Higher Specialist Training in Internal Medicine

HST: The final step towards becoming a specialist

On satisfactory completion of Higher Specialist Training (HST), you will receive a Certificate of Satisfactory Completion of Specialist Training (CSCST) which allows you to enter the Specialist Division of the Register with the Medical Council. This means you can apply for consultant posts.

Many doctors spend some time working abroad and building up their portfolio of research, audits and publications before becoming a consultant.

However, you will have met the core requirement for consultant appointment, which is registration on the Specialist Division of the Register with the Medical Council.

We offer 17 HST programmes in internal medicine.

We offer Higher Specialist Training programmes in

Cardiology
Clinical Pharmacology and Therapeutics
Clinical Genetics
Dermatology
Endocrinology and Diabetes Mellitus
Gastroenterology
Genitourinary Medicine
Geriatric Medicine
Infectious Diseases
Medical Oncology
Nephrology
Neurology
Palliative Medicine
Pharmaceutical Medicine
Rehabilitation Medicine
Respiratory Medicine
Rheumatology

To find out what HST in each specialty involves and what the entry requirements are, check the relevant curriculum at the link below:

HST Training Programme Curricula

The duration of each HST programme is four to six years depending on the specialty. Training is completed in Specialist Registrar (SpR) posts.

What to Expect

Your first two years of HST will be spent in full-time clinical SpR posts in Ireland.

After that, you can continue to train in full-time posts in Ireland, or you can start a period of full-time research or develop a subspecialty interest.

You can apply for up to 12 months’ credit towards your Certificate of Satisfactory Completion of Specialist Training (CSCST) for research undertaken during HST.

During the annual allocation of SpR posts, we will endeavor to be as flexible as possible, within the confines of your specialty requirements, to allow you to develop a subspecialty interest.

Depending on your specialty, you will need to see a set number of emergencies and complicated cases, attend a certain number of outpatient clinics, and demonstrate competence in certain procedures and practical skills during HST.

Dual Training

As a specialist in internal medicine, you will need expert knowledge of a wide range of common acute disorders due to the nature of your specialty and the patients you will encounter.

Some specialties have developed Dual Training (additional training in General Internal Medicine), whereby you receive a Certificate of Satisfactory Completion of Specialist Training (CSCST) in both your main specialty and in General Internal Medicine.

The following specialties offer Dual Training:

Cardiology
Clinical Pharmacology and Therapeutics
Endocrinology and Diabetes Mellitus
Gastroenterology
Geriatric Medicine
Infectious Diseases
Nephrology
Respiratory Medicine
Rheumatology

For further information about Dual Training please refer to the General Internal Medicine Curriculum.

What Do I Need to Do in Addition to Clinical Training?

In addition to supervised clinical training in the hospital, you will attend a number of mandatory courses and study days designed to help you develop professionally and acquire the non-clinical skills and knowledge needed to provide excellent patient care.

Depending on your specialty, you may be required to attend more mandatory courses in addition to the ones listed below. To see what’s required for your specialty, check the HST curriculum.

facts about HST in internal medicine
Duration	Four to six years depending on specialty
Job title/grade of doctor	Specialist Registrar (SpR)
Average intake each year	Cardiology - 11 Clinical Genetics - 1 Clinical Pharmacology - 3 Dermatology - 5 Endocrinology and Diabetes - 7 Gastroenterology - 12 Genito-Urinary Medicine - 1 Geriatric Medicine - 19 Infectious Diseases - 8 Medical Oncology - 9 Nephrology - 7 Neurology - 6 Palliative Medicine - 5 Pharmaceutical Medicine - 0 Rehabilitation Medicine - 1 Respiratory Medicine - 12 Rheumatology - 8 * these numbers are current and indicative and not a future predictor
Exams to pass	None
Mandatory educational courses to be completed as part of HST	• HST Leadership in Clinical Practice • Ethics, which involves four separate modules: Professionalism, Law, Research, and End of Life issues • Performing Audit • Mastering Communications • Health Research Methods – An Introduction Check the Minimum Requirements for Training section of your curriculum to see if there are other courses that are mandatory for your specialty.
Study days to attend	Three to six per year, depending on specialty Check the Minimum Requirements for Training section of your curriculum
Training body	Institute of Medicine

RCPI Helpdesk

Tel: +353 1 8639721

Contact our Helpdesk for assistance with using our online products and services. Open Monday to Friday, 9:00am - 5:00pm.