The medicine stream of ACCS is designed for trainees who think they would like to become Acute Physicians; although this can still be a satisfactory form of core training to subsequently apply to train in acute medicine plus a specialty. In the original design of MMC, the ACCS medicine stream was intended to only last 2 years. However there is now general concern that trainees who were appointed to this programme in 2007 will only achieve 6 months out of the 2 years training in general medicine which is not now considered adequate to take on ST3 level responsibilities in general medicine. Therefore we are now extending this to a third year in which medicine themed trainees will extend their general medical experience. JRCPTB is currently approving this as a national revision to ACCS training.