Rehabilitation medicine is one of few specialities in which you can truly practice holistic medicine. You use your high level medical knowledge and skills, setting them in the context of the whole person – their family and friends, their work and other interests and passions, their home and the area they live in, and their ambitions, hopes and fears. You work within a multi-disciplinary team as an equal member of the team. Your contribution is your detailed knowledge of disease. Your special skill is in understanding how disease interacts with all other aspects of the person, and in using this understanding to help the team and the person achieve the best outcome possible. You will work across all boundaries and with all agencies and professions. All your life you will be learning from other knowledgeable and skilled people. As a doctor, you may often lead the team, but this is not a right or expectation. Leadership has to be learned, and the position earned.
As a consultant in rehabilitation medicine you will face interesting and new challenges every day of your life – medical, ethical, legal, personal, and inter-personal. Because you are working closely with patients and their families, and with members of your team and other teams, you are always having to learn, to explain, to draw on your medical knowledge and skills. You also realise how much research is needed, and for anyone with an academic or research interest, the opportunities are huge.
Rehabilitation medicine - trainee characteristics
Rehabilitation medicine should be attractive to any doctor who:
- values and enjoys talking to and sharing expertise with patients and their families
- is comfortable with acknowledging uncertainty, and allowing patients to choose
- values and enjoys discussing clinical matters within a multi-professional team, as an equal member of the team, both learning from them and teaching
- wants life-long variety in their daily work
Working/training in an ST3 rehabilitation medicine post
Rehabilitation crosses all boundaries, and as a trainee you will learn how to act as a doctor in a great variety of settings, from intensive care units and specialist wards, through almost all specialist and generalist wards in hospitals, and through mental health settings, on to community settings such as nursing homes, day centres and patients’ homes.
The clinical workload in the UK currently primarily involves patients with: any and all neurological disorders, including traumatic brain and spinal cord injury; trauma, including complex musculo-skeletal injuries and limb loss; other causes of limb loss; chronic pain including back pain; other more specific musculo-skeletal disorders; and a wide-range of psychologically-based problems alone or associated with a specific disorder. However rehabilitation cover all patients, and internationally covers psychiatry and learning disability; cardiac and chest conditions; children and the elderly; renal services and so on.
The knowledge and skills applies to all people receiving health care. You will learn about the nature and utility of the biopsychosocial model of illness; establishing patient priorities and negotiating team-based goals; liaising with other teams and professions; and having good medical diagnostic and treatment skills to recognise new problems, and to place each patient’s medical problems in the correct perspective.
The changing nature of healthcare with increasing numbers of people with complex, long-term disabling disorders will require many rehabilitation medicine specialists. The increasing numbers of people with multiple morbidity, and with long-term disabilities coupled with the increasing emphasis on community healthcare gives this speciality a (potential) central place in healthcare this century. Join it.
See (freely available):
Wade DT, Halligan PW
The biopsychosocial model of illness: a model whose time has come.
Clinical Rehabilitation 2017;31:995-1004 - https://doi.org/10.1177/0269215517709890
Wade DT
Rehabilitation – a new approach: Overview and part one: the problems
Clinical Rehabilitation 2015;29:1041-1050 - http://journals.sagepub.com/doi/full/10.1177/0269215515601174
Broad remit - team-based role
The physician works within a multi-professional team utilising his or her clinical and leadership skills, ability to assess risk, and emotional intelligence to effectively manage patients in a goal-orientated rehabilitation programme.
This wide remit combines clinical skills and practice with the prospect of developing and implementing services, teaching and training members of the multi-professional team, and promoting evidence-based rehabilitation through local and national policy.
Dual accreditation
Training in rehabilitation medicine complements other specialties and there are opportunities to attain dual accreditation in neurology, rheumatology and stroke medicine.
Rehabilitation medicine is a small, but expanding, specialty and it is an excellent time to contemplate this progressive career choice. Training typically consists of a four-year programme, which encompasses learning across the clinical areas.
Competition levels
Competition ratios for ST3 posts are particularly favourable and diversity in applicants is welcomed with access to the programme being attainable after achieving MRCP(UK), MRCS, MRCGP or MRCPsych qualifications.
Rehabilitation is increasingly becoming the focus of effective patient management and in recognition of this consultant posts are predicted to expand in the coming years.
Rehabilitation medicine is a bright, exciting specialty especially suited to doctors able to ‘think outside the box' and who wish to work predictable hours with manageable on-call commitments.
Medical Care
Find out more about rehabilitation medicine and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
Further information
Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for rehabilitation medicine in 2019 is Health Education West Midlands.
| Health Education West Midlands | ||||||
|---|---|---|---|---|---|---|
| Postal address | Health Education West Midlands 1st Floor St Chad's Court 213 Hagley Road Edgbaston Birmingham B16 9RG |
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| email address | specialtyrecruitment.wm@hee.nhs.uk | |||||
| website | www.westmidlandsdeanery.nhs.uk/ | |||||
General / application queries
For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Specialty Recruitment Office via email at ST3medrecruitment@hee.nhs.uk.
Eligibility
Please be aware that this specialty accepts applicants from general practice, psychiatric and surgical training routes.
