What is AIM?

Acute Internal Medicine (AIM) is an exciting and constantly developing specialty that provides the initial assessment, investigation, diagnosis and management of patients within the first 72 hours of their hospital stay. This usually takes places on an Acute Medical Unit, or Same Day Emergency Care for patients who can be discharged on the same day.

Acute Internal Medicine also provides an outreach service for specialist inpatients, involvement in Cardiac Arrest teams, and close working with Quality Improvement, Teaching, Leadership and Clinical Management pathways.

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The history

Initially concieved as a separate specialty in 1999, Acute Internal Medicine has rapidly grown over the past two decades, with over 450 consultants specialising in AIM, and 225 hospitals Acute Medical Units across the UK. The 2015 census conducted by the RCP London shows Acute Medicine has ther largest increase in consultant posts, with a dramatic 33% expansion.

The presence of Acute Physicians in hospitals with unscheduled care has been shown to reduce mortality risk and length of stay, without affecting readmission rates.

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Why you should consider a career in AIM?

  • An exciting and rapidly progressing speciality with close links to leadership, management, and influencing clinical pathways to improve patient care
  • Dynamic job role looking after a broad range of patients with their acute illnesses
  • Dedicated 1 day per week (equivalent) towards Point of Care Ultrasound (insert link) and development of Specialist Skill (insert link) throughout SpR training
  • Flexibility in day-to-day working and job plans as an Acute Medical Consultant
  • Increasing number of consultant posts allowing for better job security including geographical location
  • Always working in a team!

A typical day in AIM

The beauty of Acute Internal Medicine is that no two days are the same, so it’s really not that easy to write a ’day in the life’ piece. But I’ll try! I’m part of a large team of acute physicians and everyone’s job is tailored to their strengths and the things that interest them – be that practical procedures, acute oncology, education, ambulatory care or my particular interest of bedside ultrasound.

3 mornings a week my work is centred around the AMU, where I typically round on 13 patients who are a mixture of new admissions and those who have been admitted for >24 hours. This means I get to maintain a continuity of care with those inpatients who require the ongoing care of an Acute Physician and also review the overnight admissions early to form a plan for the day. The MDT is based on the ward all morning so there is ready access to OTs, pharmacists, physios and nurses to ensure those that need multi-professional input can achieve it early. It also means those with a high potential to go home can have that process started early.

Lunchtime often involves departmental teaching or catching up on admin and investigation results, before an afternoon of either inter-take of acute admissions (providing early senior input proven to improve outcomes), working on ambulatory care or Supporting Professional Activity – which often involves developing new services or teaching ultrasound to junior colleagues.

The variety of each day and the spectrum of patients that we see in each setting means that you always have to be on your toes, and you continually feel challenged as each presentation has its own nuance. Acute Internal Medicine is a busy but incredibly rewarding specialty, and each day I look forward to going to work knowing I’m part of a very close knit team dedicated to providing the best care for patients when they need it most.


Nick Smallwood

Consultant Acute Physician

The variety of each day and the spectrum of patients that we see in each setting means that you always have to be on your toes, and you continually feel challenged as each presentation has its own nuance.

Real life stories

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Lynsey Threlfall

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Have any questions?

People contact us for a variety of reasons, but mainly to find out more about our events, our jobs and training options. We love to share our passion for AIM so don’t hesitate to get in touch.