Application and scoring
How does IMT selection work?
Check eligibility under the 2027 person specification, then apply through Oriel, complete self-assessment for shortlisting, respond to any evidence audit, interview, and preference programmes. The latest detailed guidance ranks appointable candidates by weighted interview score, not by adding portfolio points to that score.
Check full GMC registration at application, foundation competence route, right to work and any required reapplication forms against the 2027 person specification.
Apply on Oriel in the national Round 1 window, 22 October–19 November 2026, and justify only completed, accurately scored achievements.
Self-assessment determines the shortlist if capacity is exceeded; keep supporting evidence ready for a random audit or specific query.
If invited, attend the national online interview; the latest detailed format assesses seven aspects across two stations.
If appointable, use the released rank and programme details to submit preferences. Offers are matched to ranking and the preferences actually listed.
Shortlisting
The official 2027 notice removes the 2026 five-point bonus for applying only to IMT. Publications and presentations have revised values; the confirmed six-domain matrix totals 30 points.
Latest detailed interview scoring
Seven aspects are marked twice on a 1–5 scale. The current published appointability rule is no 1/5, at most two 2/5 scores and raw score at least 42/70. Weighted scores determine rank.
2027 national timetable
Applications open at 10am on 22 October and close at 4pm on 19 November 2026 (UK time). Online IMT interviews are 18 January–12 February 2027.
Portfolio and evidence
How should you build your evidence for IMT?
The latest detailed matrix has six scored self-assessment domains; the 2027 change notice revises two. Match a completed claim to its exact option, store proof, and separately prepare to explain the relevance and your contribution at interview.
Achievements
Know which two or three achievements are strongest and why each is relevant to IMT.
What to do: Prepare a short evidence-based explanation of your role, impact and learning for each major achievement.
Quality improvement and governance
Choose examples where you understood the problem, influenced change and can describe what happened afterwards.
What to do: Keep outcomes and reflection more prominent than process detail.
Teaching and leadership
Interviewers can probe beyond job titles, so your explanation needs to show what you actually did.
What to do: Prepare examples with a clear challenge, your action, the result and what you would change next time.
Commitment to medicine
Use experiences that show you understand the breadth, uncertainty and team-based nature of internal medicine.
What to do: Link motivation to real clinical experience rather than generic statements about enjoying variety.
Interview process
What happens in the IMT interview?
The current 2027 interview uses two 11-minute stations. Station 1 opens with a two-minute spoken achievements presentation and assesses suitability, ethics/governance and communication. Station 2 uses a progressive clinical scenario, communication and a protected one-minute handover.
- Station 1 · 2027
- 11 min · 2-minute presentation, suitability, ethics/governance, communication
- Station 2 · 2027
- 11 min · progressive clinical reasoning, communication, 1-minute handover
- Overall session
- Approximately 30 min including transitions; allow longer for online registration
What is assessed?
- Application and achievements
- Suitability for Internal Medicine Training
- Ethics, professionalism and governance
- Station 1 communication
- Clinical investigation, diagnosis and management
- Station 2 communication
- One-minute clinical handover
2027 Round 1 · checked 30 October 2026
Before you submit: deadline, competence and priority status
Complete these national checks alongside the specialty's eligibility, evidence and selection requirements.
Application deadline and limit
Round 1 applications close at 4pm UK time on 19 November 2026. The national limit is five applications per recruitment round. Some specialties also require you to choose a single regional vacancy, so check the application route before submitting.
Foundation competence and CREST
If CREST is required, national guidance accepts valid 2024 or 2027 forms for 2027 recruitment. Required competence evidence must accompany the application; there is no later upload opportunity. Check validity against the specialty person specification and resolve any conflicting specialty instructions before relying on an older form.
Check your priority status in Oriel
For standard 2027 specialty recruitment, prioritisation applies to interview invitations and training offers. Check the status displayed in Oriel after applications close. Round 1 requests to review an incorrect status are due by 5pm UK time on 24 November 2026. Priority status does not replace eligibility or appointability requirements.
2027 status
What is confirmed for 2027?
IMT Recruitment published its 2027 website update and Applicants’ Guide on 30 September. The two-station interview and scoring are current; use the explicit 2027 notice to resolve any leftover IMT-only bonus wording on older pages.
