Comparison of the GIM 2009 and AIM 2009 Curricula
This document compares the GIM 2009 and AIM curricula line by line and lists the items that appear uniquely in one curriculum but not the other. For ease of correlation with the curriculum documents the page numbers of each section are listed in the format GIM page number/AIM page number.
Symptom-Based Competencies
Cardio-Respiratory Arrest
Knowledge: AIM: Demonstrate knowledge of safe transfer to ITU if required
Demonstrate knowledge of evidence for best practice
Skills: AIM: Transfer the patient safely to ITU
Teach evidence-based best practice patient management
Debrief the resuscitation officer or department after the cardiac arrest and discuss issues for concern and improvement
Behaviours: AIM: Communicate with critical care team re transfer to critical care unit
Communicate with resuscitation department
Shocked patient
Knowledge: AIM: Outline the legal framework for organ donation
Demonstrate a detailed knowledge of the
Surviving Sepsis 2008 International Guidelines for the management of severe sepsis and septic shock
Demonstrate a knowledge of non-invasive measurements of cardiovascular haemodynamics
Demonstrate the knowledge for intra-aortic balloon pumping
Demonstrate the knowledge of safe transfer of the critically ill patient
Skills: AIM: Expert assessment of neurological status of acutely unwell patient, including diagnosis of brainstem death
Co-ordinate and manage care within a HDU/Level
2 setting
Implement surviving sepsis guidelines appropriately
Adjust therapy to non-invasive measurements of cardiovascular haemodynamics
Insert an arterial line safely when indicated.
Adopt a leadership role to perform of safe transfer of the critically ill patient.
Behaviours: AIM: Discuss issues of donation appropriately with transplant coordinators, and family/carers of patient p99/110 p99/110

Unconscious patient
Knowledge:
Skills:
AIM: Detail the legal framework for organ donation
AIM: Provide robust airways support for the unconscious patient including the use of tracheal masks and endotracheal intubation when appropriate
Perform tests for brain stem death
Behaviours: AIM: Discuss issues of donation appropriately with transplant coordinators, and family/carers of patient p100/111
Anaphylaxis
Knowledge: AIM: Recall evidence base for best practice in management of acute anaphylaxis (UK
Resuscitation Council) p100/112
Skills: AIM: Maintain and secure a patient airway in patients with laryngoedema
Behaviours:
Top 20
No difference
Abdominal pain
Knowledge: GIM: Define the indications for specialist investigations: ultrasound, CT, MRI, endoscopy.
AIM: Demonstrate a knowledge of focussed ultrasound scanning of the abdomen.
Skills: AIM: Ensure a FAST scan is performed in patients who present with abdominal pain. p102/114
Behaviours: AIM: Report results of USS with radiology and discuss findings.

Acute back pain
Knowledge: GIM: Outline secondary prevention measures in osteoporosis.
AIM: Outline the difference between vertebral osteomyelitis and epidural abscess.
Outline the indications for surgery in vertebral osteomyelitis and epidural abscess.
p102/114
Skills: AIM: Order, interpret and act on urgent MRI of spine, including urgent treatment when indicated.
Order and interpret radiology imaging to differentiate between osteomyelitis and epidural abscess.
Manage medically as appropriate and refer for surgery when indicated.
Behaviours: GIM: Recognise impact of osteoporosis and encourage bone protection in all patients at risk.
Blackout/Collapse
Knowledge:
Skills:
Behaviours:
AIM: Demonstrate knowledge of the workings of the temporary pacing system i.e. gain, threshold, capture.
AIM: Be able to adjust the temporary pacing wire to maintain adequate pacing.
No difference p102/115
Breathlessness
Knowledge: AIM: Outline the physiological effects of BiPAP and
CPAP
Draw the pressure waves of the various ventilatory modes.
Outline the indications for BiPAP or CPAP in pulmonary oedema and COPD
Outline the evidence base for non-invasive ventilation for causes of breathlessness.
Skills: AIM: Maintain and secure a patent airway
Modify non-invasive ventilation parameters appropriately
Manage patients with breathlessness who require non-invasive ventilation in a level 2 area.
Behaviours: AIM: Liaise with the critical care team re levels of care and safe transfer to level 3 facility (critical care unit). p103/115

