Acute and General Internal Medicine

Training programme director: Ian Reckless

Background
This is a 3 to 5 year training programme (entry at ST3) leading to CCT in General and / or Acute
Internal Medicine. Training takes place in up to five hospitals across the Oxford Deanery. Trainees
choose to follow the AIM 2009 curriculum and / or the GIM 2009 curriculum (4 and 3 years
respectively) or dual training can be undertaken over 5 years. If dual accrediting, up to 12 months
of approved out of programme experience can be counted.

Trainees (LAT) following the GIM 2009 curriculum (with or without AIM 2009) can transfer credit for
their GIM experience should they subsequently take up an NTN in another dual-accreditation
specialty programme.

Trainees will undertake posts in acute general medicine (AGM) and intensive care medicine at the
John Radcliffe Hospital, and typically in two or three other centres (listed below).

The training programme has particularly strong links with intensive care medicine. Previous
graduates of the scheme have gone on to work not only in acute medicine but also in intensive
care medicine and stroke medicine (with others combining their clinical work with medical
journalism, academia and healthcare management).

Posts
AGM John Radcliffe Hospital
AGM operates traditional consultant-led firms as opposed to triage and transfer. Patients have
continuity of care, being admitted, managed and discharged by a single firm. There are no
resident acute physicians on the Emergency Assessment Unit but the on-take physicians provide
approximately 12h consultant presence each day. Registrars are on-call with their firm 1 in 4 over a
period of 8 weeks, before spending 4 weeks on leave and undertaking night duties. Annual leave is
fixed in the rota. Banding is presently 1A (50%).

ITU John Radcliffe Hospital

Registrars spend at least 3 months in ITU gaining basic competencies and are always on duty with
an airway competent senior trainee. Banding is presently 1A (50%).

AGM - Horton Hospital, Banbury

Eight consultant firms operate at the Horton Hospital with a physician of the day model and triage
to the care of ward-based teams. Registrars are typically attached to a firm specialising in general
medicine or elderly care. 1 trainee from the scheme works in Banbury at any point in time and
banding is presently 1A (50%).

Wexham Park Hospital, Slough

An acute medicine model with 4 dedicated acute physicians operates at Wexham Park with triage
from the AMU to the care of ward-based teams. Registrars are attached to firms specialising in
cardiology, respiratory medicine and acute medicine. 3 trainees from the scheme work in Wexham
at any point in time. Banding is presently 1B (40%).

Milton Keynes General Hospital

An acute medicine model with dedicated acute physicians operates in MK with triage from the CDU
to the care of ward-based teams. Registrars are attached to firms specialising in rheumatology and
acute medicine. Particular opportunities exist to develop expertise in ambulatory care and VTE
follow-up clinics. 2 trainees from the scheme work in Milton Keynes at any point in time and
banding is presently 1B (40%).
Stoke Mandeville Hospital, Aylesbury
An acute medicine model operates with the physician of the day triaging patients from AMU to the
care of ward-based teams. The registrar from this scheme is attached to a firm specialising in
gastroenterology and 1 trainee from the scheme works in Stoke at any point in time. Banding is
presently 1A (50%).

Teaching
Curriculum based training sessions take place in Oxford each month for an extended half day and
a wide variety of educational activities are available in all the hospitals on the rotation.

Sept 2011