Confirmed: eligibility and national dates
Full GMC registration is required when applying, with a licence to practise by the post start. National Round 1 applications open 22 October 2026 at 10am and close 19 November at 4pm UK time. IMT interviews are online from 18 January to 12 February 2027. Check the IMT timetable and Oriel for your regional slot and offer deadlines.
Confirmed: no five-point IMT-only bonus
The 2027 IMT notice explicitly removes the 2026 five-point bonus for applying only to IMT/ACCS-IM. The shortlisting score is to come entirely from self-assessment domains. Do not restrict another application in pursuit of a bonus that has been withdrawn.
Confirmed: publication and presentation changes
The 2027 maximum for presentations/posters rises from 6 to 8; publications falls from 8 to 6. The notice gives the revised option scores and excludes abstracts/letters from PubMed-cited other-publication options. It permits abstracts in the lowest option if they are not the same work claimed in presentations/posters. Use the confirmed 2027 matrix and the explicit change notice where older wording conflicts.
Confirmed: 2027 interview structure and scoring
Two 11-minute stations assess seven aspects, with two assessors scoring each from 1–5: 70 raw marks and 96 weighted. Station 1 includes a two-minute achievements presentation; Station 2 ends with a protected one-minute handover. Follow your invitation for joining instructions.
Application domains
Build evidence against the actual scoring domains
The confirmed 2027 matrix has six scored domains: postgraduate qualifications, presentations/posters, publications, teaching experience, quality improvement and training in teaching. The six domains total 30 points. The 2027 notice changes presentation/publication scores and removes the five-point IMT-only bonus. Choose the highest justified option in each domain, keep its proof, and use the official wording.
Postgraduate qualifications
2027 matrix: research doctorate 4; eligible master's 3; relevant postgraduate diploma/certificate 1
Check level, course duration, graduate entry and the difference between a research MD and a taught clinical qualification. Intercalated degrees and MRCP(UK) cannot be scored in this domain.
- Degree certificate or awarding-body letter with title and award date.
- Programme documentation proving credits, duration and graduate-entry level.
- An unfinished master's or a course brochure without proof of award.
- An intercalated degree or MRCP Part 1 presented as postgraduate-degree points.
- If a qualification is genuinely complete, collect the award and course details.
- With weeks left, prioritise another achievable domain instead of buying a degree for points.
Presentations and posters
2027 notice: top option 8; remaining revised options 6, 4 and 2
The current wording requires novel medical data, appropriate authorship and a defined meeting level. A paid opportunity without selection is not equivalent to an accepted national presentation. Check the current option and supporting evidence before selecting it.
- Acceptance or programme/abstract-book entry identifying the meeting and authors.
- Slides or poster showing your work and a genuine delivered presentation or display.
- A teaching talk entered as a research presentation.
- A certificate from a meeting that cannot show accepted abstracts or your authorship.
- Finish a real case, QI or research abstract with a supervisor and submit to an appropriate meeting.
- Ask the organiser for an acceptance letter and programme entry as soon as work is selected.
Publications
2027 notice: top option 6; revised options 5, 4, 2 and 1
Distinguish PubMed-indexed original research from other publications. The 2027 notice moves abstracts and letters out of the PubMed-cited other-publication options; duplicate claims from the same presentation are restricted. Fully accepted in-press work may be claimable under the detailed guidance.
- PubMed record with the correct author role, PMID and article link.
- Publisher acceptance confirmation where the article is fully accepted but in press.
- A manuscript merely submitted or under review.
- Collaborator acknowledgment rather than listed authorship; an abstract already used in presentations.
- Correct the citation/authorship record if it is factually wrong.
- Finish and submit real work, but do not count acceptance that has not happened by the deadline.
Teaching experience
2027 matrix: programme organiser 5; regular teacher 3; occasional teaching 1
The detailed guidance distinguishes organising a programme and teaching regularly over about three months from occasional sessions. Formal feedback is required even for the lower scored teaching option.
- Headed tutor letter explaining your exact role, dates and programme duration.
- Timetable plus analysed learner feedback or observed-teaching form.
- Attendance or one unassessed lunchtime talk.
- A teaching title without evidence of actual delivery or formal feedback.
