Following acceptance of a post offer, prospective employers will run criminal records and other checks.

Providing these pre-employment checks are all satisfied, employers will then issue contracts of employment, as well as confirming salary details, pay banding, rotas, induction arrangements, etc.

Part of this process will be to contact referees to obtain clinical references. Your referees will be contacted directly, you do not need to supply references yourself at any stage.

Unless otherwise notified, all HST posts in round 1 will start on the first Wednesday in August - i.e. Wednesday 7 August 2024. Some posts may start on alternative dates; this will be specified when making programme preferences.

For further details on this, please liaise with the relevant region; see the region contacts page of this website for more information.

Round 2 start dates

The start date for posts in round 2 is a lot more variable than in round 1. The earliest post start date is likely to be January 2025. 

As many posts are those which were unfilled from round 1, they may be available for an immediate start once pre-employment checks have been carried out. Whilst these posts are technically available to start from the date given when you preference programmes on Oriel, it may be possible for the actual start date to be earlier or later depending on the post and your circumstances, taking into account any notice period you may need to serve or how quickly pre-employment checks can be completed. Start dates will be confirmed with your employing hospital.

In most cases you do not apply directly to general internal medicine (GIM) at ST4 level. Training in GIM will be done in parallel with training in one of the Group 1 physician specialties and access to ST4 training is gained by applying for one of these specialty programmes. Group 1 programmes offer dual accreditation in the specialty and GIM. 

The Group 1 programmes which dual accredit with GIM are acute internal medicine, cardiology, clinical pharmacology and therapeutics, endicrinology and diabetes, gastroenterology, geriatric medcine, genitourinary medicine, infectious diseases, neurology, palliative medcine, renal medicine, respiratory medicine and rheumatology. 

Single accredited GIM with sub specialty Stroke medicine recruitment

A pilot programme for single accreditation in general internal medicine coupled to sub-specialty stroke medicine is starting in 2024. Programmes may be available in regions throughout the UK. They would comprise two years of GIM and a year of stroke. This would mean successful applicants could go from completion of IM- Stage 1 to CCT after a further three years of training. They could be completed in any order but it is most likely that the middle of final year would be stroke medicine. Recruitment to these programmes will start in the second round of 2024 recruitment and the other tabs in this area of the website relate to the application and interview process. Applicants must have completed IM Stage 1 or have an alternative certificate by the time of interview. 

The specialty

The current GIM curriculum is designed to provide broad training in the key skills which will be required by consultants taking part in the admission and inpatient management of patients with acute medical problems as well as patients with chronic medical conditions. 

The curriculum builds on IMT to allow the trainee to maturate their skills in GIM.

There is a growing demand for high quality GIM skills as the UK population ages and patients develop multiple, complex co-morbidities. Delivering good GIM care will become an increasingly challenging and rewarding part of physician practice. 

General / application queries

For general queries relating to areas such as eligibility criteria, making an application, or the Oriel system, please contact the Physician specialty recruitment office.

Below are the contact details for the lead region for GIM/Stroke.

Group 1 specialty

This is a Group 1 specialty and requires completion of the internal medicine training (IMT) stage 1 programme or equivalent; all programmes in the specialty will dual specialise with general internal medicine.

Therefore, this specialty uses the standard HST eligibility criteria for Group 1 specialties and does not accept candidates from any alternative training routes. Please visit the am I eligible? section of this website for further information.

Commitment to specialty

The specialty will not be assessing your commitment to specialty as part of the shortlisting process and will score your application purely via the self-assessment scoring framework. Commitment to specialty will be assessed as part of the interview.

This specialty will be participating in round 2 of 2024.

This specialty will be participating in round 2 of 2024.

Indicative post numbers

Indicative vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts. In many cases these will be presented as a range (e.g. 1-4) as it is not always possible for regions to know at this stage how many vacancies there will be.

It is the intention that indicative post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Please note that this table is not likely to be updated subsequent to indicative numbers and actual numbers will be confirmed when programme preferences are opened later in the round.

Numbers subject to change

Please be aware that it is not uncommon for vacancy numbers to change as the round progresses.

More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. In the past, post numbers have risen an average of 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.

It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.

Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.

The interview be split across two separate stations with a separate pair of interviewers scoring you on the areas within their station. There will be five questions, 7.5 minutes each in length. You will be marked on these questions and your communication skills, giving six scored areas in total. The headings below show the question areas and in which station they will be covered, along with information about what will be assessed.

Each station will last 15 minutes, so, including the time between stations, the interview will be approximately 40-45 minutes.

Please note that this is subject to change and will be confirmed by the date of interview.

Scoring framework

The score of 1-5 an interviewer will award you for each assessment area is judged in relation to how well you perform against an expected level. Below is the framework used to award scores at interview, as well as interpretation of what these scores represent:






















not considered appointable


area for concern

performed below the level expected from a core level trainee applying to the specialty;
possibly unappointable, subject to discussion and performance in other areas



performed at the level expected of a core level trainee applying to the specialty;
the candidate is suitable for a higher specialty training post



above average ability;
the candidate is suitable for a higher specialty training post



highly performing trainee;
the candidate is suitable for a higher specialty training post

As shown in the table, for each of the question areas at interview, 3/5 is considered a satisfactory score; and reflects the level of performance that would be expected of a trainee ready to progress to a specialty training programme.

Should your performance go above and beyond this expected level, interviewers can award marks of 4/5 or 5/5 as appropriate.

Conversely, should your interview performance not reach the expected level, then interviewers can award marks of 1/5 or 2/5, as reflects their level of concern over your performance.


Raw interview score (RIS)

The RIS is the sum of all twelve scores awarded to you during your interview, but before any weighting is applied.

As each individual score will be between 1 and 5, your RIS will be between 12 and 60.

Appointability requirements

To be classed as 'appointable', you must meet all three criteria below:

  • none of your twelve interview scores can be 1/5
  • no more than two of your twelve interview scores can be 2/5
  • your RIS must be 36 or above.

If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for post offers.

However, if you fail to meet any of these requirements, your application must then be assessed as not appointable, and it will progress no further in that round.

As this is a brand new specialty, we have no historic data to share. 

This page will be populated after the recruitment round.