Subspecialty and Combined Training Careers

Although this section of IMpact explores the subspecialty and combined training careers on internal medicine, it's worth emphasizing what makes internal medicine unique. Internal medicine physicians see things differently. Holistically. And in a unique way that allows them to analyze, lead, and humanize health care in a variety of different settings and roles. See all the career opportunities internal medicine can provide.


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. Internal medicine physicians 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.


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 this 2023-2024 academic year, there are 228 Accreditation Council for Graduate Medical Education (ACGME)-accredited training programs in gastroenterology with 1,972 trainees.

Major Professional Societies

  • American College of Gastroenterology
  • The American Gastroenterological Association
  • American Society for Gastrointestinal Endoscopy
  • American Association for the Study of Liver Diseases

See all the career pathways open to internal medicine physicians.

Back to the July 2023 issue of ACP IMpact