- Join an existing teaching series and teach repeatedly with a tutor.
- Collect feedback at each session and have the tutor verify the true dates and contribution.
Quality improvement
2027 matrix: involvement in all stages of two completed cycles scores 4
A clinical audit can qualify if it uses recognised QI methodology. Four points require involvement in all stages of two completed cycles, including an implemented change and remeasurement. Three points can cover some stages of two cycles or all stages of one; one point covers some stages of one completed cycle. Claim only your own contribution.
- Completed QIPAT or headed supervisor account covering aim, measures, change, data, learning and your role.
- Results after implementation and, for the higher option, a second cycle that demonstrates remeasurement.
- Data collection alone, a registration form or a project planned after closing.
- A colleague's completed cycle described as your own.
- Choose a small ward process with a clear measure and permission to change it.
- Complete a first cycle before chasing a poster; arrange remeasurement if time allows.
Training in teaching
2027 matrix: qualifying higher teaching qualification 3; qualifying live methods course 1
A shorter course needs at least six hours of synchronous teaching-methods training outside the primary medical degree. A higher qualification has specified graduate-entry and credit requirements. General education courses belong under different rules.
- Completion certificate and provider outline showing live teaching hours.
- University award and credit record for an eligible higher qualification.
- A passive webinar of uncertain duration.
- A generic education course relabelled as teaching-methods training.
- Find an accredited or well documented course that actually meets the published definition.
- Keep the course outline and proof of completion, not just a payment receipt.
Verification
Make each claim quick to verify
The current guidance says evidence is not routinely uploaded: random audit or a specific concern may trigger a request, with at least a week to respond. Have proof at application time. If requested, use readable PDFs/images, tag the matching domain, keep files within the stated 5 MB limit, translate non-English documents and remove all patient identifiers.
A useful one-page index
For each domain record the exact option selected, completion date, single best proof and where your name/role appears. Upload only requested, directly relevant material. No evidence for three or more scored claims can prevent progression under the current detailed guidance.
Teaching-programme confirmation
Editable supervisor draft. Attach a timetable and formal feedback summary where the scored option requires them.
To the IMT recruitment evidence reviewer: I confirm that [name] [organised / regularly taught on / occasionally taught] [programme] for [audience] between [dates]. The programme ran [frequency] over [duration]. Their actual contribution was [specific work and sessions]. Feedback was collected by [method] and analysed [how, when]; [outcome/change]. I have checked the attached timetable/feedback. [Supervisor name, role, organisation, contact, date, signature] Supervisor: please edit or delete every inaccurate claim before signing.
Replace the placeholders with accurate details. Any signatory must verify the statements.
QI supervisor confirmation
Prefer the official QIPAT; use a headed letter with equivalent information only when needed.
I supervised [name] on [QI topic] from [dates]. The aim and baseline were [measure and result]. [Name] personally contributed [design/data/change/analysis]. The team used [QI method]; cycle 1 [dates, intervention, result] and cycle 2 [dates, remeasurement, result] were completed where applicable. Outcome/process/balancing measures were [facts]; lessons and future plan were [facts]. [Supervisor name, role, organisation, contact, date, signature] Supervisor: remove any cycle or contribution that did not occur; attach QIPAT if available.
Replace the placeholders with accurate details. Any signatory must verify the statements.
Presentation / research contribution confirmation
The organiser's acceptance and abstract book are usually stronger than a generic supervisor letter; the latter can clarify your contribution.
I confirm [name]'s role as [author position / contributor] in [work], accepted by [meeting/journal] on [date]. Their actual contribution was [specific tasks]. The [oral talk/poster] was delivered or displayed on [date] at [meeting scope], or the paper was fully accepted [acceptance date]. Supporting programme/citation/acceptance evidence is [reference]. [Supervisor/organiser name, role, organisation, contact, date, signature] Supervisor: do not attest acceptance, authorship or delivery without checking the record.
Replace the placeholders with accurate details. Any signatory must verify the statements.
Clinical taster or observership confirmation
Useful to explain commitment at interview; a taster is not itself a scored self-assessment domain.
