Acute and internal medicine forms the foundation of most other medical specialties. Therefore over 99% of trainees opt for dual-training in internal medicine with another subspecialty. Training requires expert knowledge and skill in the diagnosis and management of a range of acute disorders spanning the spectrum of medical diseases. Training is obtained using a mixture of high and low intensity training years rotating on different specialties with different trainers. The acute medicine programme provides another option for this training. Specific core competencies are assessed to ensure good medical practice as outlined in the specific curriculum developed by the RCPI.