Curricula Explained

Acute Medicine was finally ratified as a specialty, formally titled Acute Internal Medicine (AIM), in October 2009. Prior to that, in 2007 and 2008, it was technically a subspeciality of General (Internal) Medicine (GIM). Before 2007 a thin set of recommendations was all that existed. Thus, a trainee in Acute Medicine today could be on any one of a number of curricula, each with slightly different regulations and requirements. This has caused confusion for trainees and deaneries alike. This article explains what curriculum you are following and any notable features of it.

Which curriculum am I on?

If you started in 2009

You started training under the GIM 2009 curriculum but you are automatically being switched to the AIM 2009 curriculum and from the time of writing (June 2010) you should be working to attain the AIM competences. You will end up with an AIM CCT. However, you have the opportunity to apply for dual certification with AIM and GIM, in a similar way to how most registrars in other medical specialities train. The pros and cons of this are discussed below. It should be said that, as you were not appointed to a dual CCT post at the outset, the deanery is not technically obliged to acceed to your request for an extra year of training to dual accredit but we anticipate that most deaneries will look upon such requests favourably.

If you started in 2007 or 2008

You are training to the GIM (Acute) curriculum. You will end up with a GIM CCT*. You have the absolute right to switch to the AIM 2009 curriculum and, should you wish to do so, you deanery may let you dual accredit with GIM also. (See caveat above.)

If you started prior to 2007

You are training to older curricula, some details of which can be found on the JRCPTB Acute Medicine pages. Should you wish to switch to the newer curricula that should be possible but you are probably best off finishing on your existing curriculum.

What is the difference in the content of the two curricula?

Whilst they largely cover the same areas of medicine the Acute Medicine curriculum has an emphasis on the emergency and early management of diseases, whereas the General Medicine curriculum also covers long term management of these conditions in the outpatient setting. Acute Medicine trainees are also required to have a specialist skill, this is discussed further elsewhere on this website. The two curricula have been compared line-by-line by a group of Acute Medicine trainees. The comparison is available to download here and shows exactly what skills, knowledge and competences are unique to each curriculum.

What are the pros and cons of switching to the newer curricula?

Whether you switch to the newer curricula is very much an individual decision based on where you are in your training and what is important to you. If you opt to stay on one of the older curricula this is unlikely to exclude you from applying for consultant posts in Acute Medicine.

Curriculum GIM (Acute) 2007 AIM 2009 alone AIM + GIM 2009
Overview An older curriculum with less emphasis on management and leadership skills An updated curriculum with defined AIM clinical and organisational competences As AIM, but with additional need to demonstrate GIM 2009 competences
Length of training 4 year training programme in most deaneries 4 year training programme 5 year training programme
International recognition GIM CCT recognised worldwide AIM CCT not recognised in Europe or Australia/NZ.
The GMC says that these countries do recognise that you have a qualification which gives you entry onto the specialist register so the exact importance of this point is unclear.
AIM CCT recognised in the UK + GIM CCT recognised worldwide
Scope of practice Qualifies you to look after patients for any length of time and to follow up patients with chronic conditions Technically only qualifies holder to look after patients for 72 hours. (Whether or not you actually look after patients for longer than this is entirely at the discretion of your employing trust.) Qualifies you to look after patients for any length of time and to follow up patients with chronic conditions
Specialty training Amount of training in medical specialties (eg: cardiology, respiratory, ICU etc) depends on deanery Amount of training in three medical specialties (Cardiology, Respiratory and Medicine for the Elderly) fixed by curriculum Amount of training in three medical specialties (Cardiology, Respiratory and Medicine for the Elderly) fixed by curriculum
Portfolio and Assessments No requirement to keep logbook or do mandatory workplace based assessments (DOPS, MiniCEX, CbD etc), though the latter are recommended Logbook requirement for 1250 patients seen on Acute take + 300 patients seen in Ambulatory Care (but no need to see patients in an OP clinic). Workplace based assessments are mandatory Logbook requirement for 1250 patients seen on Acute take + 300 patients seen in Ambulatory Care + 150 new outpatient referrals + 1500 outpatient clinic follow-up patients. Workplace based assessments are mandatory
Specialty Certificate Examination AIM SCE optional Mandatory AIM SCE Mandatory AIM SCE

*The certficate will not say GIM (Acute) because from the point of view of the 2007 curriculum Acute Medicine is a subspecialty and your subspecialty is not marked on your CCT certificate. This is unlikely to affect your prospects for application to an Acute Medicine consultant post, providing that you clearly demonstrate on your CV that you have had an Acute Medicine training.

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