Application and Suitability

Question 1

What is the purpose of the IMT programme?

Answer 1

Taken between foundation and speciality training for 2-3 years depending on career choice.

Its role is to provide trainees with experiencing both acute and chronic medical problems in an inpatient and outpatient setting and to carry out the acute take.

It builds on further foundation training competencies with new procedures and clinical knowledge to allow you to become a competent SpR

Question 2

What is the structure of the IMT programme?

Answer 2

IMT is divided into three years – IMT1, IMT2 and IMT3.
IMT 1-2 is compulsory.
IMT 3 is optional depending on career choice.

IMT1 and IMT2 consist of a year each of three four-month rotations across medical specialties, where you will be working at SHO level.

The IMT3 year consists of a year of two six-month rotations, in which you work at a level above SHO, but not as a specialty registrar. On call shifts are as a junior medical registrar, in which you will be responsible for managing the on call team, but with the support of a more senior medical registrar.

You will do IMT3 if you do a group 1 speciality - cardio, resp, acute med

You will NOT do IMT3 if you do a group 2 speciality - haematology, micro-ID

Question 3

What are the key competencies of IMT?

Answer 3

The curriculum for IMT can be divided into Capabilities in Practice (CiPs), clinical knowledge, and procedures -

CIPs - the competencies expected for IMT trainees to achieve
Clinical Knowledge - List of conditions that you need experience of treating and managing.
Procedures - NG tube insertion, LPs, cardioversion, simulation.

Question 4

What aspects of the portfolio are in IMT?

Answer 4

Workplace-based assessments – CEXs, CBDs, DOPS, ACATs, OPCATs
Peer assessments – Multi-Source Feedback, Multiple Consultant Reports
Educational Supervisor Reports
End of Placement Reports
Professional Development Plans
Reflective practice
Evidence of teaching
Evidence of CPD
Certificates for exams (especially MRCP*), conferences and other achievements

Question 5

When do you need to complete MRCP by?

Answer 5

Successful completion of MRCP Parts 1 and 2 (including PACES) is expected by the end of IMT2, in order to progress to IMT3 or specialty training.

Question 6

Tell us about a Quality Improvement Project you have been involved with? What challenges did you face?

Answer 6

I am currently leading a QI project looking at the management of pyelonephritis within my trust. In particular, looking at the incidence of urine dips, blood cultures, correct abx prescribing and the appropriateness of imaging.

The major challenges I faced were -

Having to take over as lead of the project when someone moved trusts and could not continue data collection and leading the project. This was difficult as I had to push back some dates for analysing and presenting the data which was disappointing but understandable.

Trying to present data at the minute is difficult as ED prescribing a lot of broad spectrum pip-taz and we have seen increase in resistance as many don’t feel confident giving gentamicin, trying to change age old habits is difficult. Must start from top to lead example and trying to push this by presenting data at clinical governance meetings.

Minimal change has been made by reauditing, data is not finalised.

WHAT I HAVE LEARNED –> Ensure I leave enough time for deadlines and keep more in the loop with colleagues during this process. AKA monthly meetings. Possibly need to reiterate points further to drive home audit findings.

Question 7

Why is it important for trainees to be involved in Quality Improvement Projects?

Answer 7

Important for collaborative working and team work in a non-clinical facing role. This is particularly important as my career progresses and I take management/research roles.

Additionally, helps to know our MDT better and understand their job role more - aka pharmacy and micro.

Develops skills such as stats, research methodology, time management and allows us to have a vested interest in patient care beyond clinical work alone.

Question 8

How have you demonstrated your commitment to IMT training in your early career?

Answer 8

I sat the MRCP Part 1 exam in January, although I am unsure of the outcome. The commitment to sitting the exam, along with the significant time and financial investment in months of revision, has strengthened my ability to think laterally—an essential skill I have already started to apply in my current practice.

I also completed a taster week in ID and GIM at a local tertiary centre, where I attended various clinics, followed the registrar and consultant on-call, and participated in ward rounds. This experience gave me a strong understanding of the role of an ID doctor, and it further solidified my desire to pursue this specialty.

Additionally, I have another taster week lined up for the spring in my hospital’s ambulatory care unit, a key area for IMT trainees, as it often counts toward clinic time. I’m looking forward to gaining experience there and better understanding the role I would take on if successful in IMT.

