It is a requirement for all HST applicants to have achieved capability to the level described on the person specification.
These are divided into two categories, in line with the two levels of training in the UK between primary medical training (ie medical school) and higher specialty training (HST): foundation competences and core capabilities.
Foundation competences
For recruitment purposes, it is not necessary to demonstrate your achievement of foundation competences. If you can demonstrate achievement of core capability, it will be taken you have also gained the necessary foundation competences.
Core capability
The way in which this is demonstrated varies depending on the previous training of the candidate. There are five main categories of candidates and a section explaining what this means and how core capability can be demonstrated:-
Current core - this will depend on whether the specialty is a group 1 or group 2 specialty (see the JRCPTB website for details):
-
Group 1 specialties - candidates currently on the third year of a UK internal medicine training or fourth year of an ACCS internal medicine programme; JRCPTB internationally level 3 accredited equivalents of internal medical training are considered equally.
- Group 2 specialties - as per Group 1, except this also applies to those in the second year of a UK internal medicine training programme or third year of an ACCS internal medicine programme.
-
-
Completed core - candidates who have completed UK internal medicine training or ACCS internal medicine training programme to the required level by the time of application; as above, JRCPTB internationally level 3 accredited equivalents of UK core training can be considered equally to the UK equivalent
- Completion of GIM - Completion of UK ST3 in general internal medicine and satisfactory progress for any subsequent GIM training, by the advertised post start date, evidenced by ARCP. Successful completion will normally be an ARCP outcome 1 and it is expected that trainees applying in this position will have completed at least 6 months of GIM training as part of their higher specialty training programme by the advertised post start date.
-
Non-physicianly training - candidates applying to HST in specialties which accept trainees from 'non-physicianly' training routes
-
Alternative - candidates who do not fit into one of the above categories
-
Refugee doctors - candidates with exceptional circumstances that prevent them from supplying the standard evidence; in most cases, this will be because they are a refugee but could include other candidates if they have very exceptional circumstances.
Providing evidence
All candidates except those on a pre-HST UK medical training programme, or who have exceptional circumstances, will be required to upload evidence of their core competences with their application. The 'Providing evidence' section of this page has guidance on how this is done on the Oriel system.
Candidates currently in UK core medicine programmes
There are three potential UK core medicine programmes from which a trainee could apply to higher specialty training as a 'current core' trainee. This page details the programme and the requirements for both Group 1 and Group 2 specialties.
Most current core trainees will not need to provide any evidence of achievement of core capability at time of application, just give details of your current training status.
Internal medicine training (IMT)
- Group 1 - you can only apply as a current core trainee if you are on track to successfully complete IMY3 (ARCP outcome 6) by time of the advertised post commencing from date.
- Group 2 - this applies to those who are applying direct from IMY2 and on track to successfully complete IMY2 (ARCP outcome 1) by the posts commencing from date. If you are a current IMY3 applying to a Group 2 specialty, how you answer the application form depends on your position:
- ARCP outcome 1 from IMY2 - you should answer 'no' to the first question on the competences page asking: 'Are you currently on a UK core/specialty training programme, [...] and expect to gain all required competences and be issued with a satisfactory ARCP outcome before the posts commencing from date of the post to which you have applied?' You will then answer 'yes' to the subsequent question and be required to load evidence of your ARCP.
- ARCP outcome 2 from IMY2 - you should answer 'yes' to the question above and you will not need to supply any evidence at the application stage.
Acute care common stem: internal medicine (ACCS-IM)
- Group 1 - you can only apply as a current core trainee if you are on track to successfully complete the fourth year of ACCS-IM (the equivalent to IMY3) by time of the advertised post commencing from date.
- Group 2 - you can apply as a current core trainee if you are track to successfully complete the third year of ACCS-IM by the posts commencing from date. If you are an ACCS-IM trainee in your fourth year and applying to a Group 2 specialty, the guidance above for IMT applies.
Core medical training (CMT)
CMT is the forerunner of IMT and there are very few trainees left on this programme.
- Group 1 - CMT trainees are not eligible to apply for a Group 1 specialty on the basis of completing CMT. They will either need to complete an IMY3 stand alone training programme, or gain equivalent experience and capability in a non-training programme role.
- Group 2 - you can apply as a current core trainee if you are on track to successfully complete the second year of CMT by the posts commencing from date.
Stand-alone posts
Undertaking a stand-alone core training year, e.g. an IMY3 programme, does not affect how you demonstrate your core capability. You can answer in the same way as someone in the same year of training who started from CT1 and you need only give details of your training in your application form.
