A Complete Guide to IMT (Internal Medicine Training) Applications

The Internal Medicine Training (IMT) program is essential for UK doctors wishing to specialise in internal medicine, helping them improve professionally. Usually focused on junior doctors in Foundation Year 2 (FY2) or Senior House Officer (SHO), IMT is a strict, 3-year program designed to prepare trainees to become specialist medical registrars.

Internal medicine covers a wide range of specialities, and IMT guarantees that you gain both a strong theoretical understanding and the practical skills required to thrive as a specialist. It’s rather competitive. So, everyone who wants to participate in the program should know how to best proceed with the application process.

This guide is here to support your application journey for IMT. It includes important parts of the application, tips to improve your score, and advice on preparing for the interview. We’ll also introduce Medset’s IMT Interview Course to help you during the application process, as well as our Train the Trainers course to improve your teaching skills, which is useful for IMT applications and career development.

Table of Contents

A Complete Guide to IMT (Internal Medicine Training) Applications

What’s New for IMT 2025? Key Changes to the Application Process

1. Changes in the Scoring System

Key Points of Change:

2. Refined Focus on Publications and Research

Detailed Changes:

3. Interview Process Changes

Key Changes in the Interview Process:

Why Do These Changes Matter?

Recruitment Timeline for IMT 2025

The IMT Application Process: Step-by-Step Breakdown

Step 1: Eligibility Criteria

Eligibility Requirements:

Step 2: Application Form and Scoring System

Key Sections of the IMT Application Form:

1. Postgraduate Qualifications
2. Publications and Research Contributions
3. Teaching Experience
4. Clinical Experience

Step 3: Scoring and Ranking

How the Scoring Works:

Maximising Your IMT Application: Key Areas to Focus On

1. Postgraduate Qualifications
2. Publications and Research
3. Teaching Experience
4. Clinical Experience

The IMT Interview: What to Expect

Types of Questions:

How to Prepare:

Scoring for the IMT Interview

IMT Interview Scoring Breakdown

How Medset’s Courses Can Help You Succeed in IMT Applications

IMT Interview Course

Train the Trainers Course

Conclusion

What’s New for IMT 2025? Key Changes to the Application Process

For junior doctors intending to specialise in internal medicine within the NHS, the Internal Medicine Training (IMT) program is among the most sought-after career growth options. 

The application procedure exhibits slight changes on an annual basis to reflect changes in healthcare priorities, academic developments, and clinical requirements. For 2025, the IMT application cycle introduces some significant changes that could impact how candidates approach their applications.

1. Changes in the Scoring System

One of the most notable changes for IMT 2025 is the refinement of the scoring system, particularly in relation to qualifications and experience that contribute to your overall application score. In previous years, leadership roles and management skills carried considerable weight, but for 2025, these points have been reduced in favour of more directly relevant clinical experiences.

Key Points of Change:

• Leadership and Management Skills Removed: In the past, candidates were awarded points for leadership roles, such as being a clinical lead or having experience in management roles. These skills were deemed valuable but now appear to be secondary to clinical and academic experience.
• Increased Focus on Clinical Experience: Direct patient care and clinical expertise now have more weighting . Candidates with complex clinical experience, especially in general internal medicine, will gain a great advantage from this shift. Your score will now depend critically on a range of rotations, outpatient clinics, and inpatient treatment experience.
• Teaching and Educational Roles: Teaching experience, including jobs like teaching medical students, running clinical teaching seminars, and participating in educational leadership, has become increasingly important. In fact, given the NHS’s surging emphasis on medical education and faculty development, your application will now mostly reflect your teaching experience.

The changes emphasise that your application will now be driven mostly by clinical experience and education-oriented roles, aligning more closely with the present NHS requirements for well-rounded doctors who are able to contribute to both patient care and medical education.

2. Refined Focus on Publications and Research

For 2025, the IMT application process places a greater emphasis on academic achievement,  particularly publications and research contributions. This shift underscores the NHS’s growing commitment to academic excellence and its recognition that research-based skills are integral to the development of future clinical leaders.

Detailed Changes:

• Increased Points for Publications: Candidates who have authored peer-reviewed publications in reputable journals will receive a higher score. This includes first-author papers, which are especially valuable, however,  co-authorship on high-quality publications will also contribute positively to your application.
• Research Posters and Presentations: The IMT scoring system now rewards those who present their research at conferences, particularly if they have contributed to research posters or oral presentations. Academic presentations at national or international events related to internal medicine or other related specialties will provide an advantage. This change encourages applicants to be proactive in both research production and its dissemination to the broader medical community.
• Academic Awards and Grants: Candidates with involvement in research grants, fellowships, or awards for research may also gain additional points. This rewards those who actively engage in advancing the academic standing of their speciality, reinforcing the value of research contributions to both clinical practice and teaching.

