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Gastroenterology

The speciality of gastroenterology involves the diagnosis and management of patients with diseases of the intestines, liver and biliary tree, and pancreas. The specialty is broadly divided into two aspects: medical and surgical, with a close working relationship maintained between the two. Medical gastroenterology largely involves the diagnosis and management of patients using medicine and minimally invasive interventions, i.e. endoscopy. There are clearly separate pathways after Senior House Officer to become either a physician or a surgeon but both undertake training in endoscopy.

Surgical gastroenterology is split into three specialties: the upper gastrointestinal tract, the lower GI tract and the liver, bile ducts and pancreas. Medical gastroenterology is often less specialised but with the opportunity to develop a sub-specialty in liver disease, dyspepsia, inflammatory bowel disease, functional disturbances of the gut, cancer, and endoscopy.

Endoscopy ranges from diagnostic to complex therapeutic endoscopy that is best regarded as a form of minimally invasive surgery, e.g. stopping bleeding from ulcers, removing gallstones. Many procedures in endoscopy have replaced traditional surgery as the safest way to manage the elderly population.

An interesting aspect of gastroenterology is that the disease crosses age, ethnicity and social background. Gastroenterologists treat patients from the age of about sixteen to the very elderly. Paediatric gastroenterology is a specific pathway in paediatric medicine.
Gastroenterology is largely an outpatient clinic specialty with a smaller proportion of patients needing hospital admission, for example, severe inflammatory bowel disease, cirrhosis of the liver, and gastrointestinal bleeding which usually requires joint management between physicians and surgeons to identify and manage the need and timing of surgery. Endoscopy is usually carried out as a day case procedure. Gastrointestinal disorders are common in primary care (general practice) and many patients are jointly managed with primary care physicians.

Personal qualities should include:

  • a breadth of medical interest
  • flexibility
  • communication skills
  • a capacity for team working, as shift systems and hand-over of cases becomes usual practice.

Further information

For further information on this specialty, please contact:

Royal College of Physicians
11 St Andrews Place
Regents Park
London
NW1 4LE

Tel: 0207 935 1174
Website: www.rcplondon.ac.uk
Email
Education: education@rcplondon.ac.uk
International office: international@rcplondon.ac.uk
Other enquiries: visit website for appropriate email addresses

More information can also be found on the Medical Careers website under the 'medicine' link of the specialty pages list.