IMT Application 2027: Dates, Eligibility and the Competition Ratio

Internal Medicine Training (IMT) applications for the 2027 round open at 10am on Thursday 22 October 2026 and close at 4pm on Thursday 19 November 2026, according to NHS England's Round 1 timeline. You need full GMC registration on the day you apply, and IMT does not use the MSRA.

In 2025 there were 8,841 applications for 1,678 posts, a ratio of 5.27 to one, or about 19% of applicants securing a post.

Reviewed and updated 11 September 2026. Every date, score and price below carries the year it belongs to, and the 2027 IMT pages are due from the Physician Specialty Recruitment Office in autumn 2026.

Key takeaways

• IMT 2027 applications open at 10am on 22 October 2026 and close at 4pm on 19 November 2026, on Oriel, with interviews between 11 January and 2 April 2027.
• Full GMC registration is required at the point of application; the licence to practise is only required by the post start date.
• IMT is selected on the self-assessment for shortlisting and the interview alone for ranking. There is no MSRA.
• The 2025 competition ratio was 5.27 to one (8,841 applications, 1,678 posts), up from 3.69 in 2024 and 2.80 in 2023.
• For 2027 the five IMT-only shortlisting points are removed, so shortlisting comes entirely from the self-assessment.
• The IMT-specific dates inside the national window are published by the Physician Specialty Recruitment Office in autumn 2026; the 2026 dates below are the reference until then.

When do IMT applications open and close for 2027?

IMT applications for 2027 open at 10am on Thursday 22 October 2026 and close at 4pm on Thursday 19 November 2026. These are the national Round 1 dates published by NHS England, and they apply to every CT1 and ST1 specialty.

The IMT recruitment office states that its website "pertains to 2026 recruitment and will be updated for the 2027 recruitment year in the autumn of 2026". Until then, nothing IMT-specific is confirmed inside that window.

What were the 2026 IMT dates, and what do they tell you about 2027?

The 2026 IMT round ran from 23 October 2025 to interviews on 12 January to 13 February 2026, with offers by 24 March 2026. The shape of the year, rather than the exact dates, is what you can plan against.

In practice, the 2026 IMT interviews ran for five weeks from 12 January. If 2027 follows the same pattern, expect invitations before Christmas and interviews from mid January.

Who is eligible to apply for IMT in 2027?

You are eligible for IMT if you hold full GMC registration when you apply and can evidence foundation competence dated within three and a half years of the post start date. The IMT recruitment office states that a licence to practise is not required at application, only by the start date of an accepted offer.

Full GMC registration is the registration status that lets a doctor practise unsupervised in the UK, and it must appear on the GMC register before you submit. Oriel validates the number against your name.

Foundation competence is evidenced by the Foundation Programme Completion Certificate for those who completed UK foundation training since February 2023. Everyone else needs the 2024 version of the CREST, submitted with the application.

That said, the CREST rule is unforgiving. The IMT recruitment office states that applications requiring a CREST and not submitting one "will be rejected, with no opportunity to supply the correct evidence".

Does IMT use the MSRA?

No. IMT does not use the Multi-Specialty Recruitment Assessment at any stage. Shortlisting is decided by the self-assessment score, and the interview alone decides your ranking.

This separates IMT from core surgery, which weights the MSRA at 10%, and from anaesthetics, which weights it at 15%. An IMT applicant has no machine-marked exam to sit in January.

However, that concentrates everything on two 11-minute stations. The internalmedicineinterview bank holds 361 IMT questions across 56 scenarios for exactly that reason, and its spoken-practice mode is marked by AI against the published domains.

What is the IMT competition ratio?

The IMT competition ratio in 2025 was 5.27 to one: 8,841 applications for 1,678 posts, according to NHS England's 2025 competition ratios. The Physician Specialty Recruitment Office's own table lists 1,677 vacancies for the same round.

Applications have more than tripled since 2020 while posts have barely moved. The 2026 and 2027 ratios are not yet published, and the Prioritisation Act makes 2027 hard to compare with any earlier year.

How does the Medical Training (Prioritisation) Act affect the 2027 IMT round?

For 2027 the Medical Training (Prioritisation) Act 2026 applies at shortlisting as well as at offer, so it now affects who is invited to interview at all. In 2026 it applied at offer only.

According to NHS England's information for applicants, the 2027 criteria were still being agreed across the four nations in August 2026, and the 2026 immigration-status proxy "will not apply automatically". Expect the criteria before applications open.

In practice, this means an IMT applicant should read the criteria the day they publish and check which group they fall into before spending time on the self-assessment.

How does shortlisting work for IMT in 2027?

Shortlisting for IMT in 2027 comes entirely from the self-assessment score. The IMT recruitment office states that the five points previously awarded to applicants who applied only to the joint IMT/ACCS-IM vacancy are removed for 2027.

Self-assessment is the section of the Oriel form where you select one option per evidence domain, each option carrying a fixed number of points. The 2026 maximum was 30 points plus the 5 IMT-only points; for 2027 the 5 are gone.

Every claim must be backed by documentation, and the office runs randomised audits. The full points matrix, including the confirmed 2027 changes to publications and presentations, is in our IMT self-assessment 2027 guide.

What should you do between now and 22 October 2026?

Between now and 22 October 2026 an IMT applicant should register on Oriel, gather the evidence for every self-assessment claim, and start rehearsing the two-minute presentation out loud.

1. Create the Oriel account now. The account, not the form, is what takes time.
2. Check your GMC registration status and your FPCC or 2024 CREST against the three-and-a-half-year rule.
3. Assemble certificates and letters for each self-assessment domain before you claim a point.
4. Read the IMT recruitment office's 2027 pages the week they publish and note every IMT-specific date.
5. Start spoken practice early: the interview alone ranks you, and internalmedicineinterview's free sample questions at /Question-Bank/Sample-Questions show the station format.

What happens after you submit an IMT application?

After you submit, your IMT application is longlisted for eligibility, then shortlisted on the self-assessment score, and successful applicants are invited to book an interview slot on Oriel. In 2026 all three steps were complete by 18 December 2025.

The IMT recruitment office states that booking is "on a first come, first served basis" and that "there is no benefit to being interviewed at one region over another". Book the earliest slot you can prepare for.

From there, the two-station interview decides your rank. Our IMT interview 2027 guide covers the timings, the 96-mark weighting and the appointability rules.