I confirm [name] attended [service] on [dates and total days]. They observed [medical take / ward round / outpatient clinic / MDT / critical care] and discussed [learning points]. Their role was observational unless specific supervised tasks are documented here: [facts]. [Clinician name, role, organisation, contact, date, signature] Supervisor: edit the description to match attendance; this letter does not certify clinical competence.
Replace the placeholders with accurate details. Any signatory must verify the statements.
Work backwards
A practical application timeline
For Round 1 in 2027, 19 November 2026 is the national closing date. Score only achievements completed by submission, apart from fully accepted in-press publications under the detailed rules. These windows describe what is realistically possible, not official deadlines for each activity.
12+ months out
Get substantial clinical exposure to the unselected take, ward and clinic; identify a small QI problem, regular teaching with feedback, and one genuine research or presentation route. Start MRCP study for training readiness, while remembering membership exams do not score in the qualifications domain.
6–12 months out
Complete and remeasure a QI change; collect teaching feedback and a headed confirmation; submit work to legitimate meetings. Compare IMT and ACCS-IM based on actual experience, not assumed scoring bonuses.
3–6 months out
Audit every score against the published wording, gather missing proof, ask a supervisor to check your exact contribution, and prepare real examples for suitability, acute decision-making and governance.
Final weeks before submission
Finish achievable sessions and evidence, check GMC/foundation competence documents, draft concise Oriel justifications and verify dates. An unfinished degree, speculative acceptance or planned second QI cycle is not a scored achievement.
After submission and before interview
The self-assessment is for shortlisting; practise the two-minute presentation, unfamiliar ethics scenarios and one-minute handovers. Monitor Oriel and any evidence request. Compare rotations and commuting before preferences open.
Time and money
What not to chase for points
A credible IMT application is not a stack of certificates. The official matrix rewards defined, completed achievements; the person specification and interview also value clinical judgement, safety and reflection.
Do not buy an interview or portfolio course to manufacture a score
No paid course is required for the IMT interview. Teaching-methods training has its own published duration and delivery test; buying an arbitrary certificate does not satisfy it.
Do not mistake exposure for scored evidence
A taster, society membership, shadowing day or MRCP Part 1 may help commitment or training, but none is one of the six scored self-assessment domains simply by existing.
Do not relabel teaching or unfinished work
A teaching lecture is not necessarily a novel-data medical presentation; teaching without formal feedback cannot claim the scored teaching options. A QI plan without a completed cycle is not a completed QI claim.
Do not claim another person's role
The poster, paper, teaching programme and QI documentation must match your actual authorship and participation. Applications are not routinely rescored; a random audit or concern can expose overclaiming.
Starting from little exposure
Get involved in medicine before training
Choose activities that reveal what the job involves and help patients or colleagues. A prestigious badge is less useful than work you can discuss accurately.
Ask for a focused taster
Arrange sessions with the acute medical team, a specialty ward, outpatient clinic and, if possible, critical care. Ask how admissions, escalation and discharge decisions are made. Log dates and reflection; the taster itself is not a scoring domain.
Join the acute pathway
With supervision, attend post-take review, handover and a specialty MDT. Notice how a referral becomes a shared plan and how responsibility transfers overnight.
Choose a manageable QI problem
Examples include VTE reassessment, handover of pending investigations or follow-up of critical results. Agree measures and a supervisor before starting; collect only appropriately governed data and complete a change cycle.
Teach and learn from feedback
Partner with an existing FY or student teaching series, deliver repeated sessions, gather structured feedback and adjust the next session. Ask the tutor to record dates, role and outcomes.
Use networks for insight
Attend RCP or trainee events, talk to an IMT and a medical registrar, and consider a real collaborative audit or research question. Membership alone is not evidence of a scored achievement.
Clinical reality
What an IMT doctor actually does
IMT is broad physician training, not a single specialty post. A rota may combine the unselected acute take, an inpatient team, clinics, procedures and nights. The balance varies sharply by hospital and placement.
On the acute take
A new admission needs assessment, differential, initial treatment, escalation and documentation. The medical registrar coordinates risk, referrals and flow while the consultant reviews and sets wider direction. Trainees learn to revise a plan as results and capacity change.
On a medical ward
Review deteriorating patients and chronic problems, write plans, explain decisions to patients and families, coordinate discharge with therapy and social care, supervise juniors and answer interruptions from nurses, pharmacists and other specialties.
