The NHS is caring for an ageing population with increasingly complex health needs. Many patients live with multiple long-term conditions that do not sit neatly within one area of medicine – for example, someone might be living with diabetes, heart disease, and arthritis all at once. In hospital, this can mean seeing several different teams, which can feel fragmented and confusing.
To respond to this, a new training pathway for qualified doctors called Standalone General Internal Medicine (GIM) has been introduced in England. It is designed to prepare hospital doctors to take a broader view of a patient’s health, manage complex conditions, and work more closely with colleagues across different wards, clinics and community services. Early feedback from doctors and educators has been positive, but we still do not know enough about how this training is working in practice or what difference it makes for staff and patients.
Our national research project “FORGE” (which stands for Future Oriented Reform of Generalist Education) has been funded through the NIHR Workforce Voices Research Partnership, and launches this March. Over the next three years, we will study how this new General Internal Medicine training is being delivered in hospitals across England.
We will speak to doctors and supervisors, look at workforce data, and bring people together in workshops to understand what is helping the programme succeed and where improvements are needed. We are particularly interested in how it works in rural, coastal and economically disadvantaged areas, where staffing pressures can be greatest.
The purpose of FORGE is to find out whether this new kind of training helps doctors feel supported and stay in the NHS, and whether it strengthens care for patients with complex needs. The findings will help hospitals, educators and national leaders make informed decisions about the future of generalist medicine in the NHS.
