One of the main attractions of renal medicine (often referred to as 'nephrology') is the spectrum of renal disease and fascinating disease processes.
The speciality requires close interactions with all other medical specialities and joint patient management.
There are plenty of research opportunities, from disease processes to drug development, dialysis technology to transplant immunology.
Renal medicine - trainee characteristics
Training in renal medicine will appeal to candidates who are:
- self-directed
- inquisitive
- need variety
- able to work with a measure of independence.
Working/training in a HST renal medicine post
Renal medicine provides good medical training and opportunity for a wide range of research and practical procedures.
Breadth of practice
It is a tremendously varied specialty, covering areas such as vasculitis, immunology, cardiovascular disease, diabetes, acute kidney injury, fibrotic conditions; or the rare and interesting tubular or hereditary disease; as well as the dialysis technology and transplantation.
Renal physicians are uniquely placed to synthesize the diverse problems of renal patients and often do genuinely provide healthcare from 'cradle to grave'.
Renal medicine has a strong professional association basis, committed to guideline development, comparative audit, research and training needs.
Dual training
All programmes will be dual accredited with general internal medicine (GIM), leading to a dual CCT in renal medicine and GIM.
In some centres, it may be possible to undertake dual training in renal medicine and intensive care medicine. Additional guidance can be found on the Faculty of Intensive Care Medicine's website.
Increasing challenge
It is currently a challenging time in renal medicine. The advance in medical therapy has enabled us to treat more complex patients with renal failure.
Dialysis and transplantation are both high-cost therapies. Renal physicians have the pivotal role in leading and delivering high standard of care, ranging from prevention and education to maintenance, and finally end-of-life care.
Most renal service is based on a 'hub and spoke' model, which means a lot of consultants working together in one centre, providing services to other centres.
Some renal physicians (nephrologists) will have a part-time commitment because of demands from academia and/or the family.
A typical nephrologist will usually lead three/four clinics per week and supervise a dialysis unit, and some may have sessions for practical procedures.
Most consultants would also have a research, teaching, supervisory or organisational commitment.
Further information
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.
Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for renal is North West.
Renal medicine - regional contact details | |
---|---|
Regions | Contact details |
Postal address |
3rd Floor 3 Piccadilly Place |
email address & regional contact | [email protected] |
website | http://www.nwpgmd.nhs.uk/ |
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 be assessing your commitment to specialty as part of the shortlisting process. Please visit the application scoring page for more information about how this is assessed and scored.
ICM applicants seeking to dual train
Although the specialty usually only accepts trainees who have completed the full Internal Medicine Stage 1 Training curriculum requirements, an exception is for current intensive care medicine trainees who are applying with the intention to dual train in this specialty. These trainees can be considered provided that they can demonstrate all of the following:
- Completion of UK Core Medical Training or ACCS acute medicine; they do not apply to IMT trainees who left the programme early, before completing the full curriculum outcomes.
- Successful completion of ST3 in ICM by the advertised post start date.
- Making satisfactory progress with their ICM training, evidenced by ARCP.
- In addition, applicants must not be beyond the end of ST5 in ICM at the time of interview if they are applying with the intention of undertaking a dual CCT programme with ICM.
It will be necessary to complete the Internal Medicine Stage 1 curriculum as part of the higher specialty training programme and this will be reviewed with your training programme director, taking into account your individual circumstances.
These are transitional arrangements and it is not guaranteed how long they are in place at time of writing.
Expected to participate in round 2
This specialty has traditionally particpated in the second round. Although it cannot be guaranteed until the first round is completed, it is very likely that there will be a second round for this specialty this recruitment year. Participation in the second round is confirmed in June each year.
As part of the process of applying to HST, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.
To this end, we have published data dating back to 2013 (where this is available), based around four main areas:
-
Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.
-
Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.
-
Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.
-
Post fill rates - the number of posts filled by region.
We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.
Round 1
Year | Apps. | NTN posts |
LAT posts |
Total posts |
Comp. | Unique* |
2024 | 181 | 55 | 1 | 56 | 3.2 | TBC |
2023 | 163 | 52 | 0 | 52 | 3.1 | 37% |
2022 | 216 | 70 | 6 | 76 | 2.8 | 31% |
2021 | This specialty did not participate in round 1 | |||||
2020 | 215 | 64 | 3 | 67 | 3.2 | 41% |
2019 | 139 | 61 | 3 | 64 | 2.2 | 51% |
2018 | 107 | 69 | 6 | 75 | 1.4 | 50% |
2017 | 105 | 67 | 4 | 71 | 1.5 | 48% |
2016 | 110 | 84 | 3 | 87 | 1.3 | 54% |
2015 | 102 | 65 | 25 | 90 | 1.1 | 43% |
* the percentage of unique candidates that only applied to this specialty (out of the PSRO-coordinated specialties)
Round 2
Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
2023 | 82 | 29 | 0 | 29 | 2.8 |
2022 | 90 | 24 | 1 | 25 | 3.6 |
2021 | This specialty did not participate in r2. | ||||
2020 | 161 | 18 | 2 | 20 | 8.05 |
2019 | 56 | 8 | 0 | 8 | 7 |
2018 | 44 | 25 | 3 | 28 | 1.6 |
2017 | 29 | 27 | 2 | 29 | 1.0 |
2016 | 29 | 26 | 1 | 27 | 1.1 |
2015 | 31 | 32 | 10 | 42 | 0.7 |
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.
