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Subspecialty Careers: Highlights about Careers in Internal Medicine: Gastroenterology

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The Discipline

From the Greek word gaster, "the paunch or belly," and the word enteron, "the gut or intestine," this relating to the Greek enteros, "within."

Gastroenterology encompasses the evaluation and treatment of patients with disorders of the gastrointestinal tract, pancreas, biliary tract, and liver. It includes disorders of organs within the abdominal cavity and requires knowledge of the manifestations of gastrointestinal disorders in other organ systems, including the skin. Additional content areas include nutrition and nutritional deficiencies, and screening and prevention, particularly for colorectal cancer.

Procedures

Important procedural skills include flexible sigmoidoscopy, colonoscopy, upper endoscopy, all including biopsy and polypectomy, esophageal dilation, paracentesis, esophageal manometry, and endoscopic retrograde cholangiopancreatography. Other common procedures include 24-hour esophageal pH monitoring, small bowel absorption tests, gastric acid analysis, laparoscopy, liver biopsy, and percutaneous transhepatic cholangiography.

Training

Gastroenterology fellowship training requires three years of accredited training beyond general internal medicine residency. Of the three years, a minimum of 18 months must include clinical training in the diagnosis and management of a broad spectrum of medical diseases.

Certification

The American Board of Internal Medicine offers certification in Gastroenterology.

Training Positions

As of August 2005, there were 159 ACGME-accredited training programs with 1,097 active fellowship positions in Gastroenterology. 26% of the trainees were female, and 71% were US medical graduates.

Practice

Approximately 63% of the graduates enter clinical practice in gastroenterology in the United States, and 23% enter academic medicine.

Major Professional Societies

American Association for the Study of Liver Diseases
1729 King Street
Suite 200
Alexandria, VA 22314
(703) 299-9766

American College of Gastroenterology
P.O. Box 342260
Bethesda, MD 20827
(301) 263-9000

American Society for Gastrointestinal Endoscopy
1520 Kensington Road
Suite 202
Oak Brook, IL 60523
(630) 573-0600

The American Gastroenterological Association
4930 Del Ray Avenue
Bethesda, MD 20814
(301) 654-2055

Major Publications

Gastroenterology
Hepatology
Journal of Clinical Gastroenterology
The American Journal of Gastroenterology

Back to November 2006 Issue of IMpact

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