What is IMT?
IMT is a 3-year core training programme for UK junior doctors. The aim of this programme is to prepare trainees for their careers as medical registrars and wherever it may take them beyond that. Internal medicine UK training comes after the completion of foundation training and leads to higher medical speciality training.
The IMT pushes junior doctors to develop their clinical skills and knowledge by incorporating specific study time into the training programme – this includes days for revision and sitting exams, days dedicated to procedural skills, and simulation skills days.
It’s a tough path to take in your medical career, but it’s well worth taking if you’re truly passionate about medicine. You can either complete 2 years of IMT and then join a group 2 speciality training programme or complete 3 years of IMT, after which you will enter a group 1 speciality training programme. Applicants will have the opportunity to apply for a variety of different medical specialty training programmes.
Why do IMT?
While you may study for an initial medical degree, chances are you already have an idea of the specialty you want to focus on. But, if you like a bit of variety, stay calm under pressure, and cope well when things are uncertain, you may choose to go down the IMT route.
The Internal Medicine Training programme equips junior doctors with the broad knowledge base and required skills for life in inpatient hospital medicine. It allows you to experience multiple specialties and rotate rather than sticking to one – something that you would be unlikely to experience otherwise.
The IMT is a hospital-based training programme, where at least two years out of the three must take place on a ward. However, the new programme also requires outpatient clinic experience for all three years.
All IMT rotations are made up of inpatient specialties, outpatient specialties, and intensive care. Geriatric medicine is mandatory. Once you reach the end of IMY2, trainees will assume the role of medical registrar, but will still be under the supervision of ST4+ equivalent registrars. During your IMY3 year, you will take on a leadership role in ward work, the acute take, and resuscitation teams.
What is the IMT portfolio?
An Internal Medicine Training (IMT) portfolio is a collection of documentation that you will need to compile in order to show your clinical experience, skills, and achievements during the IMT programme.
Essentially, the IMT portfolio acts as a record to demonstrate your readiness to progress into specialty training. It will typically include evidence like patient case studies, procedural logs, feedback from supervisors, and details of additional learning activities like presentations or research projects.
Long gone are the days when a physical copy is mandatory; however, it is still good practice to prepare a portfolio – whether you choose to keep a physical or digital portfolio is up to you.
Why keep an IMT portfolio?
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Track your progress: Keeping an in-depth IMT portfolio gives your training journey a formalised structure so you can keep track of your development as you hit clinical, academic, and professional milestones along the way.
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Evidence: Your portfolio essentially serves as evidence for your training and development. It shows you are on the right track, ticking all the boxes required at each stage of training.
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Support learning: Keeping a portfolio of your progress encourages continuous self-assessment. You’ll find that you’re easily able to spot areas for improvement that require a little more attention.
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Feedback: If you’re working with a mentor, a portfolio becomes the perfect platform for providing valuable feedback on areas that need work.
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Accreditation: The IMT portfolio forms the basis for regular formal assessments by the Royal College of Physicians (RCP) and other governing bodies. It’s also used during the annual review of competence progression (ARCP) to decide whether a trainee is progressing as expected or needs additional support.
The 7 key areas of the IMT portfolio
Clinical experience
This section records the clinical cases and experiences you have encountered throughout your training. It includes case logs that document the variety and volume of clinical work, ensuring that a diverse range of conditions and settings are covered. You’ll be expected to document different types of cases, procedures, and medical conditions you have encountered, showing your ability to put the knowledge into practice.
Workplace-Based Assessments (WPBAs)
A key part of your IMT portfolio, WPBAs help to evaluate your performance in the workplace based on direct observation and feedback from supervisors. The most common types of WPBAs include:
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Care-based discussions (CBD): This assessment involves reflective discussions of individual clinical cases that are designed to assess your clinical reasoning and decision-making skills.
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Direct observation of procedural skills (DOPS): This involves the direct observation of you performing medical procedures in order to assess your technical skills.
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Mini-CEX (Mini Clinical Examination): This assessment involves short, focused tests where you will be observed while carrying out certain clinical tasks, such as physical examinations or taking histories.
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Multisource feedback (MSF): For this assessment, feedback is gathered from multiple sources, including nurses, consultants and peers, in order to provide a complete picture of your professionalism, and teamwork and communication skills.
Educational and academic achievements
This area of the IMT portfolio includes any formal learning activities you have completed, including seminars, courses and workshops, research projects, relevant academic achievements, presentations at conferences, or being featured in academic publications. CME (continuous medical education) records are also included in this section to show your commitment to ongoing learning.
Educational and academic achievements
Taking part in reflective writing is a key part of any IMT portfolio. You will be encouraged to reflect on your clinical experiences, along with any challenges and decisions you came across during your training. This will give you a greater understanding of your strengths and weaknesses so you can strive for continuous improvement.
Your reflective logs should also include insights into any emotional or ethical challenges you faced during your training programme, as well as any knowledge gaps you’re aware of and your future personal and professional goals.
Logbooks
You will be required to keep a logbook to document your practical experiences, which includes tracking clinical cases and procedural skills and logging any specific internal medicine competencies you have mastered.
The logbook also allows you to track any procedures you have performed to ensure that you gain the required clinical exposure in all relevant areas.
Personal and professional development (PPD)
This section addresses broader competencies that you will need for a career in medicine, such as communication, teamwork, leadership, and personal wellbeing. This helps ensure that you’re developing the necessary interpersonal skills needed to function effectively in the medical profession. A PPD can also highlight your personal achievements, such as peer teaching, leadership roles in education, and any involvement in clinical projects.
Supervisor feedback
Trainees will receive regular feedback from their clinical supervisor, consultants and peers, which will be documented in the IMT portfolio. Supervisor reviews will be carried out on a regular basis to give an insight into your strengths and any areas for improvement.
How to keep an IMT portfolio
Although keeping a physical portfolio is no longer mandatory, many trainees prefer to prepare and keep a portfolio that they can carry around with them. Creating a portfolio doesn’t have to be daunting, although it can seem so if you’ve never done it before!
Your IMT portfolio isn’t something that you can cobble together at the last minute. It’s never too early to start collating your achievements together and thinking about your application. Over time, you can slowly pull together all the information you need.
For physical copies of your portfolio, opt for a standard lever arch folder with dividers for each section and a contents page at the beginning of each section so they can be easily accessed. And don’t forget to upload a digital copy as a backup!
Name the sections whatever you wish, although our recommended approach is to base each section around the titles given to you for each of the scoring sections: Postgraduate, Additional Achievements, Presentations, etc. However you choose to do it, make sure everything is easy to find!
Your portfolio is how you can keep track of all of your achievements. Which parts are you most proud of? Which parts will ensure you are a good fit for your chosen career?
And don’t forget to include any extracurricular activities you take part in, as it shows a commitment to your specialty! Although it doesn’t feel like it sometimes, there is a life outside of medicine, so be sure to detail your “out of work” achievements, from running to baking – include what makes you, you!
Handling your medical studies alongside building a portfolio can be a juggling act, but it’s not impossible! Get your revision sorted with Pastest’s complete range of online courses so you can sail through your examinations!