Acute Internal Medicine 31st October 2025

Acute Internal Medicine ST4 Interview 2026

If you’re applying for Acute Internal Medicine ST4 in 2026, you’ll find everything you need to know here. Our Acute Internal Medicine ST4 interview guide includes the key recruitment dates, the interview format and how your performance will be scored.

Because of its varied and dynamic nature, Acute Internal Medicine ST4 is a competitive pathway. Last year’s competition ratios demonstrate this, as there were 443 applications for the 100 posts on offer. This gave a competition ratio of 4.43, meaning that more than four people applied for each position.

Acute Internal Medicine ST4 Application

The Acute Internal Medicine ST4 application window is open from 20 November — 11 December 2025. The registration and application process takes around ten hours.

The application form requires you to fill out information based on your career, experience and personal achievements. Later in the process, you’ll have to provide evidence for the claims you make.

To be eligible for Acute Internal Medicine ST4, you must have evidence of having achieved Internal Medicine Stage 1 capabilities by one of the following methods:

• UK Internal Medicine Stage 1 Training
• UK ACCS (internal medicine)
• UK Broad-Based Training (medicine route)
• a standalone UK IMY3 programme (following completion of UK core medical training/ACCS (acute medicine)

There’s also the MRCP to consider. You must have either successfully completed the MRCP(UK) Part 1 at the time of application and MRCP(UK) Part 2 by the offer date or completed the Irish Basic Specialty Training in Medicine and the MRCPI full diploma by the offer date to be eligible to apply. Being eligible for the specialist register in general internal medicine by the time of application is another alternative which will allow you to apply for Acute Internal Medicine ST4.

You can find more information about the eligibility criteria in the 2026 person specification.

Acute Internal Medicine ST4 Application Score

For the 2026 Acute Internal Medicine application, there are 38 points available across 7 domains. Each domain will have various options, reflecting different levels of achievement. You will have to choose the response that best reflects your experience level for each of the following domains:

• Postgraduate Degrees and Qualification
• MRCP(UK)
• Presentations
• Publications
• Teaching Experience
• Training in Teaching
• Quality Improvement

Boost your Acute Internal Medicine ST4 application score by Training in Teaching

Achieving a teaching qualification like a PG Cert or PG Diploma can add up to 3 points to your Acute Internal Medicine ST4 application. However, these qualifications often take considerable time to complete and may not be practical before interview season.

An easier and quicker way to strengthen your teaching score is by attending a Live Teach the Teacher Course that provides at least six hours of interactive, real-time teaching. This will award you 1 point on your application. We offer both 1-day and 2-day live course options, allowing you to pick whichever format best suits your schedule.

Acute Internal Medicine ST4 Key Dates

The Acute Internal Medicine ST4 recruitment process takes place twice a year, with the interviews for round 1 of 2026 taking place in February. You can find more key dates for the upcoming recruitment round in the table below:

Acute Internal Medicine ST4 Interview Format

The Acute Internal Medicine ST4 interview is split across two stations. There are four questions in total, each lasting seven to eight minutes. So, when you consider the time between stations, you can expect the interview to last around 40 minutes.

Station 1 – Question 1 – Clinical Scenario

You’ll be given a clinical scenario for the first question, describing a hypothetical situation that you’re involved in. The brief will only be a few sentences long, and you’ll have a short amount of preparation time to get ready to answer questions on the scenario.

During this time, you should consider the following points:

• Your next steps
• The potential treatments
• Any further information you would gather
• How you would communicate with patients, family members and colleagues in the scenario
• Any factors you deem appropriate based on your past experiences

The Medibuddy Acute Internal Medicine ST4 Question Bank features clinical scenarios tailored to reflect those you’ll encounter in the interview, giving you the preparation you need to succeed. Below, you’ll find a preview of our question bank to give you a sense of the format and depth of our questions.

Station 1 – Question 2 – Medical Registrar Suitability

This part of the interview will go over the non-clinical aspects of being a medical registrar, with a focus on two of the Capabilities in Practice (CiPs) from the Internal Medicine Stage 1 Curriculum. These are:

• Managing an acute unselected take
  Managing a multi-disciplinary team, including effective discharge planning
• The questioning within this part of the interview will require you to think about your experience managing a team caring for acute medical admissions. To provide further weight to your answers, it’s important to provide specific examples that highlight this experience.

You’ll begin this question with a one-minute presentation summarising your experience managing the acute unselected medical take as a medical registrar. In your summary, outline the roles and duration of your experience, the level of responsibility and supervision you’ve had, the size and structure of the team you managed, and the number of patients you were responsible for. You can also briefly mention any non-clinical duties. Keep your presentation clear, concise, and well-structured, as you’ll be stopped after one minute. Interviewers may then ask follow-up questions or ask you to expand on specific points.

Station 1 – Question 3 – Communication Mark

This part of the interview isn’t strictly a question. But, the interviewers will judge you based on the communication skills you display throughout the station. This includes how you would communicate with the other people in the clinical scenario, as well as how you interact with the interviewers.

Station 2 – Question 1 – Suitability and Commitment

The second part of the interview starts by focusing on your suitability and commitment to the Acute Internal Medicine specialty. This is your opportunity to build on the information you provided in your application form.

Station 2 – Question 2 – Ethical, Professionalism and Governance

The final stage of the interview assesses your understanding of ethics, professionalism and governance in a given situation. You won’t receive the question ahead of time here. Instead, the interviewers will start the discussion by asking a question verbally.

Acute Internal Medicine ST4 Interview Scoring

Each assessor will score you based on how you perform against the expected level, giving you a score between 1-5 for each section of the assessment. You can find the in-depth scoring framework below:

Later, your 10 scores will be combined to provide you with a raw interview score (RIS), which will fall somewhere between 10 and 50. But, before your application can be considered ‘appointable’ and become eligible to receive offers, your results must meet the following criteria:

• None of your interview scores can be a 1/5
• A maximum of two of your interview scores can be a 2/5
• A RIS higher than 30

Total Score

After the interview, a weighting is applied to each of the scores, giving you a total score. Your application score is included in this, although it only accounts for 20 marks. The bulk of your total score will come from your interview, where there are 80 marks up for grabs.

When you break the interview down even further, you’ll find the clinical scenario and suitability and commitment sections are worth more than the others. Because of this, it’s worth spending more time preparing for these sections.

Good luck with your application!