Dr Tom Lee, ST7
One-line ‘definition’ of specialty

A diverse specialty encompassing the diagnosis and management of conditions ranging from luminal ones such as inflammatory bowel disease (IBD), gastrointestinal cancer or irritable bowel syndrome to liver disorders such as alcoholic liver disease. Endoscopy provides a practical, hands-on dimension.

Brief run-down of training programme content and duration

A five-year programme, training takes place in a mix of district general hospitals and teaching hospitals. The usual aim is for dual accreditation with general medicine. It is possible to study sub-specialty areas of the curriculum in nutrition, IBD, hepatology and advanced endoscopy. Opportunities for research may allow a break in training.

Exam requirements

Specialty Certificate Examination (Gastroenterology).

Other requirements
  • Endoscopy and colonoscopy basic skills courses.
  • Online endoscopy portfolio.
  • Competency in gastroscopy, colonoscopy and a variety of therapeutic endoscopy techniques.
Opportunities/expectations for out of programme/research
  • Diverse areas of research available.
  • Strong UK research expertise in areas such as IBD, genetics, endoscopy and liver diseases.
A day in the life of a Registrar

8:30 am: Check on ward patients.

9:00 am: General gastro clinic, see ten patients with conditions ranging from a patient with irritable bowel syndrome that stops them socialising or going to work, to a patient with a new diagnosis of pancreatic cancer.

1:00 pm: Multi-disciplinary team (MDT) meeting, opportunity to discuss GI cases with radiologists, pathologists, surgeons and nurse specialists.

2:00 pm: Endoscopy list - four gastroscopies, one of which is a patient with haematemesis who has a bleeding ulcer that is treated endoscopically. Three colonoscopies including removal of a 2 cm precancerous colonic polyp.

Pros and cons of working in this specialty


  • Opportunity talk to patients about sensitive and embarrassing symptoms but which may have a profound effect on their day-to-day life.
  • Long-term management of chronic conditions such as IBD.
  • Practical dimension to specialty in the form of the endoscopy.
  • Diverse caseload appeals to generalists but there is the opportunity for sub-specialisation if desired.


  • Some view the general medical component and commitment throughout training as a downside.
How this specialty differs to others and what made me choose it
  • Hands-on work.
  • Still an expectation to dual accredit with general medicine unlike many cardiology trainees.
  • You get to deal with the gut, the most underrated and interesting organ.
  • The opportunity to prevent disease through bowel cancer screening or alcohol harm reduction programmes.
  • Close working with surgical colleagues is essential.
Tips for success in applying for this specialty
  • Spend ‘taster’ days with a gastroenterologist, both in a district general hospital and also at a tertiary referral centre to sample the full breadth of the specialty.
  • Observe an endoscopy.
  • Perform gastroenterology-relevant audits.
  • Attend a gastro conference or College update.
For more information

British Society for Gastroenterology