Gastroenterology is a fast-moving and hugely varied specialty.
Using both medical therapies and endoscopy, gastroenterologists investigate and manage illnesses involving multiple different organs, affecting patients of all ages and ranging from the acute life-threatening to chronic lifelong conditions.
Gastroenterology - trainee characteristics
Trainees should consider a career in gastroenterology if they:
-
would like a specialty with a varied working week
- enjoy a mix of life-threatening illness and chronic disease management
-
enjoy practical skills
-
are hard-working and motivated
-
would like a career in a rapidly evolving field with potential to sub-specialise
-
would like to work in a multi-disciplinary team
Working/training in an HST gastroenterology post
Gastroenterology is an exciting and challenging practical medical specialty, dealing with conditions affecting the entire GI tract as well as liver and pancreas, and including the investigation and management of malignant, acute life-threatening and chronic conditions for which there is an array of effective medical and endoscopic interventions.
Division of practice & sub-specialties
Currently, consultants are commonly divided by their main practice into hepatologists, luminal gastroenterologists and academics; but the specialty is developing rapidly, and it is now possible to sub-specialise in advanced endoscopy and nutrition.
All trainees learn endoscopy and most consultants continue to perform procedures, ranging from straightforward diagnostic to complex therapeutic work.
Gastroenterology also offers the opportunity to care for patients ranging from adolescence to old age and to develop lasting relationships with patients with chronic conditions.
Potential for out-of-programme-experience
Many trainees choose to develop additional skills whilst training, often done with a period of time out of programme – something encouraged by the specialty.
Commonly these include a period of research, advanced hepatology/IBD/endoscopy/nutrition training or teaching or management experience.
Prospects
With gastroenterology present in all acute hospitals, being a net income generator for NHS trusts, and already one of the largest medical specialties, there are good job prospects at the end of training.
With the advent of the national bowel cancer screening programme, the planned introduction of flexible sigmoidoscopy screening, and the increasing burden of liver disease, there are several drivers to generate consultant jobs in the specialty, an important consideration when evaluating a specialty.
With sessional elements to the job it is also suited to less-than-full-time work.
Securing an ST4 post in gastroenterology
Aspiring gastroenterologists need to demonstrate excellence in their career to date.
Demonstration of commitment to the specialty is advantageous. Clinical exposure to the specialty and some experience of related practical procedures is desirable.
Higher training - What to expect
Training in gastroenterology is combined with training in general (internal) medicine leading to dual accreditation which remains essential for the majority of consultant posts.
Training takes a minimum of four years to complete (or pro rata if training less than full-time). All trainees rotate through secondary and tertiary centres and at some point should participate in a specialist out of hours ‘bleeder’ rota.
Furthermore, there are likely to be opportunities during the programme to spend at least one year of training in acquiring advanced clinical skills such as in hepatology, endoscopy and nutrition.
Medical Care
Find out more about gastroenterology and the services delivered by the specialty on Medical Care – the RCP’s online guide to service design.
Further information
General / application queries
For general queries relating to areas such as eligibility criteria, making an application or the Oriel system, please contact the Physician Specialty Recruitment Office.
Queries regarding the progress of a submitted application should be directed to the lead recruiter for this specialty. The lead recruiter for Gastroenterology is Scotland.
| NHS Education for Scotland | ||||||
|---|---|---|---|---|---|---|
| email address (ST3/general enquiries) | ||||||
Group 1 specialty
This is a Group 1 specialty and requires completion of the internal medicine training (IMT) stage 1 programme or equivalent; all programmes in the specialty will dual specialise with general internal medicine.
Therefore, this specialty uses the standard HST eligibility criteria for Group 1 specialties and does not accept candidates from any alternative training routes. Please visit the am I eligible? section of this website for further information.
Commitment to specialty
The specialty will be assessing your commitment to specialty as part of the shortlisting process. Please visit the application scoring page for more information about how this is assessed and scored.
Please note that due to the ongoing COVID-19 situation, certain recruitment processes have been affected for round 2 ST3 PSRO-coordinated specialties. As a result, the below information on this page is not applicable for this round only and should not be used where the process has changed. Please refer to the applicant guide for the latest information about how round 2 will operate.
Further guidance about the scoring format of interviews will be published to each specialty page and we hope to have this updated by application closing date. Please visit the specialty pages closer to the time for updated information.
Interview content
You will spend approximately 10 minutes at each of the three interview stations, with three-to-five minutes' transfer time between each. Thus the overall time for the interview will be approximately 40-45 minutes.
