Gastroenterologists are doctors who investigate, diagnose, treat and prevent all gastrointestinal (stomach and intestines) and hepatological (liver, gallbladder, biliary tree and pancreas) diseases.
This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.
Nature of the work
All specialists are competent at upper gastrointestinal (GI) endoscopy and some will have had additional training in hepatobiliary endoscopy. Most will participate in acute gastroenterology admissions and manage a broad range of gastrointestinal disease, either in outpatients or following admission.
Gastroenterologists treat conditions such as:
- gastrointestinal bleeding
- gastrointestinal cancer
- anaemia – a condition where the haemoglobin the blood (a pigment that carries osygen) is below normal levels
- inflammatory bowel disease, eg Crohn’s disease (inflammation of the lining of the digestive system), ulcerative colitis (inflammation and ulceration of the lining of the rectum and colon)
- short bowel syndrome
- jaundice – a condition where the skin yellows due to an acculumation of bilirubin the blood and tissues
- management of alcoholic, viral hepatitis (Inflammation of the liver caused by a virus) and autoimmune liver disorders (where the body attacks its own cells)
- diverticulitis - inflammation of the diverticula (small pouches) in the intestine
- upper and lower gastrointestinal endoscopy
- endoscopic retrograde cholangiopancreatography (ERCP) – an endoscopic technique mainly used to diagnose and treat bile duct and pancreatic duct conditions
- endoscopic ultrasound (EUS)
- intestinal and liver biopsy
- paracentesis (puncture of the wall of a cavity using a hollow needle and insertion of parenteral nutrition line (intravenous feedling lines)
- planning and aftercare of patients undergoing liver transplant
The CCT sub-specialty is:
Many gastroenterologists develop sub-specialty interests such as:
- hepatology (diseases of the liver)
- pancreaticobiliary disease with endoscopic retrograde cholangiopancreatography (ERCP)
- inflammatory bowel disease
- functional bowel disease
- tropical diseases
- gastrointestinal cancer and its prevention
- endoscopic surveillance
- reflux oesophagitis (inflammation of the oesophagus)
- pancreatic disease
- medicolegal issues in medicine
- clinical pharmacology
- inherited cancer syndromes
- clinical nutrition
Want to learn more?
Find out more about:
- Pay and conditions Expand / Collapse
This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.
NHS Employers provides useful advice and guidance on all NHS pay, contracts terms and conditions.
Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.
- Where the role can lead Expand / Collapse
Read about consultant and non-consultant roles in gastroenterology, flexible working and about wider opportunities.
Managerial opportunities for consultants include:
- clinical lead - lead NHS consultant for the team
- clinical director - lead NHS consultant for the department
- medical director - lead NHS consultant for the Trust
Most NHS consultants will be involved with clinical and educational supervision of junior doctors.
Here are some examples of education and training opportunities:
- director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
- training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training programme director. This role will be working within the LETB/deanery
- associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery
SAS doctor roles
There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor. SAS doctors are non-training roles where the doctor has at least four years of postgraduate training, two of those being in a relevant specialty. Find out more about SAS doctors roles.
Other non-training grade roles
These roles include:
- trust grade
- clinical fellows
A significant proportion of UK acute internal medicine trainees are undergoing flexible training; arrangements are made between the trainee and their local education and training board (LETB).
If you have trained on an academic gastroenterology pathway or are interested in research there are opportunities in academic medicine.
For those with a particular interest in research, you may wish to consider an academic career in gastroenterology. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.
Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.
Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC).
There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine.
The Clinical Research Network (CRN) actively encourages all doctors to take part in clinical research.
There are currently a number of staff grade posts in clinical gastroenterology or specifically endoscopy. They provide an important role in many gastrointestinal (GI) teams.
Teaching is an integral part of most posts and there are opportunities to do research.
- Job market and vacancies Expand / Collapse
This section provides useful information about the availability of jobs, finding vacancies and where to find out more.
Job market information
Gastroenterology had 1147 substantive consultants in England (1370 in the UK, not including 20 locum consultants) (Gastroenterology Workforce Report, June 2015) and 879 gastro registrars in the UK (2015, HSCIC).
Women make up 18% of the consultant workforce, just over 37% of the medical registrar workforce and 37% of higher specialty trainees in England, Wales and Northern Ireland. This is much lower than other medical specialties and may be linked to the difficulty of balancing on call rotas with family life.
Gastroenterology and hepatology expanded the most of all medical specialties in 2013. The consultant workforce increased by 85 in England, Wales and Northern Ireland despite a third of advertised consultant posts remaining unfilled. The British Society of Gastroenterology estimates that a further expansion will be needed to meet the demands of an aging population. The Society is also aware of regional variation in consultant gastroenterologist provision. North East England and London have the most consultant gastroenterologists per population while Wales, East Midlands and South East Coast/South Central England have the least.
The competition ratio for Core Medical Training (CT1), the first stage in the training (post-foundation), in 2015 was 1.7 (NHS Specialty Training, 2015).
The ratio of applicants to ST3 posts in 2015 was 1.8 (239 applicants for 94 NTN and 39 LAT posts) (JRCPTB, 2015).
For information regarding Scotland, Wales and Northern Ireland please click on the links below.
Where to look for vacancies
All trainees apply through the online application system Oriel. You will be able to register for training, view all vacancies, apply, book interviews and assessment centres, and manage offers made to you.
Local education and training boards (LETBs)/deaneries will have details of training vacancies. Not all LETBs/deaneries will offer new training posts in all specialties in all years.
All jobs will be advertised on the NHS Jobs website.
The BMJ Careers website also advertises vacancies.
- Further information Expand / Collapse