Job File: Gastroenterologist

Every year, millions of French people are affected by pathologies closely or distantly related to the stomach or intestine. Gastroenterologists play a key role in the French healthcare system. So it was only logical that we should devote one of our job descriptions to it. In this one, we explore every facet of this specialty, from the inherent responsibilities to the level of education required, not to mention average remuneration.

What is a gastroenterologist?

Definition and scope of practice

A gastroenterologist is a physician specialized in the study, diagnosis and treatment of diseases of the digestive system. They work on the entire gastrointestinal system: esophagus, stomach and intestines, as well as associated organs such as the liver, gallbladder and pancreas.

Its field of action covers a particularly broad spectrum. It treats both benign but disabling everyday disorders - such as gastric reflux, irritable bowel syndrome or chronic abdominal pain - and more serious conditions requiring specialized care.

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.

Organs concerned by gastroenterology

The gastroenterologist's field of action covers all the organs of the digestive system, i.e. :

• Esophagus
• Stomach
• Small intestine
• Colon
• Rectum
• Liver
• Pancreas
• Gall bladder

The gastroenterologist's main missions

Diagnosis and treatment of digestive disorders

The gastroenterologist plays a central role in identifying and treating digestive pathologies. Faced with a variety of symptoms - abdominal pain, transit disorders (diarrhea, constipation), chronic bloating, digestive bleeding or reflux - he or she takes a rigorous diagnostic approach. Thanks to 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 investigations

Mastery of endoscopic examinations is one of the gastroenterologist's key skills. In particular, he performs upper digestive endoscopy (gastroscopy) to directly visualize the esophagus, stomach and duodenum, enabling the detection of ulcers, inflammation or tumor lesions. Colonoscopy also enables him to examine the colon in detail, to detect and/or remove precancerous polyps, and to diagnose colorectal cancers at an early stage. He also performs specialized fibroscopies to assess the condition of the liver, bile ducts or pancreas. These procedures, generally performed under local or general anesthesia for the patient's comfort, have a dual purpose: diagnostic, of course, but also therapeutic.

Support for chronic pathologies

Patient follow-up is an essential part of the gastroenterologist's job. 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 relapses. 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.

Skills required to practice this specialty

Technical skills and mastery of exploratory tools

In order to carry out their day-to-day tasks, practitioners must develop specialized skills that include:

• Interpretation of endoscopic images
• Lesion detection
• Therapeutic procedures
• Mastering 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 calls for special intellectual skills on the part of the experienced gastroenterologist. Faced with sometimes atypical clinical pictures or non-specific symptoms, they must demonstrate :

• Structured clinical reasoning
• A capacity for critical analysis
• Constant scientific monitoring
• Multidisciplinary expertise

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

Interpersonal skills and pedagogy

The human dimension also plays a central role in this specialty, particularly given the chronic nature of many digestive pathologies. The gastroenterologist must cultivate essential interpersonal skills:

• Active listening
• Ability to explain
• Empathy
• Teaching patience

These skills are crucial, whether in the case of serious diagnoses or chronic diseases requiring major lifestyle changes.

Training to become a gastroenterologist

General medical studies

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

• The Parcours Accès Santé Spécifique (PASS)

• Introduced in 2020 to replace the former Première Année Commune aux Études de Santé (PACES), the PASS is a year of study combining a health major with 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 pass can go on to study in the health sector.
• Those who fail can reorient themselves towards their minor before, if they so wish, trying their luck again.
• The PASS approach reduces the pressure of the former PACES exam, while diversifying students' skills.

• The Licence with Health Access (L.AS)

• Introduced in 2020 to diversify the range of training courses available in health studies, the L.AS is a course 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 exams. Depending on their performance, they may be rejected or admitted to the second year of medical school.
• The L.AS allows students to follow a diversified pathway, encouraging skills development and reorientation.
  

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

• The Diplôme de Formation Générale en Sciences Médicales (DFGSM) : a three-year course (the PASS and L.AS count as the first) comprising theoretical courses in medical sciences and clinical placements in hospitals.
• The Diplôme de Formation Approfondie en Sciences Médicales (DFASM): a direct continuation of the DFGSM, this is a three-year course of study incorporating specialist courses and advanced internships in various hospital departments.

Externship examinations

During the final year of the second cycle, students must pass a series of exams which, depending on their results and rankings, will enable them to choose their specialty as well as their city. Here's the list:

• Épreuves dématérialisées nationales (EDN): these take place in October and account for 60% of the final grade. To pass, students must obtain a mark of at least 14/20 in the theoretical knowledge required by all doctors, regardless of their specialty.
• Objective and Structured Clinical Examinations (OSCE): these are held in May and account for 30% of the final grade. They test students' ability to develop clinical reasoning and problem-solving skills. The minimum grade is 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 they have completed their general medical studies , students specializing in gastroenterology begin a five-year internship. This course is divided into theoretical and practical training:

• Theoreticaltraining : interns follow theoretical courses covering the various aspects of cardiology. They attend seminars and conferences to keep abreast of the latest advances and research in the field.
• Practicaltraining : gastroenterology interns participate in the activities of various health services.

In addition, gastroenterology interns must write and defend a thesis in order to obtain their doctorate. On completion of this specialization, interns are awarded the Diplôme d'Études Spécialisées en Gastro-Entérologie (DES) and can apply for job vacancies as gastroenterologists.

As we have just seen, today's gastroenterologist is an essential link in the modern healthcare system. Beyond the undeniable technical expertise required by this specialty, it's the human dimension that makes all the difference in helping patients deal with sometimes intimate and worrying disorders.

This profession offers a unique balance between intellectual challenge 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 doctors seeking new professional challenges, thegastroenterology jobmarket remains dynamic and diverse. Whether in hospitals, private clinics or private practice, there's no shortage of opportunities to work in this exciting specialty, at the heart of contemporary public health issues.

If you enjoyed this article and would like to find out more, take a look at our gastroenterologist salary sheet!