JRCPTB internationally level 3 accredited training
The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdom. Where a programme has been given level 3 accreditation as equivalent to UK core training, this will be accepted as a direct alternative to UK training.
If you are training in one of these programmes, you will be eligible to apply provided that you can show that your training progress to date has been satisfactory and that you are on track to gain all core competences by the advertised post commencing from date.
As the application form has been designed for UK trainees, you will need to answer no to all the competence questions until a text box asks you to explain why you are unable to supply standard documentation. You can then explain your circumstances so the recruitment team know you are entering via your internationally accredited training; you will not need to supply any documentation until later in the process as part of pre-employment checks.
Core training not successfully completed by deadline
If you are not able to demonstrate successful completion of core training to the required level by time of the advertised post commencing from date, you will not be able to take up any higher specialty training offer and would be withdrawn from the programme. If you are intending on taking up a higher specialty training programme, it is very important that you are in liaison with your Training Programme Director to ensure that you are on track for successful completion by the time of your ARCP.
Examples of unsuccessful completion include:
- An ARCP outcome 2 from IMY2 for application to Group 2 specialties - if you progress to IMY3 and do not gain an outcome 6 by the deadline required, you must be able to provide evidence from your training region that IMY2 has been fully completed to the capability level required.
- An ARCP outcome 3 for IMY3 for application to Group 1 specialties - you would not be eligible to take up an offer in that round. If your outcome 3 was just due to non-completion of the MRCP(UK), you could use your ARCP to apply in a subsequent round, and evidence completion of the MRCP(UK) separately. If the outcome is for non-examination reasons, it will be necessary to evidence full completion, either via a subsequent ARCP during an extension to the programme, or an alternative certificate if you decide not to take up an extension.
Completion of core training delayed due to deferral
The start of training may only be deferred on statutory grounds (e.g. maternity leave, ill-health). Please see the Gold Guide for further information.
This includes a period of illness or maternity leave taken during core training prior to making an application. Where applicants are unable to achieve capability on time, they may still apply whilst they complete the time/areas missed. Extended training will need to be organised in the current post to cover the time that was missed.
Under these circumstances, you would not need to submit evidence of core capability at the time of application.
Upon receiving an offer, you should contact the employing region to ensure they are aware of your desire to defer your start date and ensure this will be permissible. The final decision on whether a start date can be deferred is at the discretion of the region.
Candidates who have already completed pre-HST UK medical training
If, by the time of application, you have already completed internal medicine training, core medical training or an ACCS internal medicine programme, you can use this to demonstrate core capability; although there are rules which impact on eligibility for Group 1 specialties. You will be required to attach an electronic version of your ARCP confirming completion. Please note it is possible to download a PDF version of your ARCP outcome from the ePortfolio system.
Internal medicine training (IMT)
- Group 1 - you can only apply if you have completed the full three years of IMT and had your capability signed off for the Stage 1 curriculum.
- Group 2 - you need only have completed two years of IMT, with successful ARCP outcome (usually an outcome 1). If you are a current IMY3 applying to a Group 2 specialty, how you answer the application form depends on your position:
- ARCP outcome 1 from IMY2 - you should answer 'no' to the first question on the competences page asking: 'Are you currently on a UK core/specialty training programme, [...] and expect to gain all required competences and be issued with a satisfactory ARCP outcome before the posts commencing from date of the post to which you have applied?' You will then answer 'yes' to the subsequent question and be required to load evidence of your ARCP.
- ARCP outcome 2 - you should answer 'yes' to the question above and you will not need to supply any evidence at the application stage; eligibility to start a higher specialty programme will be dependent on being able to demonstrate successful completion of IMY2 capability to your employer.
Acute care common stem: internal medicine (ACCS-IM)
- Group 1 - you can only apply if you have completed the full four years of the programme and had your capability signed off for the Stage 1 curriculum.
- Group 2 - you need only have completed three years of ACCS-IM, with successful ARCP outcome (usually an outcome 1 but could be a 6 for those on the old three-year curriculum). If you are an ACCS-IM trainee in your fourth year and applying to a Group 2 specialty, the guidance above for IMT applies.
Core medical training (CMT)
CMT is the forerunner of IMT.
- Group 1 - CMT trainees are not eligible to apply for a Group 1 specialty on the basis of completing CMT. They will either need to complete an IMY3 stand alone training programme, or gain equivalent experience and capability in a non-training programme role and submit an alternative certificate of capability at time of application.
- Group 2 - those successfully completing CMT are eligible to apply. This includes those with an ARCP outcome 6, or where all competence apart from the MRCP(UK) was signed off on the ARCP.
