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The GUM Training Pathway

Dual accreditation/General Internal Medicine

GUM is a Group 1 Medical specialty, which means trainees will obtain a dual CCT after the completion of higher specialty training, i.e. in both GUM and GIM. Trainees must complete 3 years of General Internal Medicine Training stage 1 (IMT1-3) and then apply for and enter GUM/GIM higher specialty training at ST4. GUM and GIM Training stage 2 is 4 years (ST4-7). Trainees complete 12 months full time equivalent in internal medicine across the 4 years (usually 3 months per year whole time equivalent in internal medicine).

Training can be delivered in a variety of settings including hospitals, out-patient clinics/services and the community. The GUM element includes gaining competencies in GU Medicine, HIV Medicine, and Contraception by completion of training. Training also involves additional competencies in Obstetrics and Gynaecology, Laboratory & Pathology, Dermatology, and Public Health.


Both the GUM and General Internal Medicine curriculums can be found on the JRCPTB website on their page here.

An online e-portfolio needs to be maintained throughout training with clinical workplace-based assessments (e.g. case-based discussions), reflections, feedback from colleagues and patients, and annual ARCPs.

Figure 1: The training pathway for GUM and achievement of a CCT in GUM/GIM

*GUM/GIM training = GUM (36 months) and GIM (12 months) with GIM integrated flexibly across the 4 year specialty training programme in blocks of at least 3 months at a time with at least 3 months of GIM in the final year of training. Of note, in-patient HIV/ID experience placements can be used to deliver up to three months of the required GIM training competencies.

Knowledge based assessments

  • Diploma in Genitourinary Medicine: A best of five paper and OSCE, mandatory for all GUM trainees and required by end of ST6. Managed by the Worshipful Society of Apothecaries. See their website for the most up to date information.
  • Diploma in HIV Medicine: A best of five paper and OSCE, mandatory for all GUM trainees and required by end of ST7. Managed by the Worshipful Society of Apothecaries, see website above.
  • Diploma of the Faculty of Sexual and Reproductive Healthcare (DFSRH): Focuses on contraception and is recommended but not mandatory for GUM trainees. See the FSRH website for more details.
  • The Faculty of Sexual and Reproductive Healthcare also offer a “Letter of Competence” qualification in subdermal implants and intrauterine techniques, that is recommended but not mandatory for GUM trainees:

Less Than Full Time (LTFT)

GUM training places importance on both the training and individual needs of trainees. Trainees are supported to undertake their training LTFT if they choose.

I have been less than full time since I returned from my first maternity leave in 2021. The nature of working in GU services and being mostly outpatient-based means I have been allowed to work at 60-80% less than full time with relative ease as I have been facilitated to create a bespoke rota that allows me sufficient exposure to all relevant aspects of the service (despite this occasionally being a logistical nightmare!).

My decision to work less than full time has also been helped by the supportive nature of my consultant team who have guided me through this process and worked with me to ensure I meet my curriculum objectives at each stage of my training.

- Joanne Bassett, ST6, Sheffield

GUM is an excellent specialty for those looking for a career that is fun and varied, which supports you to develop your own interests. For example I have found there to be ample opportunities for teaching others and being involved in research and quality improvement. I became less than full time (80%) following the birth of my son and my request for this was met without challenge.

It has meant that I am able spend time with my son one day a week while still meeting all curriculum outcomes and I have never felt that I am missing out on opportunities by training less than full time.

- Fiona Windebank, ST5, Leeds


Out of Programme (OOP)

Trainees can take time out of training, this is called out of programme (OOP). OOPs need to be approved and notice is required, but as a specialty we very much encourage and support trainees who want to take OOPs. There are a number of different OOPs, including OOPT – Clinical training, OOPR – Research, OOPE – Experience and OOPC – Career break/sick leave.

More OOP information can be found on the JRCPTB website here.

Quotes from those who have worked abroad in GUM:

I am currently out of programme and working in Uganda. At the end of my ST5 year I was offered a fantastic experience of working as a clinical research fellow on a multinational clinical trial based out of Uganda. I felt extremely well supported by my mentor, my educational supervisor, and my training programme director to pursue this.

They were very appreciative of the benefits this experience could have for my future career and were also genuinely excited for me. I have since managed to obtain a PhD fellowship which I will also undertake here in Uganda, so I converted my OOPE to an OOPR.

This was also completely supported by all involved, and I was not in any way made to feel like I was creating a burden by not returning to training at the time originally intended – I have had nothing but encouragement. So I am really grateful for all the support I’ve received along the way!

– Claire, ST5, Brighton


I spent four years living and working in Botswana as the lead doctor for a multi-site clinical trial of a novel treatment regimen for HIV-associated cryptococcal meningitis. I initially moved on an OOPE and then transferred to an OOPR when I enrolled for a PhD at the London School of Hygiene and Tropical Medicine. My time in Botswana was extended due to the Covid-19 pandemic and I was able to extend my OOPR as a result. My OOP experience was one of the highlights of my career to date and has enabled me to develop into an emerging researcher in my field.

I was well supported when I returned to training at LTFT and have been able to continue my academic role alongside my clinical training at King’s College Hospital. I received phenomenal support from my Educational Supervisor and Training Programme Director throughout this entire programme and have found that GUM training really encourages and supports trainees to pursue these exciting opportunities.

– David, ST5, London


Integrated Academic Training in GUM

Integrated Academic Training is available in GUM. These include Academic Clinical Fellowships (ACF) and Academic Clinical Lectureships (ACL). These are applied for and awarded through a separate process to the standard specialty training application process. Academic Clinical Fellowship (ACF) is a clinical specialty training post in medicine that incorporates academic training. Academic trainees’ time is usually split 75% clinical and 25% undertaking research/or education training. The post attracts an NTN.

Entry level to ACF posts relevant to IMT is from ST(IMT)1, ST(IMT)2, and ST(IMT)3 and ST4 for GUM. Successful ACF candidates must still also go through the national clinical recruitment process. ACL posts are for those at a more advanced stage in their specialty training than ACFs, having already obtained a doctoral research degree.

These post-doctoral posts provide the necessary clinical and academic training for doctors and dentists to become independent researchers. ACLs last for up to four years, or until the fellow successfully completes their clinical training (CCT/CCST), whichever is sooner. If taken part-time, ACLs may last up to six years. ACLs will spend 50% of their time in specialist clinical training and 50% in research or academic training.

More information on integrated academic training can be found here.

What GUM trainees said...