3. Interview Process Changes

The IMT interview process has been adjusted to reflect a more holistic assessment of a candidate’s capabilities. Whereas previous cycles focused mostly on academic performance and portfolio assessments, the 2025 process now combines more practical assessments and clinically orientated questions. This switch seeks to evaluate applicants’ performance in a high-pressure, fast-paced clinical environment.

Key Changes in the Interview Process:

• Practical Assessments: A practical evaluation assessing a candidate’s response to real-world clinical environments will be part of the IMT interview for 2025. You may be required to show how you would treat an acutely deteriorating patient, resolve a clinical emergency, or work with a multidisciplinary team on difficult problems. Two areas under scrutiny will be patient safety and clinical decision-making.
• Increased Focus on Communication Skills: Although clinical skills are the first priority, interviewers will also give your communication skills great emphasis. Candidates will be asked to demonstrate how they would interact with colleagues and patients in various settings, including difficult talks with patient families, giving bad news, or handling clinical setting conflicts. Your capacity to work cooperatively is equally as crucial as your clinical knowledge, given the higher level of medical cooperation and patient interactions.
• Structured Behavioural Interviews: The behavioural part of the interview will have more of a focus upon personal qualities such as resilience, professionalism, flexibility, and  leadership abilities when under pressure. You may be asked about your experience managing stress, handling difficult situations, or exerting professionalism in demanding clinical or team environments.

Why Do These Changes Matter?

The changes for IMT 2025 indicate a shift towards a more clinical and educationally focused assessment process. The reduction in emphasis on management and leadership roles points towards a broader recognition that clinical expertise and the ability to teach others are more fundamental in the early stages of specialist training. The increased focus on publications and research reflects a deeper commitment to advancing evidence-based medicine within the NHS.

For candidates applying to IMT 2025, these changes mean that it’s essential to adapt your application strategy accordingly. If you have limited research experience, consider seeking out opportunities to collaborate on academic projects, present at conferences, or engage in clinical audits.

Furthermore, if you’ve been involved in teaching roles, be sure to showcase them clearly on your application. Consider courses like Medset’s Train the Trainers to enhance your educational skills and gain CPD points, which can support your application by making your teaching credentials more robust.

Recruitment Timeline for IMT 2025

We suggest you get familiar with the timeline for the internal medicine training recruitment:

The IMT Application Process: Step-by-Step Breakdown

The IMT application is an extremely competitive and comprehensive process; applicants must, therefore, carefully prepare and maximise every aspect in order to stand out. Here is an in-depth breakdown of the process which will  help you at every step of the way.

Step 1: Eligibility Criteria

Before you begin your application, it’s essential to ensure that you meet the basic eligibility criteria for IMT. These criteria are set out by the IMT recruitment body and represent the foundational qualifications and experience needed to apply.

Eligibility Requirements:

• Completion of Foundation Year 1 (F1) and Foundation Year 2 (F2): You must have successfully completed F1 and F2 training (or their equivalent in another country) by the time the IMT programme starts. For international applicants, Foundation Year equivalence will need to be verified.
• Clinical Experience: Usually gained during your F1 and F2 rotations, you must have at least two years of clinical experience in a licensed medical environment. You need to gain important skills such as patient management, clinical decision-making, and team collaboration, as well as wide knowledge of several medical specialities throughout this period.
• Eligibility to Work in the UK: IMT is aimed at doctors who are eligible to work in the UK, which typically means UK citizenship or the right to work under  current immigration and employment laws. Ensure you have the necessary documentation before applying.

These are the fundamental criteria, but it’s important to check the official IMT recruitment site for any updates or specific requirements that may apply in the current cycle.

Step 2: Application Form and Scoring System

Whether you’re accepted for an interview or not, the IMT application form is where you will list your credentials, experience, and accomplishments. The form assesses applicants in multiple key areas; each section adds to your total application score.

Key Sections of the IMT Application Form:

1. Postgraduate Qualifications

This section includes any additional academic qualifications beyond your medical degree, such as an MSc, PhD, or additional diplomas. For IMT 2025, postgraduate qualifications will still earn you  points, however the emphasis has shifted somewhat away from these achievements in favour of clinical and research experience.