Stand-alone posts
Undertaking a stand-alone core training year, e.g. an IMY3 programme, does not affect how you demonstrate your core capability. You can answer in the same way as someone who completed the full three year IMT programme and submit your CT3 ARCP as evidence of completing Internal Medicine Stage 1 capability.
Completion of GIM
Completion of UK ST3 in general internal medicine and satisfactory progress for any subsequent GIM training, by the advertised post start date, evidence by ARCP. Successful completion will normally be an ARCP outcome 1 and it is expected that trainees applying in this position will have completed at least 6 months of GIM training as part of their higher specialty training programme by the advertised post start date.
Core training not successfully completed
If you have completed core training to the required level but are not able to demonstrate successful completion via ARCP, this will impact on how you can demonstrate the required capability. This includes ARCP outcomes 2, 3, 4, 10.1 and 10.2.
- MRCP(UK) only outstanding - If you have not yet gained the full MRCP(UK) diploma, but have otherwise successfully completed core training to the required level, you can still apply. You will be required to attach the electronic version of evidence of completion of training (i.e. your ARCP) and then in the MRCP(UK) status section, you can confirm which parts of the examination you have completed and which are outstanding; you must be able to complete outstanding sections by the required deadline; see the MRCP(UK) section for details.
- IMY2 ARCP outcome 2, 3, 10.1 or 10.2 for Group 2 specialties - what you will need to provide will depend on whether you progressed to IMY3 or exited the programme:
- Progressed to IMY3 - if you are not awarded an outcome 6 for IMY3 by the deadline required, you must be able to provide evidence from your training region that IMY2 has been fully completed to the capability level required.
- Exited the programme - your ARCP outcome is not acceptable evidence and you will need to supply an alternative certificate to evidence full completion of IMY2 capabilities; no other evidence is acceptable.
- IMY3 ARCP outcome 3, 4, or 10.2 for Group 1 specialties - If your outcome 3 was due to non-examination reasons, and you exited the programme prior to completing outstanding areas, it will be necessary to evidence via an alternative certificate.
JRCPTB internationally level 3 accredited training
The JRCPTB accredits training outside the UK as meeting the standards set by the Federation of the Royal Colleges of Physicians of the United Kingdom. Where a programme has been given level 3 accreditation as equivalent to UK core training, this will be accepted as a direct alternative to the UK equivalent.
If you have completed training in one of these programmes, you will be eligible to apply and will demonstrate this by attaching your ARCP documentation to your application in exactly the same way as detailed above for UK trainees.
Please note that trainees completing a core medical training programme will only be eligible to apply on this basis for Group 2 specialties. Eligibility for Group 1 specialties requires completion of IMY3 equivalent training and the Alternative Certificate to Enter Group 1 Higher Physician Specialty Training.
Alternative certificate to enter higher physician specialty training
Alternative certificate
The only alternative method for physician applicants is to use what is called an 'alternative certificate'. There are two versions of this certificate, which can be downloaded from the document library.
- Alternative Certificate to Enter Group 1 Higher Physician Specialty Training - this can be used for entry to Group 1 and Group 2 specialties, there is no need to submit a Group 2 version if you have the Group 1 completed.
- Alternative Certificate to Enter Group 2 Higher Physician Specialty Training - this can only be accepted for Group 2 specialties and it will be necessary to get a Group 1 certificate signed if you wish to apply to one of those specialties.
The certificate provides a list of the core capabilities that are required by the IMT programme, and necessary to enter HST.
Unless you have exceptional circumstances, the form must be fully completed and attached to your application form for you to be eligible. The document itself gives some advice on its use and completion, but we have also added some further guidance below.
Acceptable versions of the certificate
In 2024 recruitment, Only the 2024 certificate will be accepted. The 2024 versions of the certificate are available from the Document Library and should be used from now on.
Completed by supervisor
You must have it completed by:
-
a consultant in a physicianly specialty (a full list can be found on the JRCPTB website) or
-
a consultant in an alternative specialty, eg emergency medicine or intensive care medicine, who holds the MRCP(UK) diploma, or is a fellow of one of the three royal colleges of physicians of the United Kingdom
And
- The signatory must have worked within the NHS within five years of the date the certificate is signed, and have an accurate knowledge of the IMT stage 1 curriculum or
- have supervised you whilst working in the Republic of Ireland, provided that they are familiar with the UK IMT curriculum.
You must have worked with them:
-
in a medical specialty, emergency medicine or intensive care medicine post
-
for a minimum continuous period of three months since 1 January 2021 (for 2024 recruitment).
Evidence of signatory's professional registration
It is your responsibility to provide adequate evidence of the professional status of any signatory who is not registered with the GMC.
