1. Federation of the Royal Colleges of Physicians and JRCPTB Shape of Training

2. The vision is: Consultant Physician in (specialty) and Internal Medicine The vision is not: Specialist in General Internal Medicine (potentially unsafe, and unpopular with work pressure and gaps)

3. Time for Training cannot be shorter Internal medicine is complex, high pressure and requires high quality training. Will take 4 years for Internal Medicine. MRCP remains essential To include acute take competences and on- going service thereafter Will require review of current CMT & Registrar roles Specialist competence takes at least 3 years

4. Possible delivery model for a 7 year program CMT becomes Internal Medicine 4 years of internal medicine – 3 years before speciality selection – 6 x 6 month posts. – 3rd year ‘junior registrar’ role 4 years speciality training to include the 4 th year of internal medicine. – with contribution to acute take

5. Credentialing must be post CST workforce planned/funded/speciality approved and assessed delivered well, due to complexity of many potential credentials centrally resourced never left to the vagaries of the market/employers Organised with good governance and equality of standards