Internal Medicine

Circuit Progression

Registrar Training

Progression Through The Training Circuit For Registrars


There is a need for a structured learning programme for Registrars in the Division of Medicine. This includes a design of the registrar circuit in order to support both the learning and the personal and professional development of the registrar.

This requires that acquisition of knowledge and skills is encouraged at a time and in an order which supports learning, and that specific professional, emotional and personal challenges are encountered only at a point where the registrar is prepared and ready to meet them.


As far as the requirements of clinical service allow, registrars will progress through the circuit in a structured fashion. In Phase 1, they will learn generic skills in General Medicine and will develop an understanding of the subdiscipline-specific skills they require to support this. In Phase 2, they will learn these subdiscipline-specific skills while attached to subspecialist departments. In Phases 1-2 they will prepare for and complete the basic science requirements of the Part 1 FCP examination. In Phase 3, they will complete their MMed research projects. In Phase 4, they will consolidate all their clinical skills and knowledge and complete Part 2 of the FCP examination.

Phase 1: Introduction to General Medicine

Registrars will begin the circuit with an attachment in General Medicine. This will as far as possible be in a supported environment: i.e.:

  • in a unit where close consultant supervision is possible
  • in a hospital where frequent case discussion centred on the learning of appropriate history-taking, physical examination and clinical reasoning skills is possible.

Phase 2: Introduction to Subspecialist Medicine

Registrars will thereafter begin a series of rotations through subspecialist departments. During this time, they will receive intensive teaching within the discipline.

It must be clearly understood that 65% of the registrar’s time during the four years will be spent in General Medicine, and periods of attachment to General Medicine will continue during years 2-4.


During Phases 1-2, registrars will receive intensive basic science tutorials directed towards exam readiness for the Part 1 examination, as well as an Introduction to Research module. Registrars will be expected to pass the Part 1 within 12-15 months: 18 at the outside.

Phase 3: Research project and further clinical experience

Registrars will proceed with their research projects. Clinical attachments will as far as possible be to units associated with their projects, or to units offering enough unstructured time to complete these projects.


Registrars will be expected to have completed their dissertations by 30 months: 33 months at the outside.

Phase 4: Consolidation of General Medicine

Registrars will continue with a series of rotations through General Medicine, interspersed with subspecialist units as appropriate. In this phase, the emphasis is on a less supported environment, where they can work more independently though with specialist supervision. They will also receive intensive clinical tutorials directed towards exam readiness for the Part 2 examination.


During Phases 4, registrars will receive clinical science tutorials directed towards exam readiness for the Part 2 examination. Registrars will be expected to pass the Part 1 within 33 months: 39 at the outside.

Completion of the Programme

Registrars should emerge after 48 months with the FCP(SA) and MMed(Med) qualifications.