This evidence must be scanned and attached with the alternative certificate. Where this evidence is not in English, an official English translation should also be provided. In cases where the signatory has historic but not current GMC registration, it is the current registration that is required; previous GMC registration will not be accepted. Where adequate evidence is not provided, you will be unable to progress to the next stage of the recruitment process.
Notes about the certificate
Below are some notes answering common questions about the criteria for completing the certificate:
-
The three months is whole-time equivalent and could be spread out over a period much longer than this; for example, if you are doing research but have been undertaking clinics during this time to maintain your clinical skills, the three months may be spread over the three-year period.
-
You do not need to have practised all capabilities within the three-year period but whoever is signing the form needs to be satisfied that there is no reason why these competences are in doubt and that they believe you are sufficiently capable to progress to HST. Examples of how supervisors can be satisfied with your capability include:
-
first-hand knowledge via supervision of you
- discussion with previous clinical supervisors
- (for those maintaining one) viewing your ePortfolio.
-
It is permissible for a supervisor to sign off capabilities which they have not personally witnessed, provided they have the satisfactory assurance that competence has been gained.
Candidates previously undertaking CMT/ACCS-AM/IMT
If you have previously undertaken an IMT, CMT or ACCS-AM programme and did not have one or more competences signed off on your ePortfolio, it is not permissible for this to be signed off on your alternative certificate on the basis of being acquired during the programme.
Instead your supervisor will need to be satisfied that any competences which are not recorded as complete in the ePortfolio have been achieved and demonstrated subsequent to leaving the core programme.
Candidates applying to HST from 'non-physicianly' training routes
In addition to applicants whose experience to date has been in 'physicianly' medicine, several specialties participating in the recruitment process also allow applications from trainees from other specialty pathways.
These specialties are: allergy, audiovestibular medicine, clinical genetics, clinical neurophysiology, dermatology, haematology, immunology, medical opthalmology, rehabilitation medicine and sport & exercise medicine.
For these specialties the competence requirements can vary slightly depending on the training backgrounds they seek. You are advised to review the relevant person specifications as their requirements are outlined within.
Demonstrating capability
Regardless of the specialty in which you have trained, unless you are a current UK trainee on track to gain all required capabilities, you will need to attach evidence to your application form.
If you are applying to a specialty which accepts trainees from another specialty pathway, and you have trained outside of a UK training programme in that specialty, the way in which you can demonstrate competence differs depending on the specialty of your training and you should check the relevant person specification.
Alternative certificates
A number of specialties have specific alternative certificates which should be used to demonstrate competence gained in these programmes. These forms are usually available from the Oriel Resource Bank; if you cannot locate this, please contact the relevant royal college or lead recruiter for that specialty pathway.
In most cases, applications made without evidence of core capability, other than those currently in pre-HST UK training, will not be eligible and their application will be rejected.
However, it is recognised some doctors have exceptional circumstances, such as refugees, and may not be able to provide an alternative certificate at time of application.
Applicants in this position will have the opportunity on the application form to explain their circumstances and, subject to approval, may be given more time to submit a certificate. Although candidates with exceptional circumstances can be initially considered without an alternative certificate, this will be required before being able to take up an offer of a programme.
Candidates who think they may have exceptional circumstances should contact their local postgraduate region for further advice - please refer to the region contacts page of this website. Where possible, regions will be able to provide assistance for bona fide refugee doctors in obtaining an alternative certificate.
Unless you are a current pre-HST UK trainee, or have exceptional circumstances, you will be required to upload/attach evidence of your achievement of core capabilities to your application form.
Evidence must be uploaded where necessary
If you are required to supply evidence but submit your application without it, it is likely that your application will be rejected as ineligible. Therefore, please ensure you have this ready to attach to your application prior to submission.
If your status requires evidence to be supplied at the time of application, the application form prompts you into attaching this and will not let you submit without. It is not permissible to claim you have exceptional circumstances and submit without evidence unless your circumstances warrant this.
Uploading/attaching documentation
Where required to provide evidence with your application, an electronic version must be uploaded to your application form when prompted.
There are two ways of doing this. You can either do it by uploading the correct documentation during the application process, or you can upload documents to your document library/repository on Oriel. The link to do this is on your Oriel dashboard.
Please ensure you select the correct document category, only categories which match the options you choose in the form can be attached to your application.
The maximum size of an upload is 10MB. However, if the document you wish to upload is bigger than 10MB, you can divide and upload this as multiple files.
In the event you encounter any difficulties with uploading or obtaining a document - please submit a query via the candidate enquiries portal.