Internal medicine training (IMT) is the main entry route to the medical specialty in the UK. 8,251 applications were considered for shortlisting in England, Northern Ireland and Wales in Round 1 of the 2026 IMT recruitment. The median score for these applications was 21 points out of a maximum of 35 points, up from 15 points in 2025. Scores are assessed separately across all portfolio areas. In 2026, the score includes an additional five points only for job applicants. Shortlisting metrics are moving beyond what can reasonably be expected at this career stage.