In clinic and the MDT
Outpatient work needs a focused problem, investigation strategy, follow-up and a letter that another clinician can act on. In an MDT, physicians contribute diagnosis, comorbidity, treatment trade-offs and patient goals rather than merely reciting test results.
A representative day: DGH medical take
Morning handover flags unstable admissions and outstanding results; referrals and new patients arrive through the day; post-take review changes priorities; evening handover transfers unresolved risks. The actual roster and supervision depend on local service design.
A representative day: tertiary specialty ward
A registrar may combine a specialty ward round, complex referrals, clinic, procedures and an MDT. Subspecialty decisions are deeper, but general medical take commitments can still interrupt planned work.
Is IMT for you?
It often suits doctors who enjoy diagnostic uncertainty, broad comorbidity, patient conversations and coordinated acute care. The hard parts include rota intensity, discharge and documentation load, interrupted clinics/procedures, exams and uneven access to training time.
Myth: IMT is just ward cover
Service-heavy placements exist, and the RCP has documented trainee concerns. The curriculum also mandates acute, outpatient, critical care and geriatric experience. Ask programmes how those opportunities are actually protected, not only listed.
Out of hours
Understand the medical on-call before you choose it
The unselected take can include sepsis, chest pain, GI bleeding, stroke mimics, delirium, respiratory failure and frailty with multiple competing risks. On a night shift the same team may cover existing wards and new admissions. Local staffing and referral arrangements differ.
How referrals arrive
Emergency department, ambulance pathways, GPs, wards and other specialties may request advice or admission. Clarify urgency, observations and immediate treatment, then allocate review based on risk rather than referral order.
What cannot wait
Recognise instability, call for immediate bedside help, start initial assessment and treatment within competence, and involve the registrar, critical care or consultant as appropriate. A stable but complex referral needs a plan and a named owner too.
How responsibility changes
An IMT1 is supervised in new decisions and sick-patient review. Later training should build independent prioritisation, supervision and medical-registrar capability with senior availability. The Federation describes IMT3 as preparation for senior acute take, not unsupervised practice by calendar alone.
Handover is part of safety
Name the patient, active problem, current risk, pending result and explicit next action with escalation trigger. A long history without a decision owner leaves a night team exposed.
After appointment
Training, exams and career branches
IMT Stage 1 is usually three years with capability-based assessment, not a nationally fixed rotation for each year. It develops acute medical take skills alongside inpatient and outpatient medicine, geriatrics, critical care and simulation. ACCS-IM has a different early acute-care structure; check its programme information separately.
Early training
Build assessment and treatment of the acutely unwell patient, safe escalation, procedures appropriate to supervision, clinic exposure, reflection and ePortfolio evidence. Agree opportunities with the educational supervisor rather than assuming the rota will deliver them.
Increasing independence
Progress towards leading acute decisions and supervising the team, with evidence across fourteen high-level capabilities in practice. IMT3 usually concentrates more on senior medical take responsibilities; progression is judged by capability and assessment.
MRCP(UK) Part 1
Broad written knowledge examination available after the requisite postgraduate experience; it is desirable in the 2027 CT1 person specification but does not create a postgraduate-degree self-assessment score.
MRCP(UK) Part 2 Written and PACES
Part 2 Written tests applied clinical knowledge after Part 1; PACES tests bedside clinical and communication skills. Full MRCP(UK) is normally needed for group 1 higher specialty entry at ST4. Always check current examination regulations.
Career branches
Group 1 specialties generally combine a physician specialty with general internal medicine and enter after three-year IMT and MRCP; some group 2 specialties may recruit after two years plus MRCP. Acute internal medicine, cardiology, respiratory, gastroenterology and geriatric medicine have different acute, procedural, clinic and continuity mixes. Check the exact higher-specialty person specification.
Less than full time and research
Discuss LTFT arrangements, rotation footprint, protected clinic/procedure exposure and academic routes with the specific training programme. Curriculum capability requirements remain; completion timing adapts to actual training and progression.
Where it leads
Different kinds of physician work
A good IMT decision includes understanding what later specialty careers feel like. These are broad contrasts, not promises about an individual consultant job plan.