Non-physician applicants must have obtained the basic specialty professional examination relevant to their training pathway prior to the start of ST3 training, in addition to specific clinical experience and competences. Therefore applicants must have one of the following:
- Physician training (eg CMT) - MRCP(UK) Part 1 at time of application; full MRCP(UK) by required deadline
- Psychiatric training - MRCPsych Part 1 and 2 at time of application; full MRCPsych diploma by required deadline
- Surgery training - MRCS (Part A) or FRCS (Primary) at time for application: MRCS (Part A) or FRCS by required deadline
- General practice - MRCGP (AKT) at time of application; Full MRCGP by the required deadline
Please view the rehabilitation medicine person specification for information about the experience and competency required for applying to the specialty from a non-physicianly training background.
Because of the complexity of the eligibility criteria, trainees who believe they are eligible and wish to be considered for rehab med should submit an application; detailing their experience and answering the eligibility questions to the best of their ability.
The recruiting team will assess eligibility at the long-listing stage, consulting with rehabilitation medicine training programme directors as required. It is appreciated that training pathways can vary in content and complexity; indeed, applications from alternative training routes are welcomed for this reason.
Please view the rehabilitation medicine person specification for information about the examinations, experience and competency required for applying to the specialty from a non-physicianly training background.
Medical trainees please view the standard eligibility criteria as detailed in the am I eligible? section.
National single centre model
This specialty uses the single centre recruitment model.
You will not be required to give any preferences of particular regions when completing your application; you are applying purely for the specialty at that stage.
Later on, you will be required to give preferences of the available posts – at that point, you can opt to be considered for as many (or as few) post vacancies available nationally as you wish.
Lead region and single centre interviews
The specialty will nominate a particular region to act as lead for the round; this region is shown under the 'Who do I contact?' tab above. This lead region will review all applications, liaise with all candidates, host interviews, verify assessments, and make offers on behalf of all regions nationally.
Your application will be handled solely by the lead region throughout the entire round, up to the point where you receive and accept an offer; after which it will be transferred to the region where the post is based for pre-employment checks.
All interviews will be held at this lead region although the clinicians making up the interview panel will be drawn from a national background – ie not just from the host region.
Flexible portfolio training
New for 2019, this specialty will be participating in the ‘flexible portfolio training’ scheme, in the Wessex region. This protects one day a week (or 20% time equivalent across the year) for the trainee to work within clinical informatics that will aid their professional development. This is an opportunity to acquire and develop key skills and engage in meaningful project work, in a different environment, alongside time in training that will be the springboard to a consultant career.
Further details about the scheme, and the regions where this is available can be found by visiting the website https://www.rcplondon.ac.uk/projects/flexible-portfolio-training or by emailing flexibleportfoliotraining@rcplondon.ac.uk
It is possible that there could be changes between now and the interview period. Please bear this in mind when reviewing the information below, although in most cases it is not expected this will change, or any changes will be minimal. You are advised to check back in closer to the time of interview. The date at the foot of this page shows when the page was last reviewed.
Interview content
You will spend approximately 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.
Click on the relevant stations below for more information on the content of the interview.
Please note that this is subject to change, and will be confirmed by the date of interview.
This is where your application form and training to date will be reviewed. This will include checking the documentation you have brought along to ensure all content on your application form is correct.
Evidence checking
Normally your evidence folder will have been reviewed by the interviewers immediately prior to your arrival in the station. They will be:
• Checking that your achievements in your evidence folder match that claimed on your application form.
• Considering your career progression to date.
• Identifying areas about which they may wish to question you during the interview.
Areas for assessment
The two main aspects of discussion here, on which you will be assessed, will be your suitability for and commitment to ST3 training in the specialty, and your achievements and engagement with training and learning to date.
Scoring at the station
It is important to recognise that the scores awarded to you at this station will not purely be about your achievements, as this already contributes towards the scoring via your application form. Interviewers will be deciding upon scores via a combination of factors, for example: your responses to the questions asked, the breadth and quality of your achievements and your career progression.
Prior to arriving at station 2, you will be given a clinical scenario to review. Upon arrival at station 2, you will be asked questions relating to this scenario.
The clinical scenario will be relatively brief (two/three sentences), so once you have read this, the remainder of the pre-station time will allow you to undertake some short preparation (just mental preparation - this does not mean making notes, etc.)
Scenario considerations
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved.
There are some points you should consider when reviewing the scenario and preparing for discussion:
- what steps you would take
- any potential treatments possible
- any further information you would gather
- how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario.
Of course, you should take into account any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
One mark will be awarded to you based on your suggestions and responses to the clinical scenario.
The second assessment carried out here will be on the communication & reflection skills you display.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers at the station; plus consideration of your reflections on the scenario afterward.
[Please note - interview nerves will be taken into account!]
This station will feature assessment of an ethical scenario, and discussion of a question on the subject of professionalism & governance.
Ethical scenario
The first assessment area will be the ethical scenario. As with the clinical scenario at station 2, this takes the form of a hypothetical situation, described briefly in text form, details of which will be given to you before arriving at station 3.