Chest pain
Knowledge: AIM: List less common but life threatening causes of chest pain p103/116
Skills: AIM: Co-ordinate expert management for lifethreatening causes of chest pain
Interpret exercise tolerance tests (ETT).
Interpret CT pulmonary angiograms in patients with large central pulmonary embolus.
Run follow up clinic for patients found not to have an acute cause for their chest pain
Behaviours: AIM: Explain to the patient the result of ETT
Confusion, Acute/Delirium
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Cough
Doesn’t exist in AIM curriculum above CMT
Diarrhoea
Knowledge: AIM: List rarer causes of diarrhoea particularly in the foreign traveller.
Demonstrate knowledge for the indications for a sigmoidoscopy.
Skills: AIM: Treat the rare causes of diarrhoea e.g. giardiasis
Perform a rigid sigmoidoscopy (+ rectal biopsy) safely and interpret the findings
Behaviours: AIM: Communicate with the infectious diseases specialists re the management of such patients
Communicate with the Gastroenterologists re ongoing management of such patients
Falls
Knowledge:
Skills:
No difference
AIM: Risk stratification of patients who present acutely with falls re admission or discharge
Co-ordinate multidisciplinary management of falls i.e. falls clinic
Behaviours: AIM: Liaise with primary care team and other community services to establish an effective falls prevention programme p104/117 p104/– p105/118 p106/118

Fever
Knowledge:
Skills:
Behaviours:
Fits/Seizure
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Haematemesis and Malaena
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Headache
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Jaundice
Knowledge:
Skills:
No difference
No difference
No difference
AIM: Recall the supportive treatment for acute liver failure e.g. indications for antibiotics, management of cerebral oedema
AIM: Co-ordinate expert management of fulminant liver failure
Behaviours: AIM: Seek prompt involvement of Critical Care team when required p106/119 p107/120 p107/121 p108/121 p108/122
Limb pain & swelling
Knowledge: AIM: Outline the importance of follow up of patients with proven DVT
Skills: AIM: Run a Venous Thromboembolic (VTE) follow up clinic
Behaviours: AIM: Explain to the patient the long term sequelae of
VTE
Palpitations
Knowledge: AIM: Outline the indications for specialist tests such as loop recorders. p109/123 p109/123
Skills:
Behaviours:
No difference
No difference

Poisoning
Knowledge AIM: Demonstrate knowledge of the management of the rarer poisons e.g. beta blockers, ACE
Inhibitors, calcium channel blockers
Demonstrate evidence based knowledge for the management of poisons.
Skills: AIM: Manage cases of the rarer poisons that present to hospital
Behaviours: AIM: Co-ordinate multiple specialty management of patient (ITU, Renal etc)
Rash
Knowledge:
Skills:
No difference
AIM: Implement appropriate management plan in cases of ‘skin failure’
Behaviours: No difference
Vomiting and nausea
Doesn’t exist in AIM curriculum above CMT p110/124 p111/125 p111/–
Weakness and paralysis
Knowledge: AIM: Recall potentially reversible life threatening causes of weakness
Outline the indications for hemicraniectomy in stroke.
OPTIONAL: Recall the NIHSS and Rankin scale
Skills: AIM: Intervene promptly in life threatening causes of weakness
Maintain and secure a patent airway
Be part of a Stroke Thrombolysis team and perform safe stroke thrombolysis
Behaviours: AIM: Refer to neurosurgical services appropriately
Obtain consent as appropriate from a patient for stroke thrombolysis
Other Important Presentations p111/125
Abdominal Mass/Hepatosplenomegaly
Knowledge: AIM: Demonstrate awareness of potential acute complications of hepatomegaly and splenomegaly
Skills:
Behaviours:
No difference
No difference p113/127

Abdominal Swelling & Constipation
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Abnormal sensation (Parasthesia & Numbness)
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Aggressive/Disturbed Behaviour
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Alcohol and Substance Dependence
Knowledge: AIM: Outline the indications for inpatient and outpatient alcohol withdrawal
Skills:
Behaviours:
AIM: Run an outpatient alcohol withdrawal service
No difference
Anxiety/Panic Disorder
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Bruising and Spontaneous Bleeding
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Dialysis
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Dyspepsia
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference p113/127 p114/128 p114/128 p114/129 p116/129 p115/129 p118/130 p116/131

Dysuria
Knowledge:
Skills:
Behaviours: n/a
No difference
No difference
Genital Discharge and Ulceration
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Haematuria
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Haemoptysis
Knowledge:
Skills:
Behaviours:
Head Injury
Knowledge:
No difference
No difference
No difference
AIM: Outline the indication and the duration of anticonvulsant therapy in posttraumatic seizure.
Outline the indication for intravenous mannitol.
Skills: AIM: Perform safe transfer from secondary settings to a neuroscience unit
Outline how to perform safe transfer from secondary settings to a neuroscience unit
Outline indications for intubation and ventilation for transfer from secondary settings to a neuroscience unit
Behaviours: AIM: Communicate with the neuroscience units to facilitate safe transfer of patients.
Hoarseness and Stridor
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Hypothermia
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference p117/131 p117/131 p118/130 p118/132 p118/133 p119/133 p119/134