Acute internal medicine and geriatrics
Acute physicians triage, admit and stabilise undifferentiated illness in ambulatory and short-stay units, with high turnover and close ED/critical care links. Geriatricians manage frailty, delirium, multimorbidity and discharge planning with therapists, community teams and families.
Cardiology and gastroenterology
Cardiology spans heart failure, imaging, devices and emergency coronary care; some careers are highly procedural. Gastroenterology combines luminal/hepatology clinics, inpatient consultation and endoscopy, with endoscopy out of hours in some services.
Respiratory and renal medicine
Respiratory work ranges from acute respiratory failure and pleural procedures to chronic lung disease and cancer MDTs. Renal medicine combines complex inpatient electrolyte/AKI care, dialysis, transplantation and long-term outpatient relationships.
Endocrinology, rheumatology and neurology
These fields often have a stronger outpatient diagnostic and continuity component, but still involve inpatient advice and, depending on programme and job, general medicine duties. Specialty practice and dual-training requirements differ.
People and resources
Which professional groups are useful?
Join a group for learning, representation or a real project. Passive membership is not one of the six IMT shortlisting domains.
Federation and JRCPTB
The physician colleges' training body publishes IMT curriculum, capabilities and pathways; use it to understand what training should deliver.
Royal Colleges of Physicians
RCP London, RCPE and RCPSG provide physician education, policy, trainee events and professional networks. Choose events or mentoring that match your interests rather than collecting three membership logos.
Society for Acute Medicine
For applicants interested in the unselected take and ambulatory acute care: conferences, trainee representation, education and QI ideas.
Specialty and research networks
Look at the British Geriatrics Society, British Thoracic Society or other relevant specialty society for meetings, trainee groups and collaborative research. Ask the local R&D or QI team how a junior doctor can contribute to a governed project.
Preferences
Compare programmes without a league table
Official IMT recruitment publishes regional information and offers against rank and preferences. The hospital list, available posts and actual rotations are more informative than reputation alone; Scotland uses a separate vacancy process.
Ask about the rotation footprint
Map the hospitals and commuting distances for all three years, how often sites change, and whether an ACCS-IM post is actually offered in that region.
Ask what protects training
Compare acute take supervision, clinic and critical care access, geriatric exposure, procedures, simulation, teaching and time for MRCP preparation. Seek recent trainee accounts as context, not as a ranking.
Ask how nights work
Clarify registrar and consultant presence, escalation, ward-cover footprint, handover and whether the rota changes as IMT3 responsibility grows. Discuss LTFT arrangements with the actual programme.
Preference strategically
A rank alone does not guarantee a particular hospital; offers depend on rank and the programmes you include. Read each post's start date and rotation information before ordering preferences.
Dated policy
Issues worth understanding in 2026–27
Use these to demonstrate judgement about patient care and training; they are not predictions of interview questions.
2027 recruitment prioritisation
2027 person specification / national policy
The Medical Training (Prioritisation) Act applies to 2027 recruitment; the IMT notice says prioritisation applies at shortlisting and offers and says its individual impact cannot yet be forecast. Candidate angle: understand the actual rules and avoid claiming a likely personal outcome.
Service pressure versus learning
RCP resident survey, 2025
RCP respondents described IMT as often service heavy with limited time for clinic, procedures and education. Candidate angle: explain how supervised exposure, scheduling and feedback improve patient care as well as progression; do not dismiss service work.
Physician workforce and acute care capacity
RCP workforce reporting, 2025–26
Rota gaps, delayed discharge and staffing pressure affect acute decisions. Candidate angle: show safe prioritisation, early escalation, handover and realistic multidisciplinary planning, not a generic promise to work harder.
AI in physician workflow
RCP Medicine 2026
Digital tools can help documentation and decisions, but clinical accountability, validation, bias, confidentiality and workflow fit matter. Candidate angle: give an example of checking an output against the patient and escalating uncertainty.
Candidate-reported — not official
What recent applicants say caught them out
Reports from 2026 interviews describe time pressure, unfamiliar ethics follow-ups and confusion about whether there was clinical preread. They are individual experiences, not a station specification. The current official page says the scenario is read on entering Station 2; follow your own 2027 invitation.