Click on the relevant stations below for more information on the content of the interview.
Please note that this is subject to change, and will be confirmed by the date of interview.
This is where your application form and training to date will be reviewed. This will include checking the documentation you have brought along to ensure all content on your application form is correct.
Evidence checking
Normally your evidence folder will have been reviewed by the interviewers immediately prior to your arrival in the station. They will be:
• Checking that your achievements in your evidence folder match that claimed on your application form.
• Considering your career progression to date.
• Identifying areas about which they may wish to question you during the interview.
Areas for assessment
The two main aspects of discussion here, on which you will be assessed, will be your suitability for and commitment to ST3 training in the specialty, and your achievements and engagement with training and learning to date.
Scoring at the station
It is important to recognise that the scores awarded to you at this station will not purely be about your achievements, as this already contributes towards the scoring via your application form. Interviewers will be deciding upon scores via a combination of factors, for example: your responses to the questions asked, the breadth and quality of your achievements and your career progression.
Prior to arriving at station 2, you will be given two clinical scenarios to review; one on the subject of luminal gastroenterology, the other on a hepatobiliary case.
Upon arrival at the station, you will be asked questions relating to these scenarios.
Each clinical scenario will be relatively brief (two/three sentences), so once you have read both, the remainder of the pre-station time will allow you to undertake some short preparation (just mental preparation - this does not mean making notes, etc.)
Scenario considerations
The scenarios will describe hypothetical clinical situations which have arisen in which you are, or have become, involved. Some points to consider when reviewing the scenarios and preparing for discussion are:
-
what steps you would take
-
any potential treatments possible
-
any further information you would gather
-
how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario.
You should take into account any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
As with other stations, you will receive two assessments here (four marks - two from each interviewer) - one for your response to the luminal gastroenterology scenario, and the other for your response to the hepatobiliary scenario.
At this station, you will be asked to give a presentation, which you are expected to prepare in advance on a given subject (see below). The station will be divided into two parts - five minutes for your presentation, followed by five minutes for discussion of it.
Presentation
Upon arrival at station 3, you will need to give a presentation on one of the following topics, for no more than five minutes:
'An interesting case I have been involved in'
OR:
'An interesting recent development in gastroenterology '
Again, we stress you should only present on one of these topics, not both. When preparing your presentation, please bear in mind the points below:
-
Clarity & relevance most important - The major purpose of this station is to assess communication skills. Thus you should select a topic that is relevant to gastroenterology, and which you can present with clarity. This is more important than trying to impress by choosing a subject that is esoteric or complex. The topic should be relevant to your application where possible.
-
No aids/resources - There will be no projectors or laptops for PowerPoint, no OHPs, flip-charts, etc. You are welcome to use prompts on small cards, but these should be for your own use only, and should not be given out as hand-outs.
-
Five minute time limit - Your presentation must last for no more than five minutes . Please note that you will be stopped after five minutes so as to allow further discussion to take place, so try and get your main points across before then. At the same time, bear in mind that interviewers will be assessing the level, depth and content of your presentation, as well as expecting some structure.
Interview nerves will be taken into consideration.[collapse]
Post-presentation discussion
Once your presentation is finished (interviewers will stop you at the five minute-mark), interviewers will discuss it with you and ask further questions relating to the items you raise and any further points.
This discussion will take place for approximately another five minutes.
Areas for assessment
The first area for which you will receive a score at station 3 will be your presentation and its accompanying discussion; essentially, this mark will reflect your understanding of the subject matter, as displayed via your presentation and the accompanying dicussion.
While assessing your presentation and discussion, interviewers here will also assess your communication skills.
Interview scoring
Appointable - automatic
If you are awarded a score of at least 3/5, for all marks given to you at your interview, then you will automatically be classed as appointable.
If your 12 interview scores contain one or two marks of 2/5 (and the rest 3/5 or above), and you receive a total raw interview score of 36 or above, then you will automatically be classed as appointable.
Not appointable - automatic
If any of the 12 scores awarded to you at interview are 1/5, this will reflect poor performance and an area of major concern.
If three or more of your 12 interview scores are of 2/5, this will reflect several areas of concern across your whole interview.
Should your interview assessment falls under either category above, the level of concern over your potential progression to ST3 will see your application classed automatically as not appointable .
Total score calculation
After interview, a weighting is applied to the scores in each area, as well as the application form score, to give a 'total score'. This score determines your ranking which is used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, can be seen by clicking on 'Total score calculation' below.
