Tropical Medicine with General Internal Medicine CESR Portfolio Guide
Complete guide to the Tropical Medicine with General Internal Medicine Portfolio Pathway: 22 Capabilities in Practice (CiPs), 6 evidence sections, and a 5-year currency window. Based on official GMC Specialty Specific Guidance, published by Joint Royal Colleges of Physicians Training Board.
SSG Version: 21 September 2021
Capabilities in Practice (CiPs)
The Tropical Medicine with General Internal Medicine SSG defines 22 Capabilities in Practice (CiPs) that Portfolio Pathway applicants must demonstrate competence in.
Able to function successfully within NHS organisational and management systems
- Evidence may include consultant reports, MSF, governance/service development evidence, NHS or health service management courses and management CPD.
Able to deal with ethical and legal issues related to clinical practice
- Evidence may include consultant reports, MSF, mental capacity reflections, best-interest decision evidence and relevant legislation training.
Communicates effectively and is able to share decision making, while maintaining appropriate situational awareness, professional behaviour and professional judgement
- Evidence may include consultant reports, MSF, patient feedback, reflective practice, mini-CEX and communication or simulation CPD.
Is focused on patient safety and delivers effective quality improvement in patient care
- Evidence may include MCR, MSF, reflective practice, inter-service communication evidence and QIPAT or quality improvement activity.
Carries out research and manages data appropriately
- Evidence should demonstrate research, critical appraisal, evidence-based practice and appropriate data handling.
Acts as a clinical teacher and clinical supervisor
- Evidence should demonstrate teaching, supervision, feedback and development as an educator.
Able to provide clinical leadership and support to the laboratory
- Evidence should show independent clinical leadership and laboratory support relevant to tropical medicine practice.
Able to use the laboratory service effectively in the investigation, diagnosis and management of infection
- Evidence should show effective use of laboratory services for investigation, diagnosis and infection management.
Able to advise on infection prevention, control and immunisation
- Evidence should show advice and leadership in infection prevention, control and immunisation.
Able to manage and advise on important clinical syndromes where infection is in the differential diagnosis
- Evidence should show management and advice across important infection syndromes.
Able to lead and advise on treatment with and stewardship of antimicrobials
- Evidence should show antimicrobial treatment advice and stewardship leadership.
Providing continuity of care to inpatients and outpatients with suspected or proven infection
- Evidence should show continuity of care for suspected or proven infection in inpatient and outpatient settings.
Able to manage and advise on imported infections
- Evidence should show management and advice for imported infections.
Able to deliver equitable and high quality care in resource poor settings
- Evidence should show delivery of equitable, high-quality care in resource-poor settings.
Managing an acute unselected take
- Evidence should show independent acute unselected take practice at Entrustment Level 4.
Managing the acute care of patients within a medical specialty service
- Evidence should show independent acute care within a medical specialty service at Entrustment Level 4.
Providing continuity of care to medical inpatients, including management of comorbidities and cognitive impairment
- Evidence should show continuity of inpatient medical care, including comorbidity and cognitive impairment.
Managing patients in an outpatient clinic, ambulatory or community setting, including management of long term conditions
- Evidence should show outpatient, ambulatory or community practice including long-term condition management.
Managing medical problems in patients in other specialties and special cases
- Evidence should show management of medical problems in other specialties and special cases.
Managing a multi-disciplinary team including effective discharge planning
- Evidence should show multidisciplinary team management and discharge planning.
Delivering effective resuscitation and managing the acutely deteriorating patient
- Evidence should show effective resuscitation and management of the acutely deteriorating patient.
Managing end of life and applying palliative care skills
- Evidence should show end-of-life and palliative care skills.
Evidence Requirements
The SSG specifies 6 evidence sections. Each section describes what evidence to provide and how to present it.
Supervised Learning Events
ACAT, OPCAT, CbD and mini-CEX evidence.
What evidence should show
SLEs should show that the applicant is performing in an independent manner at Entrustment Level 4 across GIM and Tropical Medicine practice, with cases and feedback sufficient to demonstrate the relevant CiPs.