I have also discussed the IMT programme with current trainees and medical registrars, and I feel it would be an excellent fit for me. Furthermore, I have started to perform extended procedures, such as lumbar punctures and ascitic taps, which are key skills for an IMT trainee.

Question 9

Is research important in healthcare?

Answer 9

Yes, I believe so -

Improves Patient Outcomes: Research helps doctors stay updated on the latest treatments, improving care and patient recovery rates.

Evidence-Based Practice: It allows physicians to base their decisions on proven, scientific evidence, leading to more accurate diagnoses and treatments.

Improves clinical reasoning: Understanding medical stats/studies helps us develop a degree of understanding and clinical reasoning when managing cases.

Education: Allows us to clinically justify our decisions and educate our patients

I have felt the benefits of this by publishing 2 papers and taking part in a 4 part critical appraisal workshop in F1 to develop these skills further

Question 10

Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine.

Answer 10

“Hello, my name is Ronan, and I’m excited to share why I believe I’m a strong candidate for the IMT programme.

Throughout my medical training, I’ve consistently strived for excellence. I graduated with a distinction and received several awards, including the elective medal prize in my final year. I’ve also taken the initiative to continue building on my knowledge by sitting for the MRCP in January, which further demonstrates my commitment to achieving high standards in medicine.

I’m passionate about academic research, something that I developed during my intercalated year in physiology which I came top of my year for. I am particularly proud of my work on novel complications of Cystic Fibrosis, which I published and presented internationally in Vienna. This experience not only strengthened my research skills but also deepened my commitment to pursuing academic medicine alongside clinical practice.

In addition to my academic and clinical focus, I’ve taken on leadership and teaching roles to support my colleagues and contribute to the education of medical students and junior doctors. I organized and lead an anatomy teaching programme at medical school and have been actively involved in other leadership roles, including as a BMA LNC member, class representative and mentor for F1 doctors. These positions allowed me to advocate for my colleagues and work towards improving their working conditions, and I’m eager to continue this work in IMT.

I’ve also focused on developing my clinical skills, having carried out advanced procedures such as lumbar punctures and ascitic taps. Participating in medical taster week in ID which has further fuelled my passion for a diagnostic and acute career in medicine. My colleagues find me as an approachable, reliable and valuable team member.

Overall, I’m deeply committed to a career in medicine, and I believe my academic achievements, leadership experiences, and clinical development show that I have the right attributes for IMT. I’m motivated to continue growing as a doctor and contributing to both clinical and academic medicine.”

Question 11

What qualities do you have that make you a good fit for the IMT programme?

Answer 11

Communication skills: I’ve received positive feedback during F1 and F2, particularly in challenging conversations like TEP/DNAR and end-of-life discussions.

Adaptable: My experience in ED, GP, Medicine, and Surgery has helped me understand different patient perspectives and job requirements in various settings. Ensuring clear continuity of care for patients and an understanding of the wider healthcare system, adaptability like this is key for an IMT trainee where pt follow-up and chronic disease management is well within our remit. Additionally, these rotations on non-medical jobs have only increased my desire to persue medicine.

Team working: As an FY doctor, I work closely with the MDT - physios, pharmacists, nurses, other doctors, PAs/ACPs . I’ve received positive feedback in PSGs and TABs for my teamwork and work ethic, and I have also lead audits, teach, and participate in mess football which continuously develop my teamwork and interpersonal skills further

Passionate/enthusiastic: I’m eager to learn and go the extra mile for patients and staff. I’ve sought out learning opportunities, gaining skills like ascitic taps, LPs, and US-guided bloods, for which I’m now competent. I have also sat MRCP part 1 early to feed this passion for clinical knowledge.

Question 12

What are your interests outside of medicine? Do you think these help you perform as an IMT trainee?

Answer 12

My diverse interests outside of medicine, such as running, gym training, and football, contribute to my overall well-being and make me a stronger candidate for an Internal Medicine Training (IMT) role. Running has taught me discipline and perseverance, qualities that are crucial when managing long shifts and complex cases. Completing the Great North Run and planning another race shows my commitment to setting and achieving goals. Regular strength training helps me manage stress, maintain focus, and avoid burnout, which was especially important during my F1-F2 years.

As a keen footballer, I also understand the value of teamwork, which directly translates into better collaboration within the MDT. Playing recreational football with my mess 5-a-side team builds relationships, promotes team morale, and helps me develop effective communication skills, all of which are essential in a high-pressure environment like internal medicine.

