In addition to internal medicine training, there is an alternative route into physicianly training - via acute care common stem (ACCS).

The aim of ACCS training is to produce multi-competent junior doctors able to recognise and manage the sick patient, and who have the complementary specialty training required for higher specialty training.

ACCS-IM is a four-year programme during which trainees will get experience of acute medicine, critical care, anaesthetics, emergency medicine and general medical specialties.   

Recruitment to ACCS is done via separate streams, dependent on the parent specialty.  While the first two years of ACCS will share a common curriculum, and any competences acquired are transferable, Internal Medicine Stage 1 Curriculum it is not possible to switch between ACCS career paths without a further competitive selection process.

Candidates are therefore advised to select their initial ACCS pathway of choice with care.

Please visit the ACCS website for more information.

There are three separate streams of training through the pathway of ACCS which share a common curriculum.

Recruitment to each of these streams will be handled separately, by different bodies and via different recruitment processes.

  • ACCS (internal medicine)
  • ACCS (anaesthesia)
  • ACCS (emergency medicine)

Recruitment to ACCS (internal medicine) is handled alongside recruitment for IMT and detailed in this website. Information about the other streams can be found on the 'Other ACCS streams' tab in this section.

Further information on ACCS training programmes can be found on the ACCS website.

ACCS-IM is a four-year programme and successful completion fulfil the Internal Medicine Stage 1 Curriculum, enabling entry to Group 1 and Group 2 higher physician specialties. Successful completion of the third year of ACCS-IM will enable entry to Group 2 physician specialties only.

Years 1 & 2

During the initial two years (CT1/CT2) of the ACCS progamme, you will normally spend six months in each of the four core specialties:

  • acute medicine
  • emergency medicine
  • anaesthetics
  • critical care medicine.

The exact time spent in each will depend on the region in which you are working, and your year of appointment.

All ACCS trainees will work towards completing the generic ACCS curriculum in their first two years.

Year 3 and 4

In years three and four you will be doing the equivalent of IMT year 2 and 3, consisting of four-to-six month posts in general medical specialties. The Internal Medicine Stage 1 Curriculum has more information about what this entails.

Please note that recruitment to ACCS-anaes and ACCS-EM posts is not coordinated by the IMT Specialty Recruitment Office.

ACCS-anesthesia (ACCS-anaes)

Anaesthesia posts - both in ACCS (anaesthesia) and in 'pure' anaesthesia core CT1 programmes - will be recruited to as one process. The recruitment is led by the Anaesthetics National Recruitment Office (ANRO) – based in Health Education West Midlands.

There will be one single 'anaesthetics' application form - that is, regardless of whether candidates would prefer to be considered for CT1 core anaesthesia posts, or CT1 ACCS-anaesthesia posts (or both), they need only complete one application.

Those candidates assessed to be eligible will be guaranteed an interview (providing they have ranked enough regions).

Preferences for one type of post or other can be given at a later stage of the recruitment process.

Following interview, places in programmes will be allocated according to rank and expressed performance for programme.

Once a post in an ACCS-anaes programme is accepted (or held), there can be automatic upgrade to a higher preferenced programme within anaesthesia/ACCS-anaes, should one become available.

ACCS-emergency medicine (ACCS-EM)

Applications for CT1/ST1 posts in ACCS-EM are managed by the London and Kent, Surrey and Sussex recruitment team.

Following interview, places in programmes will be allocated according to rank and expressed preference for programme.

Once a post in ACCS-EM is accepted (or held), there can be automatic upgrade to a higher preferenced programme within emergency medicine, should one become available.