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NHS career in Gastroenterology: What would your future look like?

Hi, I am Abhishek, an IMG from India and a former MTI trainee in Medicine in 2018 - 2020. I passed my MRCP in 2021 and I am currently a Speciality Trainee (ST3) in Gastroenterology and Hepatology in the NHS, UK. Today I would like to portray what your career in gastroenterology would look like if you decide to choose this specialty.

What does gastroenterology involve?

This is a specialty that deals with the treatment of diseases involving the gastrointestinal tract. As per the latest curriculum designed by the JRCPTB, this speciality would henceforth be known as gastroenterology and hepatology. You would be trained accordingly and at the end of your training, expected to be competent in dealing with pathologies involving the oesophagus, stomach, bowels, liver, and pancreas. In addition to that, you would also need to gain competence in procedures like endoscopy and colonoscopy as a minimum.

How to get into training?

Gastroenterology training is super-speciality training which is also called Higher Specialist Training (HST). The minimum requirement is for you to complete Internal Medicine Training (IMT) program for 3 years or gain alternative competency for IMT. Following completion, you can then apply for gastro training through the ORIEL website twice a year for the 2 rounds. Do keep in mind, that if there are no vacant seats after round 1, the round 2 recruitment process would not go ahead. Once your application goes beyond a certain score, you are then longlisted and subsequently shortlisted. Shortlisted would mean getting called for an interview and then ranked based on that. There is another way to become a gastroenterologist in the UK is through the CESR pathway, but this is beyond the scope of this blog.

Is it the right specialty for you?

It is all down to what you are passionate about. Remember this would be your bread and butter for the next 40-50 years at least and then how long you would work. But some of the things that you should be aware of are as follows:

  • This is one of the busiest and most acute specialities where your patients in the hospital would be quite acutely sick and need your 100% attention and effort all the time. You would be a registrar in demand all over the hospital. Your bleeps would be ringing almost constantly.

  • Be a team player and have good leadership skills.

  • Be non-judgemental. You would come across a lot of patients with problems secondary to substance abuse and you have to be equally empathetic and compassionate to them.

  • Interested in doing procedures. Upper and Lower GI endoscopy and then ERCP and EUS take a lot of effort to perfect.

  • Gastroenterology is a speciality that like other specialities is dual certified with medicine. So a lot of your training time would go towards doing medicine on calls. Your annual leaves, zero-days, and study leaves go from your specialty days as you are not allowed to take off on your GIM days. Thus, it is common that the usual training time might be extended for you in order for you to be granted CCT.

  • There are lots of “eeky stuff”. Be prepared to enter a ward smelling of stools and patients vomiting around, but that shouldn’t concern you beyond a certain period of time.


Lots of scope in the UK and worldwide. Consultants are in demand and you would be allowed to work privately once you are a consultant.

Ok, so I have decided to do it, what's next?

  1. Finish your IMT training/gain IMT competencies.

  2. Show commitment to the speciality.

  3. Attend the BSG taster session and various events. These help with the above.

  4. Do a taster week in gastro/gastro rotation as a JCF/SCF if possible. This depends on your trust and sometimes might not be possible. I wasn’t able to get one. In that case try to negotiate for a gastro clinic, once per week.

If you have any questions about the NHS career in gastroenterology & hepatology, I would be happy to answer them at

Good luck,

Abhishek Ray

ST3 Gastroenterology and Hepatology

Webinars with Abhishek

TrewLink, in collaboration with Dr Abhishek, has recently hosted an informative webinar about the Medical Training Initiative (MTI) scheme for International Medical Graduates (IMGs).

If you would like to know more about the MTI scheme, please watch our FREE webinar with a Q&A session “Medical Training Initiative (MTI) for IMGs: process, requirements, top tips” at

MTI is the sponsored route of GMC registration which allows IMGs with considerable work experience to come and work in the UK for a period of 2 years. After their training, they return back to their home country and utilize their expertise to improve/suggest modifications to the existing health care there. NHS gains by reducing dependence on locums to cover for the shortage of doctors, getting experienced doctors on board and learning from their experience. Read more in our blog Medical Training Initiative (MTI) for IMGs or watch the webinar Medical Training Initiative (MTI) for IMGs: process, requirements, top tips

Written by Abhishek Edited by Julia


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