Working in gastroenterology: 5 Pros and 5 Cons

Working in gastroenterology: 5 Pros and 5 Cons

Gastroenterology is not for everyone. Here goes.

5 Pros – why should I work in gastroenterology

1. Practice general medicine. There are great first hand learning opportunities as patients with inflammatory bowel disease and liver diseases, usually have other endocrine (especially diabetic) and abdominal surgical problems. There is alot of contact with general surgeons, especially upper and lower GI
2. Procedures. There are alot of procedures, e.g. endoscopy, colonoscopy, ERCPs, ascitic taps, and liver biopsies. So if you are practical and like using your hands, and want to be a physician, this may be a specialty for you
3. Variety and continuity. There is a huge variety of patients and illnesses – from common ones like IBS, NASH, peptic ulcer, GORD; to rare ones like primary biliary cirrhosis. On a gastroenterology ward, you will always be seeing something new, which means you will regularly face new challenges and learn new skills. Also the ‘hot work’ (mainly GI bleeds and liver disease, on the wards) is balanced by ‘cold work’ (especially IBD, in the clinics); where you will also have to make careful plans for liver transplants, for example. There are many long-term patients with IBD and coeliac disease who you will get really fond of
4. The hours are largely social. As a consultant you will not often be working at night, weekends, and bank holidays. Some will be on a upper GI bleed rota, but they don’t often have to come in at night
5. Finance. And there is alot of private practice as a consultant. But you can seriously boost your salary by endoscopies, colonoscopies and other procedures.

5 Cons – why you may not want to work in gastroenterology

Here is a list of cons for gastroenterology.

1. Too much general medicine in some jobs. Gastroenterological disease is very common. This means all hospitals have them, from small local hospitals to large teaching hospitals. Consultants in the smaller hospitals still have to do alot of general medical takes, that do not always interest them that much
2. Not a huge amount of clinical immunology. For those of you that like clinical immunology and pathology, this may not be the place for you. Biological agents are increasingly used. Nephrology or haematology may be specialties you might look at if you like clinical immunology
3. Senior supervision. This is usually good but perhaps not as close (and stifling!) as some medical specialties. There are pros and cons to this issue, e.g. it does promote independent thinking
4. Even pace. Whilst most staff enjoy the even, others miss a specialty where there is a faster pace
5. Emotionally draining. In liver disease, you are likely to encounter a lot of pain and tragedy – e.g. a lot of deaths (especially from alcohol related disease). Seeing such things can be emotionally draining. And that’s doubly true when patients die before you can save them. While it is important to have empathy for your patients, the best gastroenterology staff need the ability to remain slightly detached and emotionally healthy, even in the face of other people’s suffering.

Summary

We have described working in gastroenterology, and its pros and cons. We hope you have learnt something.