I also enjoy building plastic model of war-time planes and tanks, a long term hobbie of mine from childhood with my grandad which I feel greatly help my manual dexterity, key for lumbar punctures and central lines that I would do in IMT!
Overall, my extracurricular pursuits help maintain a healthy work-life balance, support my professional growth, and strengthen my candidacy for IMT.

Question 13

Is work-life balance important and how do you manage stress?

Answer 13

Yes, work life balance is key to preventing burnout, decision fatigue and overall - making clinical mistakes that can be costly in a fast paced environment such as medical wards or the acute take. I find that being organised yet assertive with my time management and role as a foundation doctor has allowed me to ensure I am doing the best for my team and the patients without feeling overwhelmed. I understand the importance of having health ways to deal with stress.

My diverse interests outside of medicine, such as running, gym training, and football, contribute to my overall well-being and make me a stronger candidate for an Internal Medicine Training (IMT) role. Running has taught me discipline and perseverance, qualities that are crucial when managing long shifts and complex cases. Completing the Great North Run and planning another race shows my commitment to setting and achieving goals. Regular strength training helps me manage stress, maintain focus, and avoid burnout, which was especially important during my F1-F2 years.

Furthermore, I find bouldering a key skill taht I enjoy, I enjoy the mental challenge.

Question 14

How has your training to date influenced your decision to apply for IMT?

Answer 14

Since medical school, I’ve always been fascinated by the intricacies of pathophysiology and pharmacology, particularly in relation to medical conditions. As I transitioned into clinical practice, I discovered that the most rewarding aspects of my job are a combination of effective communication and teamwork with the MDT and patients, as well as developing my diagnostic skills and becoming a true generalist is something I am passionate about.

While I’ve gained valuable experience in emergency medicine, GP, and surgery, I found that I wasn’t as clinically satisfied in these specialties compared to my medical rotations. I was always keen to follow the patient journey, diagnose their condition or treat them beyond stabilising them. My taster week in Infectious Diseases reinforced my passion for internal medicine. I realized that being on the acute take, communicating with families and the MDT, conducting clinics, and participating in ward rounds are the aspects of medicine I enjoy the most and where I feel I can make the most impact and get the most satisfaction.

Question 15

Tell us about your publication/presentation.
What was your role in this project? What challenges did you face?

Answer 15

I’ve published two papers, but the one that has been most influential in shaping my passion for research was my study on the effects of triple therapy (elexacaftor, ivacaftor, and tezacaftor—Kaftrio) in cystic fibrosis (CF) patients. My research found a significant rise in lipid levels, particularly total cholesterol and LDLs, in CF patients using this therapy. What made this study novel was that I looked at both diabetic and non-diabetic CF patients and found no significant difference in lipid changes between the two groups using multiple linear regression for sex and diabetes.

This was the focus of my elective, and I completed the entire project from start to finish, which gave me a deep understanding of the challenges in data collection, analysis, and how such findings contribute to the broader scientific community and how I could convey this to this audience. Presenting my research at the European CF Conference in Vienna was both daunting and rewarding. Speaking to a group of experts was intimidating, but it was fulfilling to see them take an active interest in my work. It sparked meaningful conversations about cardiovascular protection for CF patients. Being part of such a ground-breaking shift in CF treatment was incredibly rewarding, and it reinforced my desire to pursue research alongside my clinical work in the future.

Question 16

What your career aspirations are beyond this stage of training?

Answer 16

Key points to include:

• Specialty/specialties considering
• Understanding of application process
• Portfolio work you have already done to prepare for specialty training
• Your enthusiasm about progressing

During F1, I had a rotation in acute medicine, led by the ID consultants at my DGH, which reinforced my desire to pursue this career. I also completed a taster week at a tertiary centre in Newcastle, where I attended various clinics, followed the reg and consultant on-call, and participated in ward rounds. This experience gave me a strong understanding of the role of an ID doctor, and it’s a specialty I am eager to pursue further.

I recognize that ID and GIM is a competitive field with limited training numbers, but I am committed to completing all three years of IMT in order to apply. I’ve also started tailoring my portfolio toward this goal, including being the first author on a letter to the editor in the International Journal of Infectious Diseases and leading an audit on antimicrobial prescribing in pyelonephritis. I’m currently completing the first cycle of this audit under the guidance of the ID consultants.