Relevance matters—qualifications in medical education, clinical specialties, or research are highly valued. However, don’t focus solely on postgraduate qualifications if you have stronger achievements in other areas (e.g., clinical experience or publications).

2. Publications and Research Contributions

Publications are one of the most heavily weighted aspects of the IMT application process. High-quality, peer-reviewed journal papers (especially if you are the first author) will greatly strengthen your application. These contributions demonstrate your participation in evidence-based medicine and your ability for academic excellence.

Journals are scored on research quality and impact, not quantity. An original research article published in a credible publication, for instance, has greater weight than a case report or letter to the editor.

Presenting research posters or undertaking  oral presentations at national or international conferences will also count towards points. Participating in academic research projects (clinical, laboratory, or instructional) will increase your credibility as a candidate.

3. Teaching Experience

In IMT 2025, teaching experience plays a vital role. The ability to teach and mentor junior doctors and medical students is increasingly seen as a key skill for internal medicine specialists. This can include:

• Clinical teaching: Teaching medical students or junior doctors during ward rounds or clinic sessions.
• Tutorials and lectures: Delivering formal teaching sessions to students or colleagues.
• Involvement in teaching programmes: Contributing to training programmes for foundation year doctors, junior doctors, or postgraduates.

Medset’s Train the Trainers course can help enhance your teaching skills and provide valuable CPD points, which are increasingly important for boosting your application and ensuring that your teaching experience is recognised for its high quality.

Teaching roles also demonstrate leadership and organisational skills, as these roles often involve planning, delivering, and evaluating educational sessions.

4. Clinical Experience

This section assesses your hands-on patient care experience. You will be required to go into great depth on your clinical rotations, the range of medical specialities you have encountered, and your particular duties within those rotations.

In clinical environments, leadership will count for extra points. For example, make sure your application highlights your expertise in leading different teams or as a clinical lead for a team.

The IMT program is based on clinical skills, hence highlighting the variety of clinical situations you have come across, from emergency care to long-term chronic disease management. Emphasise any experience in general internal medicine, which forms the cornerstone of IMT.

Step 3: Scoring and Ranking

Once you’ve submitted your IMT application, your form will be assessed and scored based on the points system for each of the sections mentioned. The scoring system has been designed to reward candidates with a broad range of experience and achievements across key areas, particularly clinical experience, publications, and teaching.

How the Scoring Works:

• Total Points: Each section of the application form is assigned a maximum number of points, and your overall score is a combination of points from all areas.
• Ranking: After scoring, candidates are ranked based on their total score. The higher your score, the better your chances of receiving an offer  to interview. For example, a candidate with a high score in clinical experience, publications, and teaching experience is likely to rank higher and, therefore, have a better chance of being selected for an interview.
• Cut-off Scores: The exact cut-off score for interviews can vary from year to year, depending on how competitive the applicant pool is. Therefore, to increase your chances of success, aim to maximise your score in every section.

Maximising Your IMT Application: Key Areas to Focus On

To make your IMT application as competitive as possible, focus on the following key areas:

1. Postgraduate Qualifications

While postgraduate qualifications, such as MSc, PhD, or medical diplomas, carry fewer points for IMT 2025, they still provide valuable academic credibility. These qualifications demonstrate a commitment to further learning and academic development. However, if you lack these qualifications, focus on other areas, such as publications and clinical experience.

• Tip: Ensure that any postgraduate qualifications are clearly listed in your application, even if they carry fewer points.

2. Publications and Research

Publications remain one of the most highly weighted components of the IMT application. Peer-reviewed articles, particularly as a first author, will boost your score. Research in internal medicine or acute care shows your capacity for critical thinking and scientific contribution.

• Tip: If you haven’t yet published, consider contributing to research projects, clinical audits, or case reports to gain valuable experience.

3. Teaching Experience

Teaching has become  an increasingly important aspect of IMT applications. Experience in teaching medical students, mentoring junior doctors, or running clinical workshops enhances your profile. Enrolling in CPD-accredited courses like Medset’s Train the Trainers course can further demonstrate your commitment to education and mentoring.

• Tip: Document all teaching roles and consider additional training in medical education, which will contribute both to your CV and your CPD points.

4. Training in Teaching

Training in teaching is an intrinsic part of the IMT application, rewarding candidates who have completed structured courses in medical education. Beyond standard teaching experience, obtaining additional qualifications in teaching enhances credibility and illustrates  a strong commitment to medical education.

