regional Royal College of Physicians programme of education, including teach-ins and training days.

 

Clinical skills teaching and simulation sessions are integral part of the regional educational programme. There are well established PACES teaching within individual sectors.

 

Research/Audit/Teaching

The Manchester medical school has recently undergone significant expansion, incorporating the use of problem-based learning. Junior hospital doctors, particularly in medicine, form an important group of the trainers at undergraduate level.

 

The University runs a regular programme of teaching the teachers, which CMT trainees are encouraged to attend. All trusts have an actively supported programme of audit; CMT trainees are expected to undertake audit and are actively supported to do so.

 

Research is also supported, with presentation of research at national and international meetings and publications of research achieved regularly by trainees in the trusts in the regional programme.