However, as you would expect this scenario focuses less on a clinical situation, and deals more with consideration of the moral, ethical, legal (etc.) issues which may arise in a particular situation.
The first area of assessment at station 3 will be your suggested reponses to the ethical scenario during discussion here, as well as your knowledge of the different considerations required.
Professionalism & governance
Following the ethical scenario will be discussion of professionalism & governance.
This discussion will be prompted by a short question (often a single sentence) provided by interviewers. This will not be given to you before arriving at the station - this will be given verbally by interviewers once ethical scenario discussion is finished.
This section of the interview is designed to assess your demonstration and understanding of professionalism and governance in a given situation.
Familiarise yourself with Good Medical Practice
Please note - assessment at station 3 is underpinned by the principles of GMC Good Medical Practice.
Interview scoring
Appointable - automatic
If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.
Not appointable - automatic
If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.
If four or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.
Should your interview assessment fall under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable.
Appointability subject to panel decision
In the event that your 12 interview scores contain one, two or three marks of 2/5 (and the rest 3/5 or above), your appointability status will be subject to discussion in the post-interview 'wash-up' meeting.
The clinicians who have interviewed you will discuss your general performance during the interview and any concerns or otherwise they have about your application as a whole.
Should they deem it appropriate, your application will be classed as appointable, and you can then be considered for post offers; whereas if they feel their concerns are too substantial for this outcome, they must class your application as not appointable, and it will progress no further in the current recruitment round.
Review vs automatic status
Please note there is no distinction made between candidates judged as appointable automatically, and those classed as appointable on review. Once deemed appointable it is only your overall score which will be used to determine ranking.
Total score calculation
After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.
Please note that this is subject to change, and will be confirmed by the date of interview.
| Int. 1 | Int. 2 | Weighting | Max score | |
| Station 1 | ||||
| Evidence | / 5 | / 5 | x1.6 | / 16 |
| Suitability for specialty | / 5 | / 5 | x1.2 | / 12 |
| Station 2 | ||||
| Clinical scenario | / 5 | / 5 | x1.6 | / 16 |
| Communication reflection mark | / 5 | / 5 | x0.8 | / 8 |
| Station 3 | ||||
| Ethical scenario | / 5 | / 5 | x1.6 | / 16 |
| Professionalism and governance | / 5 | / 5 | x1.2 | / 12 |
| Raw interview score | / 60 | |||
| Interview score (including weighting) | / 80 | |||
| Short-listing (app form) | / 80 | x0.25 | / 20 | |
| Overall assessment score | / 100 | |||
As part of the process of applying to ST3, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.
To this end, we have published data dating back to 2013 (where this is available), based around four main areas:
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Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.
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Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.
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Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.
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Post fill rates - the number of posts filled by region.
We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.
Round 1
| Year | Apps. | NTN posts |
LAT posts |
Total posts |
Comp. | Unique* |
| 2018 | 39 | 33 | 0 | 33 | 1.2 | 67% |
| 2017 | 34 | 21 | 0 | 21 | 1.6 | 32% |
| 2016 | 30 | 19 | 0 | 19 | 1.6 | 40% |
| 2015 | 36 | 22 | 1 | 23 | 1.6 | 50% |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
Round 2
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
| 2018 | 13 | 20 | 0 | 20 | 0.7 |
| 2017 | 12 | 20 | 0 | 20 | 0.6 |
| 2016 | 14 | 10 | 0 | 10 | 1.4 |
| 2015 | 8 | 12 | 1 | 13 | 0.6 |
Provisional post numbers
Specialty vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts.
It is the intention that initial post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Numbers will be updated as and when notifications are received from each region and will be checked later in the round when programme preferences are open for selection.
Numbers subject to change
Please be aware that it is not uncommon for vacancy numbers to change throughout the round.
More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. On average post numbers rise between 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.
It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.
Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.
Round 1 Interview dates & post numbers
| Region | NTN posts | LAT posts* | Interview date(s) |
|---|---|---|---|
| West Midlands (lead) | 4-5 | TBC |
West Midlands (lead) |
| East Midlands | 0 | TBC | |
| East of England | 0-1 | TBC | |
|
London and KSS |
0-2 |
TBC | |
| North East | 1-2 | TBC | |
| North West |
North Western 3-4 |
TBC | |
|
Mersey 3-4 |
|||
| South West |
Peninsula 0 |
TBC | |
|
Severn 1 |
TBC | ||
| Thames Valley | 0-2 | TBC | |
| Wessex † | 1-3 | TBC | |
| Yorkshire & Humber | 1-2 | TBC | |
| Scotland** | 0-3 | TBC | |
| Wales | 0 | TBC |
*English LATs
Please note, English regions do not recruit to LAT posts.
**Scotland post numbers
If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish deaneries is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.
Please note that whilst we endeavour to keep the Physician ST3 recruitment website up to date, the SMT website will always be the more accurate one where they differ.
† Regions taking part in flexible portfolio training
Trainees will be able to preference posts with or without the 'flexible portfolio training' option where available. For further information on acute internal medicine, and the distribution of regions to each pathway, please visit https://www.rcplondon.ac.uk/projects/flexible-portfolio-training