Internal medicine training - implementation and impacts of a new curriculum: findings from a 3-year longitudinal evaluation

Background: In 2019, Internal Medicine Training (IMT) replaced Core Medical Training1; a 3-year programme where IMT Stage 1 forms the first stage of specialty training for most doctors training in physician specialities, preparing trainees for participating in the acute medical take. IMT training continues in Stage 2 for certain trainees, integrated within higher specialty training. Changes aim to enhance training and prepare doctors to manage patients with complex comorbidities and provide trainees with wider exposure to medical specialties, including dedicated experience in the intensive care unit. We will present findings from our 3-year longitudinal evaluation, commissioned by HEE, that assesses the impact of changes in IMT training, particularly on perceptions and experiences of those involved, progression through physician training, service delivery and learning outcomes. Methods: A longitudinal programme evaluation (2019-2022) comprising trust level data, online surveys, focus groups/interviews with participants (trainees, educators, employers, local offices) collected both quantitative and qualitative data. Quantitative data are descriptively analysed using Excel/PowerBi; qualitative data (open-comment/transcripts) underwent thematic analysis. Results: Unsurprisingly, the Covid-19 pandemic significantly impacted trainee experience, clinic attendance and exams. Key themes from the qualitative research include quality of teaching and level of service provision, supervisor interaction and the curriculum. Quantitative analysis for Year 1 presents emerging impacts of IMT (increase in training posts, changes in ARCP outcomes received, reduction in attrition). Longitudinal analysis also shows improved confidence in clinical decision-making, contact with educational supervisors and greater confidence in raising concerns