Requirements for Training Institutions, Separate Departments, and Sections: Working Group 9

Abstract

The manner in which a gastroenterologist is trained will reflect the national program for undergraduate and postgraduate education and also particularly the degree to which speciality medicine is practised in a country. At the one end of the spectrum (as is seen in much of the United Kingdom's specialist medicine) the gastroenterologist both practises as a general physician and exhibits his special clinical, technical, and intellectual skills in gastroenterology; at the other extreme is the gastroenterologist who sees no other type of medicine (or surgery) than gastroenterology. This latter pattern is probably a less common method of gastroenterologic practice. There is continuing argument about the benefits and disadvantages of the two systems. The gastroenterologist with a narrow field of interest will be an expert in this particular field but not have the capacity to manage the total medical problems of his patient. The gastroenterologist with a general medical interest may well be deficient in the depth and detail of his speciality but can be more competent in managing the illness of his patient. A great deal will depend on the financial resources of a country and the level of sophistication of its medical services. The two systems are not mutually exclusive. We do not make a value judgement on the two systems. There are all grades between the two extremes. The training must ideally be university-based or -associated.