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. Internists 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 the 2019-2020 academic year, there are 202 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in gastroenterology with 1,742 trainees. There are also 64 ACGME-accredited training programs with 314 trainees in pediatric gastroenterology.
Major Professional Societies
- American College of Gastroenterology
- The American Gastroenterological Association
- American Society for Gastrointestinal Endoscopy
- American Association for the Study of Liver Disease
Back to the September 2019 issue of ACP IMpact