Additionally, I plan to gain more experience in ID, general medicine and related specialties during IMT to help work towards my long-term goal.

Question 17

Tell us about a difficult experience that you have had in your training. How did this make you feel? What steps did you take to manage this?

Answer 17

During my second F1 rotation in the ED, the department had to adjust its structure due to hospital pressures. One F1 was assigned to care for patients who had been admitted to a medical ward after acute treatment, while a medical registrar was usually available to assist with unwell patients in ED. However, during one shift, there was no registrar cover, and I ended up with 31 patients, many of whom were still unwell and hadn’t yet had a post-take ward round. Some had only been seen by other junior colleagues.

I had to manage a large number of unwell and often frustrated patients and families, as many had been in the ED for 12-18 hours. With an ever-growing list of tasks to prioritize, I found it particularly challenging to manage my time effectively. Without direct senior support, I questioned many of my medical decisions, which now I would feel more confident about. Decision fatigue set in as the 12-hour shift wore on, and I began to feel overwhelmed.

Recognizing the need for support but also anxious about who to turn to, I left the ED to contact the medical registrar on the AMU ward. I explained the situation and was relatively assertive for my junior grade and asked politely for additional assistance, which they kindly provided. I also raised the issue through the junior doctor forum and BMA LNC meetings, which led to changes in the system. As a result, medical SHOs, usually F2s, now help manage this system with registrar cover either on-site or by phone.

While the system is still not perfect due to ongoing strain on the healthcare system, these changes have made it safer for both colleagues and patients. Patient flow has improved, as they receive a medical post-take more quickly instead of waiting in ED for hours, and F2s and above now have the opportunity to take a more active role in clerking and supporting their F1 colleagues. I’m proud to have contributed to making this change, improving safety and efficiency for both staff and patients.

Question 18

What is your biggest achievement?

Answer 18

I would say my biggest achievement was my study on the effects of triple therapy (elexacaftor, ivacaftor, and tezacaftor—Kaftrio) in cystic fibrosis (CF) patients. My research found a significant rise in lipid levels, particularly total cholesterol and LDLs, in CF patients using this therapy. What made this study novel was that I looked at both diabetic and non-diabetic CF patients and found no significant difference in lipid changes between the two groups using multiple linear regression for sex and diabetes.

This was the focus of my elective, and I completed the entire project from start to finish, which gave me a deep understanding of the challenges in data collection, analysis, and how such findings contribute to the broader scientific community and how I could convey this to this audience. Presenting my research at the European CF Conference in Vienna was both daunting and rewarding. Speaking to a group of experts was intimidating, but it was fulfilling to see them take an active interest in my work. It sparked meaningful conversations about cardiovascular protection for CF patients. Being part of such a ground-breaking shift in CF treatment was incredibly rewarding, and it reinforced my desire to pursue research alongside my clinical work in the future.

Question 19

What do you like least about IMT/speciality?

Answer 19

One aspect of IMT and internal medicine that can be challenging is the sheer breadth of knowledge required. The specialty covers a wide range of conditions, and staying up to date with advancements in multiple areas can be overwhelming at times. Additionally, the pressure of managing acutely unwell patients and coordinating with multiple specialties can be stressful, particularly when resources are stretched. However, I view these challenges as opportunities for growth and development. Despite the difficulties, I’m drawn to the variety of cases and the ability to make a tangible difference in patient care, which keeps me motivated to pursue this path.

Question 20

Where do you see yourself in 10 years?

Answer 20

I hope to have successfully completed IMT, take a year out of training to work abroad in Africa like some of my IMT 3 colleagues have. By doing this I would hope to build knowledge and experience of tropical diseases for my career in ID and take this time to further build on my portfolio and develop my research, clinical and teaching skills through a PG cert in teaching, the diploma of hygiene and tropical medicine.

Afterwards, I would hope to use this experience to apply for ID + GIM and be well on my way to CCT. Hopefully working in a tertiary centre but would happily work in a DGH as I have enjoyed my time at one as an FY doctor and med student

Question 21

What is your biggest weakness?

Answer 21

I feel my biggest weakness is public speaking. I am a confident extrovert within a team but really struggle with public speak which somewhat hampers by ability to present research at meets and conferences. I have gradually improved in this aspect though and have carried out some departmental teaching in general surgery in front of 10-20 people which does help develop my confidence in public speaking and I am always looking for new opportunities to build on this.