Renal R1 Interview dates and posts
Region | NTN posts | LAT posts* | Evidence upload date(s) | Interview date(s) |
---|---|---|---|---|
East Midlands | TBC | n/a |
12 December 2024 - 2 January 2025 |
TBC |
East of England | TBC | n/a | ||
London |
London TBC |
n/a | ||
Kent, Surrey and Sussex |
TBC |
|||
North East | TBC | n/a | ||
North West |
North West TBC Mersey TBC |
n/a | ||
South West |
TBC |
n/a | ||
Thames Valley | TBC | n/a | ||
Wessex | TBC | n/a | ||
West Midlands | TBC | n/a | ||
Yorkshire & Humber |
TBC |
n/a | ||
Scotland** | TBC | TBC | ||
Wales | TBC | TBC |
*English LATs
Please note, English regions do not recruit to LAT posts.
**Scotland post numbers
If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish regions is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.
The SMT website will always be the more accurate one where they differ.
Interview content
The interview will be split across two stations with a separate pair of interviewers scoring you on the areas in their station. There will be four questions which will range between 5–10 minutes each in length. You will be marked on these four questions and your communication skills, giving five 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 minutes.
Please note that this is subject to change and will be confirmed by the date of interview.
Prior to this question you will be given a clinical scenario and a short while to review it. You will then be asked questions relating to this scenario. This question will last approximately 8 minutes.
The clinical scenario will be relatively brief (two/three sentences), so once you have seen this, the remainder of the preparation time will allow you to undertake some short mental preparation. Whilst it is permitted to make notes, these must be destroyed as soon as your interview is completed and not shared with anyone.
Clinical scenario considerations
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved. Some points to consider when reviewing the scenario and preparing for discussion are:
- what steps you would take
- any potential treatments possible
- any further information you would gather
- how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario
You should also consider any other factors you deem appropriate, using your experience and professional judgement.
This question will see you given an ethical scenario to answer. This question will not be available to you to consider in advance and the hypothetical scenario will be given on completion of the clinical scenario. There will be approximately 7 minutes of questioning on this area.
This scenario focuses less on a clinical situation, and deals more with consideration of the moral, ethical, legal (etc.) issues which may arise in a situation.
The area of assessment here will be your suggested responses to the ethical scenario during discussion, as well as your knowledge of the different considerations required.
Not an actual question, you will be assessed and scored specifically on the communication skills you demonstrate throughout the station.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenarios, as well as of how well you communicate with interviewers throughout both scenarios.
This question will explore the non-clinical aspects of being a medical registrar, focusing on two of the Capabilities in Practice (CiPs) from the Internal Medicine Stage 1 Curriculum:
- Managing an acute unselected take
- Managing a multi-disciplinary team including effective discharge planning
This discussion will be prompted by a short question provided by interviewers. This will not be given to you before - this will be given verbally by interviewers at the start of the station. This question will last approximately 10 minutes.
Questioning will ask you to draw on your experience of managing a team caring for acute medical admissions by giving examples of how you have managed that type of situation.
This question will focus on your suitability for and commitment to training in the specialty and give you opportunity to expand on the information provided in your application form.
This question will last approximately 5 minutes.
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:
Mark
|
Rating
|
Assessment
|
1 |
poor |
not considered appointable |
2 |
area for concern |
performed below the level expected from a core level trainee applying to the specialty; |
3 |
satisfactory |
performed at the level expected of a core level trainee applying to the specialty; |
4 |
good |
above average ability; |
5 |
excellent |
highly performing trainee; |
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.
Appointability
Raw interview score (RIS)
The RIS is the sum of all ten 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 10 and 50.
Appointability requirements
To be classed as 'appointable', you must meet all three criteria below:
- none of your ten interview scores can be 1/5
- no more than two of your ten interview scores can be 2/5
- your RIS must be 30 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.
Total score
After interview, a weighting is applied to the scores in each area, as well as your application score.
These scores are then combined to give your total score which determines your ranking, which will, in turn, be used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, is detailed in the table accessible through the link below:
|
Interviewer 1
|
Interviewer 2
|
Weighting
|
Max score
|
Question 1 |
||||
Clinical scenario |
/ 5 |
/ 5 |
2.0 |
20 |
Question 2 |
||||
Ethical scenario |
/ 5 | / 5 | 1.5 | 15 |
Question 3 |
||||
Communication mark |
/ 5 |
/ 5 |
1.0 |
10 |
Question 4 |
||||
Medical registrar suitability |
/ 5 |
/ 5 |
1.5 |
15 |
Question 5 |
|
|||
Suitability and commitment |
/ 5 |
/ 5 |
2.0 |
20 |
Raw interview score |
/ 50 |
|||
Interview score (w weighting) |
/ 80 |
|||
Application score |
/ 40 |
0.5 |
/ 20 |
|
Total score |
/ 100 |