Job File: Gastroenterologist

Every year, millions of French people are affected by pathologies remotely or closely linked to the stomach or intestine. In this context, the macute;tier de gastro-entérologue has a prominent place within the French health system. It was therefore only logical that we should devote one of our special reports to the subject. In this one, we'll explore every facet of this speciality, from the inherent responsibilities to the level of education required, and the average income.

What is a gastroenterologist?

Définition and field of intervention

A gastroenterologist is a specialist in the study, diagnosis and treatment of diseases of the digestive system. This practitioner intervenes on the entire gastrointestinal system: oesophagus, stomach, intestines, but also associated organs such as the liver, gallbladder and pancreas.

its field of action covers a particularly broad spectrum. It treats both minor but disabling day-to-day disorders - such as gastric reflux, irritable bowel syndrome or chronic abdominal pain - and more serious conditions requiring specialized treatment.

This discipline requires in-depth, up-to-date knowledge of digestive function in all its complexity: from the physiology of the intestinal mucosa to the subtle interactions of microbial flora, via the enzymatic and hormonal mechanisms that regulate digestion. The gastroenterologist must also master cutting-edge techniques, from endoscopy to advanced medical imaging.

Bodies concerned by gastroenterology

The field of action of gastroenterology covers all the organs of the digestive system, i.e.:

• Œsophage
• Stomach
• Great intestine
• Côlon
• Rectum
• Foie
• Pancréas
• Gallbladder

The main missions of the gastroenterologist

Diagnosis and treatment of digestive disorders

The gastroenterologist plays a central role in the identification and management of digestive pathologies. Faced with a wide range of symptoms - abdominal pain, transit disorders (diarrhoea, constipation), chronic bloating, digestive bleeding and reflux - he applies a rigorous diagnostic procedure. Using in-depth biological tests, cutting-edge medical imaging techniques and specialized endoscopic explorations, he establishes a precise diagnosis that enables him to prescribe the right treatment for each situation.

Expertise in endoscopic explorations

Maîtrise of endoscopic examinations is one of the key skills of the gastroenterologist. In particular, he performs upper digestive endoscopy (gastroscopy) to directly visualize the œsophagus, stomach and duodénum, making it possible to detect ulcères, inflammation or tumor lesions. Colonoscopy also enables him to examine the colon in detail, detect and/or remove pre-cancerous polyps, and diagnose early-stage colorectal cancer. He also performs specialized fibroscopies to assess the condition of the liver, bile ducts or pancreas. These procedures, usually performed under local or general anaesthetic for the patient's comfort, have a dual interest: diagnostic, of course, but also therapeutic.

Accompaniment of chronic pathologies

Patient follow-up is an essential dimension of the métier of gastroenterology. Chronic inflammatory bowel diseases (IBD), such as Crohn's disease or ulcerative colitis, require regular monitoring and constant adaptation of treatments to maintain remission and prevent flare-ups. Similarly, patients suffering from cirrhosis, chronic hepatitis, pancreatitis or digestive cancers benefit from personalized, long-term support aimed at preventing complications and optimizing their quality of life.

The skills required to practice this speciality;

Technical skills and mastery of exploration tools

In order to accomplish their daily missions, practitioners must develop specialized skills that include:

• The interpretation of endoscopic images
• The détection of lésions
• The performance of therapeutic gestures
• The mastery of new technologies

This technical dexterity is acquired through ongoing training and regular practice, guaranteeing the safety and effectiveness of interventions.

Analytical skills and scientific rigor

The complexity of digestive pathologies demands particular intellectual skills from the gastroenterologist. Faced with sometimes atypical clinical pictures or unspecific symptoms, he must demonstrate:

• Structured clinical reasoning;
• A capacity for critical analysis
• A permanent scientific watch
• Multidisciplinary expertise

This scientific rigor will enable him to adapt his practices to the latest recommendations and offer care based on the most recent evidence.

Relational qualities and pedagogy

The human dimension also occupies a central place in this speciality, not least because of the chronicity of many digestive pathologies. The gastroenterologist must cultivate essential relational qualities:

• Active listening
• The ability to explain
• Empathy
• Pedagogical patience

These skills are crucial, whether it's during the announcement of serious diagnoses or in the accompaniment of chronic illnesses requiring major lifestyle modifications.