Question 22

How would you describe your communication skills?

Answer 22

One of my strengths is communication, which I thoroughly enjoy and consider a key part of my role. During FY1 and FY2, I gained significant experience managing acutely unwell patients and delivering difficult news, such as explaining deteriorating conditions or new cancer diagnoses. I’ve also had the opportunity to lead challenging conversations, such as DNAR/TEP discussions, where I focused on educating patients and addressing their concerns with care, empathy and attention. Additionally, I have experience in conflict resolution, particularly with patients who are delirious or under the influence. I’ve learned how to de-escalate situations effectively while ensuring the safety of both patients and staff. These skills have been highlighted in mini-CEXs, TABs, and PSGs, where I’ve received positive feedback.

Question 23

Describe a time where you communicated poorly

Answer 23

A patient in A&E was withdrawing from a heroin overdose. After administering naloxone, their condition improved, but they had not received methadone that day. I explained that we couldn’t source it due to the time of day and the pharmacy being closed. During this time, the patient made a racist comment towards the nurse. While I told the patient not to say that, I wasn’t firm enough in my response. The patient made another racist remark shortly after, which a consultant overheard and intervened. The consultant rightly and firmly explained the hospital’s zero-tolerance policy on racism, and the patient was subsequently discharged.

Looking back, I wish I had been more assertive in addressing the situation and stood up more firmly for my colleague. I regret that my response may have conveyed that I didn’t view the incident as serious enough, even though I was angered by what was said. Since then, I have learned from this experience and have become more assertive in similar situations, using my role as a doctor and team leader to ensure both patient and staff safety.

Question 24

What makes a good team player?

Answer 24

A good team player in medicine is someone who collaborates effectively to ensure safe, high-quality patient care. Key qualities include:

Communication – Clear, respectful, and timely handovers and discussions with colleagues and patients.
Reliability – Completing tasks efficiently, supporting team members, and asking for help when needed.
Adaptability – Adjusting to changing clinical situations and different team dynamics.
Leadership & Initiative – Taking responsibility when required while recognizing and valuing others’ contributions.
Empathy & Support – Encouraging colleagues and fostering a positive, inclusive work environment.

Question 25

What makes a good team leader?

Answer 25

Clear Communication: "A good team leader communicates clearly and effectively. In a medical context, this means ensuring that team members understand their roles, the goals, and how to prioritize tasks. It's also essential to provide clear instructions during patient care and to foster open communication within the team." Empathy and Support: "A good leader shows empathy toward team members, especially in stressful situations. Being approachable and understanding helps maintain morale and ensures that team members feel supported. I believe that building trust and offering help when needed are key aspects of a strong leader." Decisiveness: "A team leader must be able to make quick, informed decisions, especially in high-pressure situations. This requires being confident in your judgment, but also being open to input from others to ensure the best outcomes for patients and the team." Adaptability: "Medical teams often face unexpected challenges, and a good leader adapts quickly. They assess the situation, remain calm, and help guide the team through uncertainty. Flexibility in leadership helps maintain team effectiveness, even in unpredictable environments." Fostering Growth: "A good team leader mentors others, providing opportunities for learning and development. This includes offering constructive feedback, encouraging critical thinking, and creating a safe environment where team members can ask questions and grow in their roles." Lead by Example: "Finally, a good leader leads by example. They demonstrate professionalism, clinical excellence, and a positive attitude. This sets a standard for the team and motivates others to follow suit."

Question 26

Give an example of when you were a good leader

Answer 26

During my final year of medical school, I co-founded the Phoenix Project, a program designed to help Year 1 students who had failed their formative OSPEs prepare for their resits. As president, I led a team of senior students in organizing 12-week, structured teaching sessions. I ensured we created a supportive, focused learning environment and was always available to answer questions or offer guidance. By maintaining open communication, adapting the teaching methods based on feedback, and offering constructive support, we helped 11 out of 12 students pass their resits. This experience taught me the importance of empathy, clear direction, and adaptability in leadership.

Question 27

How do you organise your workload?

Answer 27

I typically manage my tasks by writing lists, prioritizing them based on clinical urgency—something I’ve naturally developed as a foundation doctor. I also maintain a separate list for each ward, tracking sick patients and checking their online documentation/observations every hour, unless I'm called to review them. When overwhelmed to the point where patient safety may be compromised, or when I need assistance with specific tasks, I always reach out for senior support, which is usually necessary and well-received.

