Although the multitude of career paths within internal medicine (IM) may seem staggering, it reflects the breadth and richness of the specialty as a discipline. All IM physicians share a basic core of residency training that forms the foundation for whichever discipline they choose to pursue. Whether physicians practice general internal medicine or obtain additional fellowship training, there are many opportunities to shape a unique medical career. See all the available career paths.
Gastroenterology
The Discipline
Gastroenterology is the subspecialty of internal medicine that focuses on the evaluation and treatment of disorders of the gastrointestinal tract. Gastroenterology requires an extensive understanding of the entire gastrointestinal tract, including the esophagus, stomach, small intestine, liver, gall bladder, pancreas, colon, and rectum. Internal medicine physicians practicing gastrointestinal medicine ("gastroenterologists") are also experts in how gastrointestinal disorders affect other organs and manifest themselves clinically. Gastrointestinal medicine also includes extensive training in nutrition and medical nutritional disorders.
There are many models of gastroenterology practice. Many gastroenterologists practice in groups who see ambulatory patients with gastrointestinal problems both in consultation for other physicians or follow them longitudinally for management of their gastrointestinal issues. These groups frequently also provide consultation services to hospitals and may manage patients with gastrointestinal problems as inpatients. Many gastroenterology practices provide endoscopy services (such as for colon cancer screening) and other diagnostic procedures for either or both their own patients or those referred by other physicians. Some gastroenterologists choose to further focus their practice around specific gastrointestinal disorders, such as motility problems or liver diseases; advanced training and certification is available in transplant hepatology. In academic settings, gastroenterologists provide consultative and ongoing care in ambulatory clinics and inpatient settings and may be involved in other activities such as liver transplantation. Academic gastroenterologists may also perform basic science and clinical research and teach medical students and residents.
Training
Following completion of a three-year internal medicine residency, an additional three-year fellowship in gastrointestinal medicine is required. After successful completion of a gastroenterology fellowship, trainees are eligible for certification in gastroenterology by the American Board of Internal Medicine.
Training Positions
In this 2023-2024 academic year, there were 238 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in gastroenterology with 2,070 trainees.
Major Professional Societies
- American College of Gastroenterology
- The American Gastroenterological Association
- American Society for Gastrointestinal Endoscopy
- American Association for the Study of Liver Diseases
See all the career pathways open to internal medicine physicians. Be sure to also explore a day in the life of an IM specialist/subspecialist.
Back to the July 2024 issue of ACP IMpact