What to provide
- Six GIM ACATs, each including at least five cases, indicating independent performance at Entrustment Level 4
- Six Tropical Medicine ACATs indicating independent performance at Entrustment Level 4
- Two OPCATs to Level 4 entrustment
- Eight further GIM SLEs made up of CbDs and mini-CEXs to Level 4 entrustment
- Four to six Tropical Medicine SLEs made up of CbDs and mini-CEXs to Level 4 entrustment
- For consultant-level applicants, countersigned evidence such as logbooks, ward round records or specialty MDT documentation may be considered
How to present
Map each SLE to the relevant GIM or Tropical Medicine CiP. Do not duplicate one document; cross-reference where it supports multiple CiPs.
Workplace Based Assessments
ECE, DOPS, QIPAT, Patient Survey, Teaching Observation, MSF and MCR evidence.
What evidence should show
WPBA evidence should demonstrate clinical, laboratory, procedural, teaching, patient feedback and quality improvement capability, with required recent evidence where specified.
What to provide
- Twelve Evaluation of Clinical Events
- DOPS evidence for each procedure for which the applicant must be competent to perform unsupervised, or accepted structured report evidence for core GIM procedural skills
- One QIPAT completed in the last 12 months of most recent practice
- One patient survey completed in the last 12 months of most recent practice with approximately 15 patients
- One teaching observation completed in the last 12 months of clinical practice or structured report commentary on teaching
- One MSF completed in the last 12 months before application, plus any available from the last five years
- Four Multiple Consultant Reports completed in the last 12 months
How to present
Upload each WPBA once and cross-reference to the CiPs it supports. Ensure assessor comments, feedback and dates are clear.
Other portfolio evidence
Portfolio evidence beyond formal SLEs and WPBAs.
What evidence should show
Other evidence should show acquisition and maintenance of knowledge, skills and key skills across clinical and non-clinical CiPs.
What to provide
- Appraisals or performance review evidence
- Reflective diaries or evidence of self-reflection
- Supervisor reports from trainers and supervisors
- Logbooks covering the last five years, showing procedure type and applicant role
- Training events, courses, study days and meetings over the last five years
- Evidence of seeing patients over the last five years across settings, referral contexts, conditions, stages of illness and ages
- Academic activities
- Management activities
- Structured reports
- CPD evidence including personal reflective diary and courses attended
How to present
Organise evidence against the relevant CiPs and use cross-referencing rather than duplicate uploads.
Training, qualifications and knowledge
Training and qualification evidence.
What evidence should show
Evidence should show the applicant's training pathway, primary and specialist qualifications, comparable knowledge and any formal assessment or curriculum mapping needed to demonstrate Internal Medicine and Tropical Medicine knowledge.
What to provide
- PMQ evidence where required by registration status
- Authenticated overseas specialist qualifications where applicable
- Evidence of completion of full MRCP(UK) or comparable qualification
- Evidence of CICE or FRCPath Part 1 where held, or robust portfolio evidence of breadth and depth of curriculum knowledge
- DTM&H and/or Diploma of HIV Medicine where held
- Specialist curriculum or examination syllabus and formal periodic assessments for overseas specialist qualifications
- Recent specialist training curriculum or syllabus where relevant
How to present
Provide clear mapping for any alternative or comparable qualification. Training evidence should be verified and submitted as background evidence where relevant.
Employment, duties and clinical setting evidence
Employment and role evidence.
What evidence should show
Evidence should show current and recent clinical activity, post duties, breadth of practice, setting, caseload and appraisal or performance review history.
What to provide
- Up to date CV
- Employment letters matching the CV
- Job descriptions showing department position, post title, clinical/non-clinical commitment and teaching/training involvement
- Rota samples from the last three years of clinical practice
- Departmental or unit annual caseload statistics from the last three years
- Annual appraisals, performance reviews or alternative appraisal evidence
How to present
Group employment evidence by post or institution and ensure dates, role and whole time equivalent status are explicit.
Practical procedures
Internal Medicine procedure evidence.
What evidence should show
Procedure evidence should show the required level of competence for Internal Medicine procedures, using logbooks, DOPS or structured report evidence where permitted.