• Tip: Consider obtaining a higher qualification in teaching (e.g. PG Cert, PG Diploma) or taking an accredited teaching course (with 6 or more hours of live teaching time) to strengthen your application. Participating in faculty-led training programs and structured mentorship initiatives can further highlight your dedication to medical education.

5. Clinical Experience

Clinical experience is the foundation of your IMT application. A variety of clinical rotations, especially in internal medicine, emergency medicine, or acute care, demonstrates your readiness for the demands of IMT. Emphasising complex cases, leadership in clinical teams, and decision-making skills will help your application stand out.

• Tip: Ensure detailed documentation of your clinical rotations, highlighting challenging cases and your role in multidisciplinary teams. Engage in leadership roles within clinical settings, such as supervising junior doctors, leading ward rounds, and collaborating with other medical teams.

6. Quality Improvement (QI)

Participation in Quality Improvement (QI) projects is a crucial aspect of the IMT application; demonstrating your ability to analyze and improve healthcare processes using structured methodologies. Engaging in multiple QI initiatives, contributing to healthcare innovations, and implementing process improvements will strengthen your application.

• Tip: Engage in PDSA (Plan-Do-Study-Act) cycles or similar methodologies, ensuring you actively contribute to all stages of a QI project. Consider leading a project, collaborating with multidisciplinary teams, and ensuring measurable outcomes that can be referenced in your application.

The IMT Interview: What to Expect

If your application is successful, you’ll be invited for an IMT interview. This is where you’ll be assessed on your clinical knowledge, communication skills, and professionalism.

Types of Questions:

• Clinical Scenarios: You’ll be presented with a clinical situation and asked to explain how you would manage the patient. Interviewers will analyse your approach to diagnosis, treatment, and communication.
• Communication Skills: You may be asked to demonstrate how you communicate with patients, colleagues, or families. This is a critical skill in any medical profession.
• Professionalism: Expect questions that explore your ethics, leadership ability, and how you handle pressure or difficult situations.

How to Prepare:

• Stay updated on the latest clinical guidelines and protocols.
• Practice communication techniques, especially when breaking bad news or discussing difficult topics with patients.
• Medset’s IMT Interview Course can provide mock interviews, scenario-based questions, and expert feedback to help you prepare for this crucial step. The course is designed to enhance your interview confidence, communication, and clinical reasoning skills.

Scoring for the IMT Interview

The IMT interview consists of six scored areas, with each interviewer assigning a score from 1 to 5. The total raw score is then weighted, giving greater emphasis to Ethical, Professionalism & Governance, Clinical Scenario – Diagnosis/Management, and Communication.

Candidates must focus on these higher-weighted areas to maximize their scores, as they significantly influence the final ranking.

IMT Interview Scoring Breakdown

The interview has two stations, each containing different question types. Here’s how scoring is structured:

Since sections Ethical & Professionalism, Clinical Scenario – Diagnosis/Management, and Communication are weighted more heavily, candidates should pay extra attention to preparing for these topics.

How Medset’s Courses Can Help You Succeed in IMT Applications

Medset offers targeted training to enhance your IMT application, focusing on key areas such as interview preparation, teaching skills, and professional development.

IMT Interview Course

Medset’s IMT Interview Course is tailored to help you succeed in your interview by offering mock interview sessions, scenario-based training, and detailed feedback from experienced medical educators. This course is the perfect tool to fine-tune your clinical knowledge and interview technique, ensuring that you stand out to interview panels.

Train the Trainers Course

The Train the Trainers course by Medset is a CPD-accredited programme designed to develop your teaching skills, making it essential for improving your application for IMT or any other specialty training. Recognised for portfolio development, specialty interviews, and CCT purposes, this course will add value to your CV by demonstrating your dedication to medical education and clinical teaching.

Whether you’re teaching medical students, mentoring juniors, or involved in research or quality improvement, Medset’s Train the Trainers course is an ideal course for helping develop and evidence teaching skills and advancing your career.

Conclusion

The IMT application process can be competitive, but with the right preparation and focus, you can significantly improve your chances of success. By carefully crafting your application, gaining valuable clinical and teaching experience, and preparing thoroughly for your interview, you’ll be in the best possible position to secure a spot within the IMT programme.

Consider enhancing your application with Medset’s IMT Interview Course for expert training and insights, and improve your teaching portfolio with the Train the Trainers course—both being designed to support your career progression in the NHS and beyond.

Good luck with your IMT application, and remember, preparation is the key to success!