Training to become a gastroenterologist

Études générales de médecine

Before entering higher education, the aspiring gastro-entérologuemust obtain a scientific baccalaureate. Once this has been completed, students wishing to pursue health studies can choose between two options:

• Le Parcours Accès Santé Spécifique (PASS)

• Introduced in 2020 to replace the former Premiée Année Commune aux Études de Santé (PACES), the PASS is a year of study combining a health major; é a minor from another discipline. This structure makes it possible to diversify skills and offer avenues for reorientation.
• Students are assessed on the basis of continuous assessment and final exams.
• Those who succeed can enter the health sector.
• Those who fail can reorient themselves towards their minor's field of study before, if they wish, trying their luck again.
• The PASS approach relieves the pressure associated with the former PACES single entrance exam, while diversifying the student's skills.

• La Licence avec Accès Santé (L.AS)

• Introduced in 2020 in order to diversify the training offer in health studies, the L.AS is a program combining any major (law, humanities, economics, etc.) with a specific health minor (biology, physiology, etc.).
• At the end of the first, second or third year, and if they have passed the minimum requirements, students can apply for health studies. They then sit specific examinations. Depending on their performance, they are either rejected or admitted to the second year of medical school.
• The L.AS enables students to follow a diversified pathway, promoting skills and orientations.
  

After the PASS or L.AS (see above), general medical studies are divided into two diploma sections:

• Le Diplôme de Formation Générale en Sciences Médicales (DFGSM) : three-year curriculum (the PASS and L.AS count as the first) consisting of theoretical courses in medical sciences and clinical internships in hospitals.
• Le Diplôme de Formation Approfondie en Sciences Médicales (DFASM) : A direct continuation of the DFGSM, this is a three-year course that includes specialized courses and advanced internships in various hospital departments.

Éend-of-clerkship proofs 

During the final year of the second cycle, students must pass a battery of tests which, depending on their results and rankings, will enable them to formulate vœux de spécialit; mais également de ville. Here's the list: 

• Épreuves dématérialisées nationales (EDN): these take place in October and count for 60% of the final grade. In order to pass, students must obtain a mark of 14/20 or higher in the thematic knowledge required by all doctors, regardless of their specialty.
• Examens cliniques objectifs et structurés (ECOS): these are organized in May and count for 30% of the final grade. They test students' ability to develop clinical reasoning and problem-solving skills. The minimum mark must be 10/20.
• Academic progress grade: this continuous assessment takes into account the student's commitment, curriculum, mobility and level of English, and accounts for 10% of the final grade.

Specialization in gastroenterology

Once the études générales de médecine completed, students specializing in gastroenterology enter a five-year internship. This course is divided between theoretical and practical training:

• Training théoric : interns follow théoric courses covering the various aspects of cardiology. They attend seminars and conferences to keep up to date with the latest advances and research in the field.
• Training practical : gastroenterology interns participate in the activities of various healthcare departments.

In addition, the gastroenterology intern must write and defend a thesis in order to obtain a doctorate. Upon completion of this specialization, the intern obtains the Diplôme d'Etudes Spécialis;es en Gastro-Entérologie (DES) and can apply for job offers gastro-entérologue. 

As we've just seen, the gastroenterologist today embodies an essential link in the modern healthcare system. Beyond the indisputable technical expertise required by this speciality, it's the human dimension that makes all the difference in supporting patients in the face of sometimes intimate and preoccupying disorders.

This profession offers a unique balance between intellectual challenges and relational satisfaction, thanks to an often prolonged follow-up that enables lasting therapeutic bonds to be forged. The outlook is promising, particularly with advances in personalized medicine and the emergence of new therapeutic approaches.

For physicians seeking new professional challenges, the market for gastroenterology jobsremains dynamic and diversified. Whether in hospitals, private clinics or independent practices, there is no shortage of opportunities to practise this exciting speciality, at the heart of contemporary public health issues.