CMT (Core Medical Training) was replaced by IMT (Internal Medicine Training) — a longer, more structured programme designed to produce more comprehensively trained physicians before specialty differentiation.
IMT Structure
IMT1-IMT3. Three years of internal medicine rotations covering acute medical take, specialty rotations (cardiology, respiratory, gastroenterology, nephrology, ID, endocrine, haematology, neurology, rheumatology), and procedural competencies. The programme is more structured than old CMT — with defined competencies for each year and a clearer progression framework.
Mandatory MRCP. You must pass MRCP Part 1, Part 2 Written, and PACES by the end of IMT2 to progress to IMT3. This is a hard gate — failing to pass MRCP within the required timeframe can block your progression. Begin MRCP preparation in IMT1. iatroX provides free MRCP Part 1 questions.
After IMT: Specialty Applications
Upon completing IMT3, you apply for specialty training (ST4) in your chosen medical subspecialty: cardiology, respiratory, gastroenterology, nephrology, rheumatology, infectious diseases, dermatology, neurology, endocrinology, geriatric medicine, acute medicine, clinical pharmacology, and others. Competition ratios vary dramatically — cardiology and dermatology are among the most competitive (8:1 to 15:1+), while geriatric medicine, rehabilitation medicine, and palliative medicine are more accessible.
Your IMT portfolio (audit, QIP, teaching, research, presentations, leadership, management experience) determines your competitiveness for specialty applications. Build this systematically throughout IMT — not in the final months.
How IMT Differs from CMT
IMT is 3 years (CMT was 2). IMT includes more structured competency progression. IMT requires MRCP by end of year 2 (CMT had the same requirement but with a 2-year window). The additional year provides more clinical exposure and competency development time.