Question 28

Tell us about your teaching experience.

Answer 28

During my final year of medical school, I served as president of the Peer Assisted Learning scheme, where Year 4 and 5 students taught younger students anatomy and clinical skills. Along with the vice president, a fellow Year 5 student, I co-founded the Phenoiz Project, aimed at supporting Year 1 students who had failed their formative OSPEs and preparing them for resits at the end of the semester. The project consisted of 12 two-hour weekly sessions over four months, covering each body system with active questions, study break rooms, and models. Students practiced OSPE-style questions in the final session. Out of the 12 students, 11 passed their summative OSPE resit and avoided repeating Year 1. This experience deepened my passion for teaching. I learned the importance of being approachable and empathetic to help students develop self-reflection, active learning, and professional growth through constructive feedback. The adaptability required was a challenge, but we received positive feedback, and the students were eager for us to continue running it in their second year. Unfortunately, we moved on to F1 before we could. The project still runs at Aberdeen University, and the VP and I presented it at the Anatomical Society’s Winter Conference, encouraging other medical and anatomy schools to adopt peer learning in their curriculum.

Question 29

Give some qualities of a good teacher.

Answer 29

A good teacher for junior doctors and medical students is patient, approachable, and empathetic, fostering a supportive learning environment. They have a deep knowledge base and are skilled at explaining complex concepts in a clear, understandable manner. They encourage active learning, critical thinking, and self-reflection, providing constructive feedback that helps with professional growth. A good teacher leads by example, demonstrating best practices, clinical decision-making, and effective communication. They are adaptable, tailoring their teaching to the learner's needs and learning style, and they create opportunities for hands-on experience, ensuring their students feel confident and supported in their development. I have shown all of these particular qualities in my PALS teaching called the phoenix project when...

Question 30

What is a clinical audit (steps).

Answer 30

Planning: Establishing the audit scope, objectives, question and timeline. Fieldwork: Gathering evidence through data collection Analysis: Evaluating the collected data to identify issues, risks, and discrepancies against guidelines. Reporting: Presenting findings, conclusions, and recommendations to management or team, highlighting any weaknesses or areas for improvement. Usually through posters/powerpoints. Follow-up: Ensuring that corrective actions are implemented and evaluating their effectiveness by reauditing.

Question 31

What common problems are associated with the audit process?

Answer 31

Common problems in the audit process include insufficient access to data, lack of cooperation from staff, incomplete or inaccurate records, limited time or resources, and resistance to change. These issues can hinder thorough evaluation, delay findings, and reduce the effectiveness of recommendations for improvement.

Question 32

What is research governance?

Answer 32

Research governance refers to the framework of policies, systems, and regulations that ensure research is conducted ethically, safely, and to high standards. It involves overseeing the planning, conduct, and reporting of research to ensure compliance with legal, ethical, and scientific guidelines. Key aspects include protecting participant rights, maintaining data integrity, ensuring transparency, and upholding accountability. Research governance promotes adherence to best practices, minimizes risks, and fosters responsible and ethical research. It also involves the oversight of funding, approval processes, and ensuring that research outcomes are disseminated appropriately, contributing to advancements in knowledge while maintaining public trust.

Question 33

What is clinical governance?

Answer 33

Clinical governance is a framework used in healthcare to ensure that high-quality care is provided consistently and safely. It involves systems and processes to monitor, evaluate, and improve healthcare services, focusing on patient safety, clinical effectiveness, patient experience, and professional development. Key components include risk management, quality assurance, staff training, and accountability. The goal of clinical governance is to create a culture of continuous improvement, reduce errors, and enhance patient outcomes by ensuring that healthcare professionals adhere to best practices and standards. It fosters transparency, responsibility, and collaboration within healthcare organizations.

Question 34

What is evidence-based medicine

Answer 34

Evidence-Based Medicine (EBM) is the integration of: Best Available Evidence – Using high-quality research, such as randomized controlled trials and systematic reviews. Clinical Expertise – Applying professional judgment and experience to interpret and implement evidence. Patient Values & Preferences – Ensuring care aligns with individual needs and circumstances. EBM improves patient outcomes, enhances decision-making, and ensures treatments are safe, effective, and up to date. In practice, it involves critically appraising research, applying guidelines, and adapting to clinical situations. If have to give an example - could be patient with acute pancreatitis and IECOPD. Held off giving her abx until PCT, COVID and flu swab and blood cultures and sputum cultures were done and back as was not keen to treat exacerbation due to long-term abx resistance with pancreatitis. Still opted not to give abxs in the end as flu positive.

