Workforce, training and education
East Midlands

Midlands Enhance Programme

Frequently Asked Questions


What does ‘Generalism’ mean?

Following the NHS Long Term Plan and subsequent People Plan report, Health Education England (HEE) launched the Future Doctor Report, which highlighted the need for a greater proportion of doctors and other healthcare professionals to have generalist skills. This became even more pertinent during the COVID-19 pandemic. Healthcare professionals with generalist skills are adept at working throughout their careers, across organisational boundaries, bridging the community, primary and secondary healthcare settings.

HEE’s Medical Education Reform Programme (MERP) have been developing a strategy for implementing Generalism into the early years of postgraduate medical training. The programme aims to broaden the expertise of all clinical professionals by ‘enhancing’ the current training programmes. MERP has partnered with expert to produce an educational syllabus covering six healthcare domains supported by four cross-cutting themes. Further information can be found here:

How do I apply for an ‘Enhance’ post?

Recruitment currently takes place within the IMT recruitment process – further details can be found here:

How will the programme benefit my training?

Enhance offers added value beyond traditional IMT training. It aims to enable you to develop holistic approaches to both the health and wellbeing of the individual and also entire populations. Immersive experience opportunities will have specific focus on addressing local population health needs and reducing health inequalities among marginalised groups. Community healthcare placements are offered within rotations to provide insight into healthcare outside of a hospital setting.

What will the teaching sessions cover?

The teaching includes

  • Public health
  • VITA (social medicine)
  • Human factors
  • Placement in the Community trust
  • Immersive experience

Will the teaching sessions be face to face or virtual?

There will be a combination of face to face and virtual teaching sessions, depending upon the material being presented and group preferences to try to accommodate all involved.

Will the enhance teaching sessions be in addition to my regional teaching sessions?

Yes, enhance teaching sessions are separate and will be in addition to your mandatory regional teaching sessions. Enhance trainees are allowed additional study leave.

Where is the training taking place currently?

The first enhance posts commenced in August 2022 in Derbyshire (5 trainees). Two other sites in Coventry (3 trainees) and Lincolnshire (3 trainees) will be launching from August 2023.

What will my community rotation cover?

There are various learning opportunities available during the community placement such as diabetic clinics, heart failure management, frailty and home visiting services. These will vary depending on local availability and trainee preferences. Community leads will do their best to ensure learning is tailored to your interests and learning needs.

Will I be expected to undertake a project?

Yes. you will engage in ‘Immersive experiences’ during which they will be paired up with community based (voluntary) organisations who work with vulnerable communities to tackle health inequalities. Trainees are encouraged to identify a project based on their area of interest and collaborate with the organisation.

What will the ‘immersive experience’ involve?

You will spend a few days in a rotation to understand the organisation’s ethos, observe the team at work and meet with service users to appreciate some of the challenges in accessing health care.  Trainees will then be able to identify an area of interest and in collaboration with the organisation, make a recommendation to tackle the challenges.  They will also have the opportunity to take the recommended proposal forward in the second and third years.  This opportunity has the potential for conference abstracts in the second year and a publication in third year.  Academic support will be provided throughout the project.

Do I need to be able to drive?

A driving licence is recommended to be able to travel for the community part of the rotation. You may also need to drive to face to face enhance training days, although the faculty will aim to use central venues that are easily accessible via public transport.

How do I claim back expenses?

This process will be utilising the process within your employing Trust who will be able to share details of this at induction.  Please ensure you have business insurance in order to claim travel expenses during community placements.

Will the Enhance programme cover my whole training programme?

The Enhance programme will run in parallel and will be interwoven into the 3 years of IMT stage 1.

Will the Enhance programme be assessed during annual appraisal/ARCP?

There are no separate e-portfolio requirements for enhance. However, work based placed assessments performed in the community such as OPCATs and clinic attendance will be counted towards ARCP requirements. The teaching and learning opportunities within Enhance can provide evidence which will support and strengthen trainee e-portfolios.

Here are some reflections and comments from the current cohort of Enhance IMT trainees:

  • “Learning how discharge letters play a great part in community care as community services do not have access to the hospital systems.
  • Clinical judgements and safety netting advices are very important in community settings where investigations are not easily available.
  • Reflecting my leadership role as a professional doctor when working with different professionals.
  • Knowing these community services exist, it can potentially prevent long hospital stays.
  • To focus on patient-centered treatments and management.
  • Understanding social determinants and health inequalities.
  • Understanding how limited capabilities the community services have.
  • Generalism in my opinion focuses on patient-centered but wider view and rationalizing appropriately.”


If you require further information, please email