- Internal Medicine Training (IMT) lasts three years (IMT1–3).
- You aim to pass MRCP(UK) (Part 1, Part 2 Written and PACES) during IMT.
- After IMT you apply to a medical specialty at ST4 level (for example cardiology, gastroenterology, respiratory medicine, geriatrics).
- In most medical specialties you also sit a Specialty Certificate Examination (SCE).
- You usually dual-train with general internal medicine in some specialties.
What IMT looks like
- Rotations across general medicine and several specialties, with on-call duties for acute admissions.
- Progress is checked yearly at ARCP; MRCP(UK) is the main gate for progression to higher training.
- Many doctors take time to prepare for PACES with a study group and clinical teaching.
Choosing a medical specialty
Ask yourself whether you prefer procedures (cardiology, gastroenterology), long-term relationships (diabetes, rheumatology), acute care (acute medicine, respiratory) or diagnosis-led work (infectious diseases, neurology). Taster weeks and shadowing help. Check each specialty’s competition ratios.
This page is general education, reviewed 24 October 2026. Rules, fees and dates change: always confirm with the official sources below. It is not medical, legal or immigration advice.