Question 35

How do you analyse a paper?

Answer 35

The journal impact factor could be key. Abstract – Identify key findings and relevance. Introduction – Assess the research question, hypothesis, and background context. Methods – Evaluate study design, sample size, controls, randomised? and biases. Peer reviewed? Results – Examine data presentation, statistical analysis, and significance. Discussion – Assess interpretations, limitations, and whether conclusions align with results. References – Check sources for credibility and relevance. Overall Impact – Consider reliability, real-world application, and potential biases using risk of bias tool and caspr checklist for formal assessment.

Question 36

Give an example of when you were a good team player.

Answer 36

During my foundation year, I was part of a multidisciplinary team managing a cardiac arrest patient on the ward. The patient had had a chest drain put in and had bled afterwards and then rapidly deteriorated. From this, the patient underwent a clamshell thoracotomy as a bedside ECHO showed a significant pericardial effusion. Understanding this was out with my competencies and the anaesthetic and surgical team had arrived. I took the responsibility for monitoring the patient’s clinical parameters and administering medications, I noticed that the senior nurse was struggling with coordinating other aspects of care. I recognized the importance of teamwork, so I stepped in to assist by helping with documentation and communicating updates to the rest of the team for when to give IV adrenaline and amiodarone and rhythm checks. By doing so, I ensured that the patient received timely care while easing the nurse’s workload. Unfortunately, the patient died but the experience reinforced the value of collaboration and mutual support in healthcare settings.

Question 37

Ix for abdo pain

Answer 37

Bloods - VBG, CRP, LFTs, U+Es, FBC, Amylase, BHCG Scans - US pelvis/CT

Question 38

Discussions for acutely unwell patients

Answer 38

TEP/DNAR Family updates Datix if required

Question 39

SVT management

Answer 39

ABCDE Unstable - 2222 cardioversion Stable - ABCDE, valsalva, med reg, 6mg adenosine, 12mg adenosine

Question 40

Clinical signs of IBD

Answer 40

Athropathy Pyoderma gangrenosum Erythema nodosum Anterior uveitis

Question 41

Key competencies of IMT

Answer 41

3 main areas in portfolio - Competencies in practice - outcomes you need to pass Clinical experience - experience managing a range of conditions Clinical procedures

Question 42

How have you demonstrated your commitment to IMT training in your early career?

Answer 42

MRCP Part 1 Taster week Clinical procedures - LP and ascitic taps

Question 43

Give an overview of your achievements to date which are most relevant to your application to be a trainee in internal medicine.

Answer 43

"Hello, my name is Ronan, and I’m excited to share why I believe I’m a strong candidate for the IMT programme. Throughout my medical training, I’ve consistently strived for excellence. I graduated with a distinction and received several awards, including the elective medal prize in my final year. I’ve also taken the initiative to continue building on my knowledge by sitting for the MRCP in January, which further demonstrates my commitment to achieving high standards in medicine. I’m passionate about academic research, something that I developed during my intercalated year in physiology which I came top of my year for. I am particularly proud of my work on novel complications of Cystic Fibrosis, which I published and presented internationally in Vienna. This experience not only strengthened my research skills but also deepened my commitment to pursuing academic medicine alongside clinical practice. In addition to my academic and clinical focus, I’ve taken on leadership and teaching roles to support my colleagues and contribute to the education of medical students and junior doctors. I organized and lead an anatomy teaching programme at medical school and have been actively involved in other leadership roles, including as a BMA LNC member, class representative and mentor for F1 doctors. These positions allowed me to advocate for my colleagues and work towards improving their working conditions, and I’m eager to continue this work in IMT. I’ve also focused on developing my clinical skills, having carried out advanced procedures such as lumbar punctures and ascitic taps. Participating in medical taster week in ID which has further fuelled my passion for a diagnostic and acute career in medicine. My colleagues find me as an approachable, reliable and valuable team member. Overall, I’m deeply committed to a career in medicine, and I believe my academic achievements, leadership experiences, and clinical development show that I have the right attributes for IMT. I’m motivated to continue growing as a doctor and contributing to both clinical and academic medicine."