Marco Smit
Whether you trained in Ireland or abroad, the Basic Specialist Training (BST) programme in General Internal Medicine (GIM) offers a critical next step for doctors who want to sharpen their clinical skills, explore a wide range of subspecialties, and progress toward Higher Specialist Training (HST). It’s a structured, hands-on experience that equips you to thrive in a wide range of hospital settings—both regional and tertiary—while offering opportunities for research, mentorship, and professional development.
BST in GIM isn’t just a formality—it’s a formative stage in your career that will shape your clinical thinking, bedside manner, and future trajectory. With limited places and a competitive application process, preparation matters. Whether you’re completing an internship, working in a service role, or already holding NCHD experience, understanding how to plan and present your application can give you a real edge.
Why choose BST in GIM in Ireland?
Ireland’s specialty training in GIM offers a superb blend of clinical exposure, supportive mentorship, and clear progression pathways. Doctors with a special interest in core medical competencies will benefit from the structured training programme with formal support and clear progression goals. In addition, many pathology specialities require completion of the BST, including microbiology, immunology, chemical pathology, genetics, and anatomical pathology. The Irish training environment offers a mix of tertiary and regional hospitals, giving successful applicants a broad base of experience before heading further into Higher Specialist Training (HST) in their preferred speciality. Irish hospitals have an excellent track record of supportive training structures and a strong research culture while providing good work-life balance, making it an attractive choice for aspiring physicians.
The BST application process: an overview
In broad strokes, the BST application process is the same as an application to medical school, a post graduate degree or a job application, and should be treated as such. However, the application process differs in that it spans several months between application and interview, and is quite competitive. Applications are done through the Royal College of Physicians of Ireland (RCPI) webpage, and the annual application cycle opens around September each year. Applicants will be required to submit an up to date curriculum vitae (CV) and supporting documents to prove they meet the eligibility requirements (see below). Foreign trained applicants have additional requirements to fulfil, including English language proficiency tests to complete. After the CVs are screened for eligibility, scored and ranked, the majority of applicants are called to an interview, and further assessed on their clinical acumen, competency and academic prowess. Finally, after applicants are scored, successful candidates will be offered choices for centres where they would like to complete the BST. The BST uses a hub and spoke training structure, and applicants will rank the choices for which hub / centre they would prefer to work at. Higher scoring candidates are given advantage in these rankings, so it is in the applicant’s interest to score as high as possible to ultimately end up in the training centre and training rotations of their choice.
Actual versus stated minimum competencies and eligibility criteria
The stated minimum requirements from the RCPI BST application programmes are than an applicant:
- must have completed their internship by the start date of the programme
- must clearly demonstrate their eligibility for registration with the Irish Medical Council (IMC)
- must have proof of competency in the English language in line with HSE guidance
- must be eligible to work in Ireland at the time of application
- must be competent in intravenous cannulation, phlebotomy, nasogastric tube placement.
The stated entry requirements are supremely achievable by most doctors who have completed their internship, and in fact do not reflect the actual threshold for entry into the programme. In fact, several other competencies are assessed throughout the application process, which is why advance planning, smart selection of additional academic pursuits and, interview practice using is paramount for success.
The practical, actual requirements for successful application are more stringent. Successful candidates are scored on their academic achievements (that is, the centile or decile position within their graduating class), and publications in academic journals or at conferences, or completion of audits and quality improvement projects. Masters and doctorate degrees count a small number of points for a candidate (specifically 2 points for a masters and three points for a doctorate). The paucity of recognition for these postgraduate degrees reflect the expected emphasis on clinical and research endeavours. A co-authorship in an international journal publication is worth the same amount of points as a master’s degree. Each section of the rubric also has a maximum score. Use this information in table 1 to your advantage when planning to improve your CV.
| Section | Points and maximum points awardable |
|---|---|
| Academic Achievements | 40 points maximum |
|
Undergraduate achievement: Decile / centile rank in your graduating class |
20 points maximum |
| No centile position available, with letter from the university | 6 points maximum |
| No centile position, no letter from the university | 4 points maximum |
| Research and other qualifications | 13 points maximum |
| Authorship: | |
| International journal, first author | 3 points |
| International journal, co-author | 2 points |
| National journal, first author | 2 points |
| National journal, co-author | 1 point |
| Master’s degree | 2 points |
| Doctoral degree | 3 points |
| Academic poster / conference presentation | 1 point |
| Professional development | 7 points |
|
Which include: Completed audits / QIPs, Hospital committees (including NCHD committee memberships or leads), Other professional accolades |
There is no stated point allocation for this, but possibly 2 points for leading a committee and 1 point for being a member of a committee. |
Applicants will also need appraisals signed from two consultants that know you, in a standard format supplied by the RCPI.
Using the online portal from the Royal College of Physicians of Ireland (RCPI)
Keep an eye out for when the applications open. There will be a brief window wherein you can apply, usually around three weeks in September. Be sure to have all your supporting documents ready.
Applications are online through the RCPI website and application portal. Applicants will be required to submit their CV, as well as a personal statement about their experience and reasons why they are applying to the scheme.
The “Why” is almost as important as the “How”. It is a good idea to reflect on the genuine interest you have for your chosen career well before your application. The median applicant will be around 28 years old when they apply, and can expect to be in the workforce for longer than that. Longer than their entire life will be spent learning, working, making a difference, communicating, writing, and pursuing excellence. I write this not to frighten the reader, but to encourage a genuine, critical appraisal of your motivations, as this will be the kernel of truth you should convey in your personal statement and interview. This unique, truthful answer to the ubiquitous “why” everyone carries around will distinguish you from a lackluster candidate as much as a good CV or a clever interview will.