Practise with no assumed preread
A 2026 candidate discussion shows confusion about a supposed three-minute preparation period. Practise listening, making brief notes and starting safely when a scenario is spoken; do not rely on community recollection to set timing. The current official station page takes precedence.
Expect practical follow-up questions
Individual 2026 candidates reported ethics questions moving from principle to whom they would contact in their own organisation. Prepare a route for advice, documentation and escalation, while acknowledging local policy rather than inventing one.
Do not judge outcome from feelings
Recent candidates described leaving unsure despite extensive preparation. The official appointability and ranking rules, not post-interview impressions, determine the result.
Resource map
Where to go at each stage
Start with primary sources for rules and use focused guides for deliberate practice.
Explore the career
Read the Federation curriculum, speak to an IMT and medical registrar, and use the working-life guide to test assumptions.
Build and prove the application
Use the 2027 person specification, IMT change notice and official matrix; match evidence to each claim and keep the proof ready.
Prepare every interview function
Work through the two-minute achievements presentation, suitability, ethics/governance, clinical reasoning, communication and handover; practise unfamiliar original prompts.
Practise communication in both stations
Communication is marked separately in Station 1 and Station 2 in the latest detailed process. Practise a patient explanation, a concise panel answer and a safe transfer to a colleague.
Plan exams and later pathways
Use Federation MRCP regulations and specialty person specifications; decide exam timing with your supervisor and actual rota.
See existing Interview Bank practice
Question-based practice is listed in the authenticated Question Bank; the IMT product page states the current status of full spoken interview practice. Do not assume the latter is live.
Focused preparation
Go deeper on the interview tasks that need practice
These focused guides break the broader interview into specific question types, decision structures and original practice scenarios.
IMT clinical station & handover
The IMT clinical station rewards organised clinical reasoning and a concise handover. Your plan should become clearer as information arrives, not longer.
Self-assessment & evidence
Work from the exact published option, then prove the completed achievement. The 2027 notice removes the IMT-only shortlisting bonus and changes presentation and publication points.
Achievements & suitability
The latest detailed Station 1 opens with a two-minute spoken achievements overview, followed by questions on your application and fit for physician training.
Ethics & governance
The published ethics function starts with an unseen hypothetical and may test how you apply GMC principles in your own clinical workplace.
Communication across stations
The latest detailed guidance gives communication its own mark in each station. Clarity, listening and an appropriate audience matter as much as fluent delivery.
Working life & training
An IMT post is a mix of acute assessment, ward continuity, outpatient learning and supervised development; the service-training balance varies by placement.
Free practice questions
Example IMT interview questions
These original prompts are designed around the published assessment areas rather than recalled interview content.
Achievements and suitability
- Give an overview of the achievements most relevant to your application for Internal Medicine Training.
- Which experience best demonstrates that you can manage the breadth and uncertainty of acute medicine?
- Tell us about a quality-improvement project and what changed because of your contribution.
Clinical and professional judgement
- You are asked to review an older patient who has become acutely breathless on the medical take. Talk us through your assessment and priorities.
- A colleague asks you to sign a clinical entry for work you did not witness. How would you handle the situation?
- At the end of a clinical scenario, give a one-minute handover to the registrar taking over the patient's care.
Preparation plan
How to prepare for the IMT interview
- Practise the achievements presentation until it is concise without sounding memorised.
- Prepare several evidence-backed examples for suitability, leadership, teaching and QI.
- Work through acute clinical scenarios aloud and explain why each step matters.
- Practise one-minute handovers after every clinical case.
- Use professional principles flexibly rather than memorising one ethics framework.
Common questions
IMT recruitment FAQs
Is the 2027 IMT-only five-point bonus still available?
No. The official 2027 notice explicitly removes it. Older 2026 scoring and FAQ pages still describe the bonus; use the newer notice.
What is confirmed for the 2027 application?
The 2027 Applicants’ Guide, 30-point self-assessment matrix, removal of the IMT-only bonus and interview guidance are published. Interviews are online from 18 January to 12 February 2027.
Do I need full GMC registration when applying?
Yes, under the 2027 person specification; a licence to practise is required by the post start date.
How do I show foundation competence without the UK Foundation Programme?
The 2027 person specification lists eligible routes, including 12 months' post-registration medical experience with CREST. Check its dates and the specific route you qualify under.