Immobility
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Incidental Findings
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Involuntary Movements
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Joint Swelling
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Lymphadenopathy
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Loin Pain
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Medical Problems Following (Acute Illness and) p119/134 p120/135 p121/136 p121/136 p121/136 p122/137 p123/137
Surgical Procedures
Knowledge: AIM: Outline pre-operative assessments which risk stratify surgical risk
Skills: AIM: Perform inreaching of appropriate surgical patients to the AMU/medical HDU for stabilisation
Behaviours: AIM: Liaise closely with the critical outreach team
Medical Problems In Pregnancy
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference p123/138

Memory Loss (Progressive)
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Micturition Difficulties
Knowledge: of acute kidney injury
Skills:
Behaviours:
AIM: Outlines management of patient to minimise risk
No difference
No difference
Neck Pain
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference p124/139 p124/139 p124/139
Physical Symptoms in Absence of Organic Disease
Knowledge:
Skills:
AIM: Recall the reattribution approach
AIM: Use the reattribution approach:
1) Feeling understood – engage the patient and gather information
2) Broadening the agenda – to include social and psychological factors
3) Making the link – between physical symptoms, psychological distress, and social problem
Behaviours: No difference
Polydipsia
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Polyuria
Knowledge:
Skills:
Behaviours:
Pruritus
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
No difference
No difference
No difference p125/140 p125/141 p126/141 p126/142
Rectal Bleeding
Knowledge:
Skills:
No difference
No difference p127/142

Behaviours: No difference
Skin and Mouth Ulcers
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Speech Disturbance
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Suicidal Ideation
Knowledge: AIM: Outline the principles of the relevant Mental
Health Act (e.g. sections 2, 3, 4 and 5) and common law in detail
Skills:
Behaviours:
No difference
AIM: Liaise with psychiatric services re the use of the
Mental health Act
Swallowing Difficulties
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Syncope & Pre-syncope
Knowledge: AIM: Understand the pathophysiological response to head up tilting.
Outline the protocol for head up tilt testing.
Interpret the head up tilt test and classify the types of positive responses.
Understand the pathophysiological response to carotid sinus massage.
Outline the protocol for carotid sinus massage.
Interpret the positive response to carotid sinus massage.
Outline the indications for cardiac loop recorder.
Skills:
Behaviours:
AIM: Perform carotid sinus massage appropriately.
No difference
Unsteadiness/Balance Disturbance
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference p127/143 p128/143 p128/143 p128/144 p129/144 p129/145

Visual Disturbance
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Weight Loss
Knowledge:
Skills:
Behaviours:
No difference
No difference
No difference
Symptom Specific Competences
Allergy
Competences:
Common problems:
Clinical Science:
No difference
No difference
No difference
Oncology
Competences: AIM: Recognise that patients with ontological illness may present with co-exist illness separate from the primary disease and/or complicating the illness
Common Problems: AIM: For the acute physician active liaison with local oncology services is vital to ensure management of complications of oncological disease is prompt effective and based on agreed protocols.
Clinical Science: No difference
Palliative & End of Life Care
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Cardiovascular Medicine
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Clinical Genetics
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference p130/145 p130/146 p133/148 p134/149 p136/151 p137/152 p139/154

Clinical Pharmacology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Dermatology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Diabetes & Endocrinology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Gastroenterology & Hepatology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Haematology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Immunology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Infectious Diseases
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Elderly
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Musculoskeletal
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference p141/156 p144/159 p146/161 p148/163 p150/165 p152/167 p153/168 p155/170 p157/172

Neurology
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Psychiatry
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference
Renal Medicine
Competences: AIM: Recognise predisposing factors that precipitate acute kidney injury and develop management plans to avoid its further development
Common Problems:
Clinical Science:
No difference
No difference
Respiratory Medicine
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference p159/173 p161/175 p162/177 p163/178
Public Health & Health Promotion
Competences:
Common Problems:
Clinical Science:
No difference
No difference
No difference p166/180
Synthesis of competences that must be acquired (AIM only) p–/184
Investigation Competences
No difference p170/191
Procedural Competences p173/194
AIM:
• Endo-tracheal Intubation and safe airway protection
• Sengstaken-Blakemore Tube insertion
The comparison was compiled by: Jane Atkinson, Stephan Birkner, Timothy Bonnici, Stephen
Bonny, Allan Cameron, Sarah Hoye, Nigel Lane, Caroline Lebus, Sabina Moola, Francesca
Neuberger, Ascanio Tridente, Ashley Warnock, Anne Whiteside, Jacob de Wolff