Dual & Triple CCTs

Curricula and programmes

The Faculty and its partner colleges have undertaken cross-mapping exercises to identify shared competencies that can be dual/triple counted as leading to dual and triple CCTs in ICM and one of the defined partner specialties.

It is important to note that it is the programme which is dual/triple; the trainee is following two/three separate CCT curricula which are combined into a dual/triple programme with mapped capabilities. There is not an individual curriculum for each dual/triple route.

Routes of entry

For dual/triple CCTs, trainees may enter either programme first and have the appropriate capabilities dual/triple counted for the second/third CCT, simultaneous entry to all programmes is not currently possible. Since 2016, doctors are not be able to apply for Dual/Triple CCTs if they are beyond the end of ST5 in their initial specialty of appointment at the time of interview for ICM.

Progression in combined training programmes

Updated January 2024

It has come to our attention there is some confusion around establishing the training year for our doctors following a dual/triple CCT programme with a partner specialty.

We have therefore produced guidance to help clarify the training pathways for doctors following a dual/triple CCT programme with ICM. It outlines our principles for incorporating prior training (usually from core training programmes but not explicitly) onto the ICM training programme. There may be doctors that fall outside of this guidance due to having a complex training history. Where possible, we endeavour to incorporate all relevant prior medical training onto our programme to avoid any unnecessary prolongation of training.

Guidance and clarification

Doctors in ICM Dual/Triple CCT Programmes take longer to complete their training than they would do if they were training in just one of the specialties.

In counting the years of training, it is agreed that the training years start at admission to the first specialty training programme, and years are added linearly as they are completed irrespective of the responsibility levels reached in the individual specialties, assuming that satisfactory outcomes have been achieved.

The training year at entry (ST3/ST4 etc.) needs to be determined by the Training Programme Director. Due to the different entry routes, trainees may have covered varying amounts of the ICM curriculum prior to appointment, and so would enter at a different point; for example, a doctor from an ACCS core training programme may be appointed at ST4 instead of ST3 level to account for previous experience.

For detailed information on the respective Dual/Triple CCT Programmes, please see the following documents on our website:

Should you have questions regarding this please do not hesitate to contact the Faculty: contact@ficm.ac.uk

Guidance documents

The guidance below is for dual/triple CCTs undertaken with the CCT in Intensive Care Medicine.

ICM Triple CCT FAQs

Can I count ICM regional training days towards to the 75 hours of GIM teaching if they are relevant, for example, an ICM day on liver disease?

Yes, where teaching is relevant to both ICM and GIM, it can count towards both specialty teaching hours.

Does it matter what order my Stage 3 placements are in?

No, stage 3 can be completed in any order although GIM on calls must be completed within the final 12 months of training leading up to your CCT, to maintain capability. If your final year of training is a 12 month ICM placement, contemporaneous acquisition and maintenance of GIM capabilities can be achieved by 'release' from ICM for GIM sessions on an ad hoc locally agreed basis, and via applicable practise and experience in ICM/other environments.

I joined ICM at the end of ST5 (having completed two years of a Resp/Renal/AIM +IMS2). Do I have to do further AIM/IMS2 during my ICM Stage 2 year?

No, the requirement is to complete 2 years (and a further 3 months in AIM/Renal) of the medical specialty in Stages 1 and 2. For those who join ICM training at the end of ST5, this will already have been completed. There remains the need to obtain some GIM training in the last year (as above) to ensure that GIM capabilities are current. Medicine placements should be limited to the required levels after the main experience has been obtained to ensure ICM Stage 1 & 2 capabilities are also achieved. The later an Intensivist in Training (IiT) commences triple CCT training, the likelihood of the minimum described period of training will be lengthened, as there will have been less time to dual/triple count capabilities. If anyone has any queries regarding this, please contact us for advice via: contact@ficm.ac.uk

I have been told my training has to be extended – is the GIM curriculum time or outcome based?

All curricula are now outcome based, as per the GMC’s Excellence by Design standards & requirements. Therefore, extensions to training time should only occur if you are deemed not to have met the outcomes. This includes the necessity to ensure all capabilities are current and that there is adequacy of experiential learning.

Can capabilities and experience gained during my ICM placements count towards GIM?

Yes. Some experience in ICM can count towards GIM outcomes where it is relevant. Examples can include looking after patients with GIM related illnesses on ICU, end of life care and reviews on the wards and in emergency departments.

Can ICU follow-up clinics count towards GIM clinics?

ICU follow-up clinics can count towards some of the GIM clinic requirement but not all. To fulfil the clinic requirement for GIM there must be some experience of medical specialty or GIM clinics.

Can ICU on call shifts count as an unselected medical take?

The FICM & JRCPTB would support a doctor in training, who was part of the ICU outreach role covering medical wards and admissions, counting this towards the GIM requirements of HILLO 1 of the Internal Medicine CiPs. However, time also needs to be undertaken as the medical StR leading/overseeing the medical take to fully achieve this capability. This includes experience in the final year of training.

Can patients, seen during an ICU on call (who are presenting with acute medical problems), count towards the overall number of patients seen on the acute medical take?

Yes, patients who are a part of the acute unselected medical take (for example, patients with IECOPD or OOH cardiac arrest) can count towards the requirement to see 750 patients overall presenting with acute medical problems.

Dual and Triple CCTs with Physician specialties

Following recent approval of the triple CCT principle by the GMC, guidance for triple CCT programmes with ICM and the physician specialties with Internal Medicine have been updated. Please see above for the guidance downloads.

Transition options for current physician trainees training in Intensive Care Medicine (ICM)

The GMC recommends that trainees undertaking dual CCTs with ICM and physician specialties (for ICM-physicians recruited before August 2021) should transition a new curriculum as soon as possible but it is recognised that some learners may require longer to transition based on the impact the new curriculum and transition should take into account feasibility, trainee and patient safety. Where possible, trainees should transfer to the new curriculum, unless in their final year of training.

The new curricula for group 1 physician specialties include learning outcomes for internal medicine and if a trainee has dropped general internal medicine to take up ICM it may not be in the best interest of patient safety or impractical for a trainee to transfer curriculum. A gap analysis should be carried out and to determine whether it is possible for the trainee to transition and if not, postgraduate dean’s approval should be sought for the trainee to complete training on the previous curriculum.

The options for current Acute Internal Medicine/Renal Medicine /Respiratory Medicine trainees who are training in ICM and are not in their final year of training are:

Transfer to the new curricula and train in their group 1 specialty (Acute Internal Medicine, Renal Medicine or Respiratory Medicine), Internal Medicine and Intensive Care Medicine. They will be eligible for CCTs in all three specialties.
Remain on the previous curriculum if it is not safe or practical for them to also train in internal medicine and CCT in their group 1 specialty and ICM.

Do you have any questions?
Please contact the Faculty.

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