Does the self-assessment score determine my final ranking?
The latest detailed guidance uses self-assessment to shortlist; the interview score determines appointability and rank. Use the current 2027 guidance and your invitation.
Must I upload evidence with my application?
The current detailed guidance says generally no, unless selected for audit or a concern prompts verification. Have documents ready when you apply and obey any later request.
Can I claim a QI project that is only planned?
No under the current detailed matrix. A completed first cycle is needed before any QI scoring option is available.
Does an intercalated degree score?
No under the current detailed IMT self-assessment guidance. Check the current matrix for exact eligibility rules.
Does MRCP Part 1 score as a postgraduate qualification?
No under the current matrix. It is listed as desirable in the 2027 person specification and helps prepare for training.
Is a taster required?
No published self-assessment taster domain exists in the current detailed matrix. It can improve your understanding of medical work and your suitability discussion.
Can I use the same project for QI and a presentation?
The current guidance can allow an achievement to support more than one domain if it genuinely meets each definition; the 2027 notice has a specific restriction for abstracts duplicated from presentations. Check the current wording.
What if my paper is only submitted?
A submitted manuscript does not score as a publication. The current guidance makes an exception for fully accepted work in press.
What if my teaching has no formal feedback?
The current scored teaching-experience options require formal feedback. Ask for structured learner feedback or a documented observed session for future delivery.
How long is the interview?
The current 2027 guidance specifies two 11-minute stations, about 30 minutes including transitions. Interviews run online from 18 January to 12 February; follow your invitation for arrival and joining details.
What are the seven scored interview aspects?
The latest detailed guidance scores achievements, IMT suitability, ethics/governance, Station 1 communication, clinical management, handover and Station 2 communication.
What are the published appointability thresholds?
The current criteria require no score of 1/5, no more than two scores of 2/5 and at least 42/70 raw. Weighted ranking is out of 96; meeting the threshold does not itself secure an offer.
Will I get clinical scenario reading time?
The current official station page says the scenario is read on entry and permits brief notes. Do not rely on an older candidate report of preread time; follow the final 2027 instructions.
What is the IMT on-call like?
Expect acute referrals and deteriorating ward patients alongside handover and prioritisation. Team size, registrar supervision and consultant presence vary by hospital and rota.
Is IMT three years everywhere?
The standard IMT Stage 1 programme is three years, with capability-based progression; LTFT changes calendar timing and ACCS-IM has a distinct early pathway.
When do I need MRCP(UK)?
Full MRCP(UK) is ordinarily required for group 1 higher specialty entry at ST4. Check exam eligibility and your later specialty's current person specification.
Can I train less than full time?
LTFT routes exist. Ask the particular programme how clinical exposure, on-call work and rotation length are arranged while meeting curriculum capabilities.
Is IMT only a route to hospital ward medicine?
No. IMT can lead to acute, outpatient, procedural, diagnostic and long-term-care physician specialties, with different group 1 and group 2 entry rules.
How should I compare training regions?
Compare rotations, commute, acute-take supervision, clinic and critical-care access, procedural opportunities, LTFT arrangements and local trainee experience. Avoid unsourced rankings.
What is different about Scotland?
The current detailed IMT site describes a separate Scotland vacancy. Use Scottish Medical Training information and the final 2027 instructions for its dates and programme choices.
Does candidate discussion reveal the interview questions?
No. The recruitment site prohibits sharing detailed interview questions. Use published domains and original practice scenarios instead of recalled material.
Official sources
Official recruitment sources
- NHS England — IMT CT1 person specification 2027
- IMT Recruitment — 2027 website update and Applicants’ Guide
- IMT Recruitment — 2027 change notice
- NHS England — 2027 national recruitment timetable
- IMT Recruitment — current self-assessment scoring
- IMT Recruitment — evidence document rules
- IMT Recruitment — current interview structure and contentReviewed after the 30 September 2026 website update for 2027 recruitment.
- IMT Recruitment — current interview scoring
- Federation — Internal Medicine curriculum and pathway
- Federation — MRCP(UK) examinations
- RCP — 2025 resident doctor training survey
- NHS England — specialty recruitment prioritisation
- IMT Recruitment — regions