1. GIM Requirements and PYA process
Dr Ursula M Davies
General Internal Medicine TPD HEKSS
External PYA Assessor RCP GIM SAC

2. Career pathway for dual CCT
FY2
MRCP
Core Medical Training
Selection
60 months to completion minimum
GIM
Specialty
Work Placed Based Assessments
Specialty
JRCPTB

3. GENERAL INTERNAL MEDICINE
SPECIALTY

5. FOR GENERAL INTERNAL MEDICINE AUGUST 2009
SPECIALTY TRAINING CURRICULUM
FOR
GENERAL INTERNAL MEDICINE
AUGUST 2009
(AMENDMENTS MADE AUGUST 2012)
Joint Royal Colleges of Physicians Training Board
Website:

6. GIM CURRICULUM
GIM CCT
ST3
CORE MEDICAL
TRAINING
FOUNDATION

7. The GIM SAC

9. GIM ARCP Decision Aid 10 WPBA (at least 6 ACAT) per year
MSF X 2 (minimum 12 raters; 3+ consultants)
Multiple consultant report
Annual GIM Educational Supervisor’s report
Procedures (maintain CMT skills)
Demonstration of senior level competences
Teaching with feedback
Management / leadership experience

10. Multiple consultant report
Additional to multisource feedback tool
Consultants only
Agreed by trainee and ES at beginning of placement
4 – 6 respondents per training year
Prior warning
Focus on clinical performance in GIM
Summary MCR contributes to ES report

11. The Firth calculator

12. GIM Outpatient Experience
Usually in primary specialty clinics
Can be obtained in other specialty clinics
Minimum of 186 outpatient clinics
Replaces previous requirement for 450 NP / 1500 FU patients
OP equivalent can include inpatient complex referrals or ambulatory care patients
Logbook record essential
JRCPTB

14. GIM ePortfolio review prior to ARCP 2015
(2) EDUCATIONAL SUPERVISOR’S REPORT FOR GIM
ES Report for GIM? (Yes / No)
Separate from main specialty? (Yes / No)
Confirms satisfactory GIM progress (Yes / No)
(3) WORK PLACE BASED ASSESSMENT IN CURRENT GIM POST
WPBA type:
Number of Mini-CEX performed
Number of CbD performed
Number of ACATs performed (6 minimum required)
MSF obtained (minimum of 12 raters required incl. 3 consultants )
Multiple Consultant Report (4-6 raters required)

15. GIM ARCP summer 2015
(4) COMPETENCIES ACHIEVED AND SIGNED OFF BY EDUCATIONAL SUPERVISOR WITH SUFFICIENT EVIDENCE (2 PIECES)
Competencies:
ALS:
Presentations:
Number of Common Competencies (15 at ST level in curriculum)
Valid ALS (yes/no)
Number of Emergency Presentations (4 in curriculum)
Number of Top Presentations (22 in curriculum)
Emgagement with Other Presentations (40 in curriculum)
(5) PROCEDURAL COMPETENCIES ACHIEVED AND SIGNED OFF BY EDUCATIONAL SUPERVISOR WITH SUFFICIENT EVIDENCE (2 PIECES)
Abdominal paracentesis (Yes/No)
DC cardioversion (Yes/No)
Knee aspiration (Yes/No)
Central venous cannulation (Yes/No)
Intercostal drainage - pneumothorax (Yes/No)
Intercostal drainage – pleural effusion (Yes/No)

16. GIM ARCP summer 2015
(6) GIM AUDIT/QIP (must have led one by GIM CCT)
(7) AMOUNT OF EXTERNAL CPD TO DATE (eg. GIM REGIONAL TRAINING DAYS)
GIM Audit/QIP (Yes/No)
Number of hours
(8) RECOMMENDED ARCP OUTCOME
(9) COMMENTS / RECOMMENDATIONS / REVIEW
Recommended ARCP Outcome (1,2,3,4,5,6,7,8,9)
Comments
Recommendations
Review conducted by GIM TPD / Representative by

17. GIM CCT Award Logbook evidence of minimum:
1000 patients seen on acute take (CCU/ ITU)
186 outpatient clinics (2 per week for 31 weeks over 3 years)
100 hours external GIM training
GIM audit (Lead 1)
Management / teaching experience
RCP CPD Online diary
Valid ALS

18. GIM PYA Occurs within 18 months of Specialty CCT
Specialty and GIM CCT dates concur
External General Internal Medicine Specialty Advisory Committee assessor
KSS GIM Lead or representative
All GIM documentation to date ST3-6 reviewed - including LAT appointments

19. GIM PYA
External GIM SAC representative sets Mandatory and Recommended targets
Specifies amount and duration of ‘refresher’ GIM in last year
Targets must be achieved in months
GIM Lead then signs off documentation
CCT in GIM granted

20. Dr X PYA Overview of SpR Jobs
ST3
ST4
ST5
ST6
ST7
On Call
1 in 12
1 in 10
none
CCU
Yes - No
PTWR
Average no pt 20 50 10
Continuity
SpR WR 3 2 4
Consultant WR 1
Clinics/week
ITU/HDU
MDT/Xray
11/4
2.5
*Cover at night

21. PYA pitfalls Too few WPBA No separate ES report for GIM
GIM curriculum competences not signed off by educational supervisor
No log book evidence for on-take and outpatient experience
Firth calculator not countersigned
<100 hours external CPD
CPD Certificates missing
No valid ALS

22. PYA

23. GIM CCT Experience in KSS posts
Regular acute on–take commitment
Intra and post-take consultant ward rounds
CCU / ITU attendance
GIM practical procedures
Workplace based assessments
GIM Educational Supervisor
Outpatient clinics in Speciality
GIM Audit
Internal and External GIM Teaching Programme
Management
Teaching
Leadership

26. External GIM CPD KSS HEE SpR GIM Training Days
Annual Specialty Training Days eg Cardiology, Neurology, Renal
Internal Medicine Research & Audit Day
Early registration essential

27. Feedback on GIM PYA process
“Thank you for your generous support today as well as your career advice.” “Thank you so much for doing my PYA today. It was a very nice experience.”

28. ARCP Decision Aid

29. ARCP Decision Aid

30. ARCP Decision Aid

31. ARCP Decision Aid

32. ARCP Decision Aid