What to provide
- Logbook and DOPS evidence for practical procedures
- Evidence of unsupervised competence where the procedure table requires it
- Skills lab or satisfactory supervised practice where the procedure table permits that level
- Structured GIM procedural report by a senior colleague where used instead of individual DOPS for core procedural skills
How to present
Map each procedure item to its evidence and competence level. Cross-reference supporting logbooks and reports.
Index Procedures
13 index procedures require procedural-based assessments (PBAs) with specified minimum assessors and competence levels.
| Procedure | Category | Min PBAs | Min Assessors | Min Level |
|---|---|---|---|---|
| Advanced cardiopulmonary resuscitation | Internal Medicine procedure | — | — | Leadership of CPR team |
| Direct current cardioversion | Internal Medicine procedure | — | — | Competent to perform unsupervised |
| Temporary cardiac pacing using an external device | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Central venous cannulation | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Access to circulation for resuscitation | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Pleural aspiration for fluid | Internal Medicine procedure | — | — | Competent to perform unsupervised |
| Pleural aspiration for pneumothorax | Internal Medicine procedure | — | — | Competent to perform unsupervised |
| Intercostal drain for pneumothorax | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Intercostal drain for effusion | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Nasogastric tube | Internal Medicine procedure | — | — | Competent to perform unsupervised |
| Ascitic tap | Internal Medicine procedure | — | — | Competent to perform unsupervised |
| Abdominal paracentesis | Internal Medicine procedure | — | — | Skills lab or satisfactory supervised practice |
| Lumbar puncture | Internal Medicine procedure | — | — | Competent to perform unsupervised |
Knowledge Requirements
Primary Path
MRCP(UK) or comparable assessment of applied knowledge
Alternative Path
Detailed mapping and robust portfolio of knowledge if required examinations are not held
Applicants should ideally provide CICE or FRCPath Part 1 evidence. DTM&H and/or Diploma of HIV Medicine may be advantageous, and the SSG lists accepted DTM&H awarding institutions.
Referee Requirements
Referee Reports Required
Current or recent practice
- Current Head of Department or other senior colleague with knowledge of breadth of clinical activity, ideally an Educational Supervisor with at least five years' experience or appropriate training experience
- One Internal Medicine referee of consultant level able to provide comments based on direct observation
- One further report from a colleague working with the applicant at consultant level in the specialty
Volume and Assessment Targets
The SSG specifies minimum volume and assessment targets for this specialty.
GIM ACATs indicating independent performance at Entrustment Level 4
GIM ACAT
Tropical Medicine ACATs indicating independent performance at Entrustment Level 4
Tropical Medicine ACAT
OPCATs to Level 4 entrustment
OPCAT
Further GIM SLEs made up of CbDs and mini-CEXs to Level 4 entrustment
GIM CbD/mini-CEX
Tropical Medicine SLEs made up of CbDs and mini-CEXs to Level 4 entrustment
Tropical Medicine CbD/mini-CEX
Evaluation of Clinical Events
ECE
QIPAT completed in the last 12 months of most recent practice
QIPAT
Patient survey with approximately 15 patients completed in the last 12 months of most recent practice
Patient Survey
Teaching observation completed in the last 12 months of clinical practice
Teaching Observation
MSF completed in the last 12 months before submission with approximately 12 colleagues
MSF
Multiple Consultant Reports completed in the last 12 months
MCR
Currency Window & Evidence Volume
Currency Window
Years
Evidence can be drawn from any point in the career, but there should be corresponding recent evidence from within the last five years of clinical practice, whole time equivalent. Approximately 50% of evidence for a curriculum outcome should be from within the last five years.
Evidence Volume
Most applications are expected to include around 100 electronically uploaded documents. Quality, breadth and relevance are more important than document volume.
Additional Notes
There is no standalone Tropical Medicine Portfolio application. The currently linked route is Tropical Medicine with General Internal Medicine.
The GMC landing page says revised SSGs for Tropical Medicine with Medical Virology and Tropical Medicine with Medical Microbiology are to be published shortly.
A successful applicant is awarded specialist registration in Tropical Medicine and the chosen second specialty.
Evidence must be mapped to the high-level learning outcomes and demonstrate Level 4 entrustment where specified.
Local terminal download of the current GMC PDF returned HTTP 403 in this environment, so the official PDF URL is recorded until the binary can be captured.
Frequently Asked Questions
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