You know the why and how, and have a year to go before you apply. What can you do now to maximise your chances of success?
Knowing what constitutes a good CV and a good application means you can start working towards building up your experience. Make sure to request your centile position in your graduating class, as this can take some time, and counts a large portion of the initial score. Around a year in advance, try to identify research you can feasibly conduct and publish before the application date. Poster presentations at conferences that also publish a conference journal are ideal for this. Be sure to use the correct Vancouver citation when adding any publications to your CV. Another strategy is to integrate yourself to a high output researcher in your current role, perhaps a consultant or a specialist registrar who needs a hand with data collection, data analysis or a general busybody to complete their current (approved) research in exchange for a co-authorship. Whether you have many publications or few, be sure to focus your CV around your expertise in research, rather than a tally of what you have done. Most publications receive fewer than 5 citations, so a highly cited study may be more of a talking point in your interview than more numerous, less impactful publications. Remember also that non-experimental research, such as narrative literature reviews, scoping reviews or case reports are quick and are immensely publishable to the right conference or journal.
If you cannot feasibly complete research before the applications open, try to enrol into short courses that showcase research skills. Evidence synthesis Ireland offers a range of systematic review training opportunities, which are a useful skill to have as a researcher and aid in critical evaluation of research – a handy skill for any clinician. Coursera offers a variety of research short courses, including some in statistics for public health or AI in healthcare that will benefit your practice and add a line to your CV. HSEland has a number of free courses hosted by the HSE beyond those that are required for practice that may be of interest and are worth a number of CPD points. The AMRIC series on antimicrobial stewardship would be a great addition to a CV for anyone interested in infectious diseases, public health or occupational health. Lastly, but certainly not exhaustively, the RCPI offers a number of short courses, certificates and diplomas as standalone courses or as part of the CPD -SS that can be added to your repertoire of completed learning engagements.
At about 9 months from the application you should start gathering evidence for your academic and professional portfolio. Try to present at journal clubs, grand rounds, or volunteer to teach medical students. Complete audits or volunteer to aid ongoing quality improvement projects. There are a number of national audits that are usually coordinated by your hospital’s quality improvement office – a phone call to them would be a great way to get involved.
At 6 months from the application, start by drafting your CV. Review the requirements and make sure your CV matches the requirements set out by the RCPI. Make sure you have the required English language proficiency tests completed, where applicable. Submit the appraisal documents to the consultants you’ve identified that will give you an honest but favourable appraisal. You only need two appraisals completed, but it is advisable to ask three or more consultants to complete the documents, allowing you the convenience of choice on which to submit.
Three months from submission, you should have your CV refined and all the documents in order. Take the last three months to tie up any loose ends and complete any courses you can to boost your CV. Your CV should showcase sustained commitment to medicine: rotations in acute and subspecialty settings, leadership roles, presentations, publications, and teaching. You should use concise descriptions, quantifiable outcomes (e.g., audit re-audit percentages, number of citations of research). Use the weights of relevant domains to guide your CV, focussing on academic achievement, research and professional development separately. Your CV should be succinct, clear and measurable and connected to the outcomes.
What makes you stand out?
In recent years, most applicants who apply and meet the minimum requirements were invited to interview. This translates to hundreds of applications for the RCPI to screen and review. Clear CVs that are easy to award points will perform better than wordy, long, and confusing CVs. Your personal statement, as well as the appraisals from your consultants are some of the areas where you can make standout, memorable advances in the shortlisting process. A personal anecdote or a weighty novel reason for pursuing GIM will always be welcomed by assessors. In my application, I shared an anecdote about the first time I saw a malaria protozoite through the lens of a microscope and knew I wanted to pursue infectious diseases. A relatable, real, memorable anecdote may make all the difference.
The interview
Typically, interviews take place in January or February of the following year. The typical interview is 15 minutes, with 5 questions. The first question will be for you to talk through your CV, and the following 4 questions vary. Interview preparation makes all the difference. Anticipating what may be asked, and practicing responses to possible questions in advance does more than soothe the nerves. A well-polished interview from a presentable candidate with a structured, clear CV will mean better scores from the panel. Making a good first impression cannot be overstated here.
Interviews are weighted more heavily than CVs, and your responses to the clinical and ethical questions make up 60% of the final score.
From Application to Appointment: The BST GIM Journey
Following your interview, a panel will tally your score. Successful applicants will be contacted around April, and given an opportunity to rank their choice of training hub. Following the allocation of the training hub, applicants will be asked to rank their choice of rotation within this hub. The rankings are done online via the RCPI portal. In both cases, your application score (the combined score out of 100) will be taken into account, and higher scorers will be preferentially allocated to their choices. Candidates are divided into two groups for the purpose of ranking and allocation. Group 1 includes: Irish, UK, EU nationals, and holders of Stamp 4 or Stamp 4 EUFAM. These candidates must be treated equally in the ranking and allocation process, as required by EU law. Group 2 includes: holders of Stamp 1G and Stamp 1H (typically associated with medical posts or education provisions). Places in the BST are allocated in the first instance to applicants who, at the time of application, are considered Group 1. And offers may only be made to candidates in Group 2 once the pool of qualified candidates in Group 1 has been fully considered and exhausted, based on ranking.
Applicants who are not immediately successful are ranked in order, based on their combined scores. There are a number of cancellations each year, mostly from applicants who apply to several training schemes, or decide to seek greener pastures abroad, so not all hope is lost if you are not successful in the first round. However, despite an expanded number of training posts, the competition for these posts are increasing, highlighting the need for adequate preparation for the interviews.
An induction process happens between May and June, and is hosted in a hybrid learning environment. Map out the post-interview timeline: when offers are typically released, the acceptance deadline, and induction processes.