What is Gastroenterology?

By Dr. Ananya Mandal, MDReviewed by April Cashin-Garbutt, MA (Editor)

According to the American College of Gastroenterology, Gastroenterology is the study of the normal function and diseases of the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver.

A gastroenterologist needs to have a detailed understanding of the normal physiology of all the above mentioned organs as well as motility through the intestines and gastrointestinal tract in order to maintain a healthy digestion, absorption of nutrients,  removal of waste and metabolic processes.

A gastroenterologist also needs to have a clear understanding of ailments affecting the organs of the gastrointestinal system like:

• peptic ulcer disease
• gastric cancers
• esophageal cancers
• achalasia
• Barret’s esophagus
• colon polyps
• colon and bowel cancers
• pancreatitis
• pancreatic cancers
• cholecystitis
• biliary tract disease
• gallbladder stones and cancer
• hepatitis
• gastroesophageal reflux
• colitis
• nutritional problems and malabsorption,
• Irritable Bowel Syndrome (IBS)
• a host of other disease conditions

Training

A Gastroenterologist must first complete a three-year Internal Medicine residency. He or she is then eligible for additional specialized training (fellowship) in Gastroenterology for two to three years. This means a total of 5-6 years of additional specialized education after medical school.

The fellowship is a hands-on intense and rigorous programme that gives the opportunity to the trainee to learn directly from nationally recognized experts and work to get a detailed understanding of gastrointestinal diseases.

Starting from evaluation of patients to caring for them in the office as well as in the hospital is part of the training. Training involves learning endoscopy (upper endoscopy, sigmoidoscopy, and colonoscopy), endoscopic biliary examination (endoscopic retrograde cholangiopancreatography or ERCP), endoscopic mucosal resection or EMR, endoscopic ultrasound (EUS) etc.

Along with endoscopy they are also trained in performing advanced endoscopic procedures such as polypectomy, esophageal and intestinal dilation and hemostasis. They are taught how to interpret imaging and pathology results in order to make appropriate recommendations to treat conditions.

The fellowship is overseen by national societies like the American Board of Internal Medicine, the American College of Gastroenterology, the American Gastroenterological Association, and the American Society for Gastrointestinal Endoscopy.

After completion of the fellowship the gastroenterologists are qualified to take the Gastroenterology board certification test administered by the American Board of Internal Medicine. Once they have successfully completed this examination they are “Board Certified.”

Renewal of certification

Gastroenterologists renew their board certification through the American Board of Internal Medicine (ABIM) via the Maintenance of Certification (MOC) program.

For this gastroenterologists need to schedule, take and pass the secure ABIM Gastroenterology Maintenance of Certification Examination as well as earn 100 points in Self-Evaluation of Medical Knowledge and Self-Evaluation of Practice Performance.

In the latter test they are needed to earn a minimum of 20 points of medical knowledge and 20 points of practice performance. The remaining 60 points may be from either medical knowledge, practice performance or both.

The ABIM Gastroenterology Maintenance of Certification Examination evaluates the knowledge and clinical judgment in relevant areas of practice. Exam questions are developed by a team of gastroenterologists in practice and in academic medicine. The computer-based examination is offered twice a year – in spring and fall.

Further Reading

• All Gastroenterology Content
• Malrotation of the Gastrointestinal Tract
• ERCP (Endoscopic Retrograde Cholangiopancreatography) Overview
• How to Recover Gut Health After Clostridium difficile Infection