Please note that this is subject to change, and will be confirmed by the date of interview.
| Int. 1 | Int. 2 | Weighting | Max score | |
| Station 1 | ||||
| Evidence | / 5 | / 5 | x1.6 | / 16 |
| Suitability for specialty | / 5 | / 5 | x1.2 | / 12 |
| Station 2 | ||||
| Clinical scenario (Lu) | / 5 | / 5 | x1.6 | / 16 |
| Clinical scenario (HPB) | / 5 | / 5 | x1.2 | / 12 |
| Station 3 | ||||
| Presentation | / 5 | / 5 | x1.6 | / 16 |
| Communication mark | / 5 | / 5 | x0.8 | / 8 |
| Raw interview score | / 60 | |||
| Interview score (including weighting) | / 80 | |||
| Short-listing (app form) | / 80 | x0.25 | / 20 | |
| Overall assessment score | / 100 | |||
As part of the process of applying to HST, you may wish to gain an idea of how recruitment progressed in previous years for the various specialties participating in the nationally-coordinated recruitment.
To this end, we have published data dating back to 2013 (where this is available), based around four main areas:
-
Competition ratios - application numbers submitted to each specialty, along with the number of NTN and LAT posts available in each. It is worth noting that posts are subject to change throughout the round (increasing on average between 20-40%), and post numbers for this data are taken at the end of the round.
-
Shortlist scores - the scores awarded to all submitted applications, including average scores and distribution nationally.
-
Total scores - the total score awarded to all candidates who completed the full recruitment process for a specialty (application and interview), including some analysis of scores.
-
Post fill rates - the number of posts filled by region.
We have published information for all specialties participating in our process that year; consequently not all specialties will have data in all cases.
Round 1
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. | Unique* |
|---|---|---|---|---|---|---|
| 2020 | 331 | 59 | 7 | 66 | 5 | 54% |
| 2019 | 245 | 77 | 7 | 84 | 2.9 | 63% |
| 2018 | 216 | 84 | 5 | 89 | 2.4 | 56% |
| 2017 | 211 | 77 | 4 | 81 | 2.6 | 53% |
| 2016 | 234 | 92 | 0 | 92 | 2.5 | 59% |
| 2015 | 239 | 94 | 39 | 133 | 1.8 | 62% |
* the percentage of unique candidates that only applied to this specialty (out of the 24 PSRO-coordinated specialties)
Round 2
| Year | Apps. | NTN posts | LAT posts | Total posts | Comp. |
|---|---|---|---|---|---|
| 2018 | 87 | 33 | 1 | 34 | 2.6 |
| 2017 | 67 | 18 | 0 | 18 | 3.7 |
| 2016 | 70 | 18 | 0 | 18 | 3.9 |
| 2015 | 73 | 26 | 24 | 50 | 1.5 |
Indicative post numbers
Indicative vacancy numbers are available in the table below, broken down by region and divided between substantive national training number (NTN) and locum appointment for training (LAT) posts. In many cases these will be presented as a range (e.g. 1-4) as it is not always possible for regions to know at this stage how many vacancies there will be.
It is the intention that indicative post numbers for all regions will be published prior to the application opening date, although this cannot be guaranteed. Please note that this table is not likely to be updated subsequent to indicative numbers and actual numbers will be confirmed when programme preferences are opened later in the round.
Numbers subject to change
Please be aware that it is not uncommon for vacancy numbers to change as the round progresses.
More commonly, post vacancy numbers can increase as the round goes on (and confirmation of posts becomes available); but it is also possible that numbers can reduce as well. In the past, post numbers have risen an average of 20-40% from the start to the finish of the round but this can vary greatly for individual specialty/region combinations.
It is possible that regions which do not have a post at the start of the round may declare one after applications have closed. Whilst we try and minimise instances of this, it is not always possible to predict vacancies so even if there appears not to be a vacancy in your preferred specialty/region combination, you may wish to consider applying in case one becomes available during the round; you can check with the region concerned if you wish to check on the likelihood of a post arising.
Generally, once a region enter a post into a round they would always have at least one post available and would only withdraw it in exceptional circumstances.
Round 1 Interview dates & posts
| Region | NTN posts | LAT posts* | Evidence upload date(s) | Interview date(s) |
|---|---|---|---|---|
| East Midlands |
3 - 5 |
N/A |
13/01/2022 - 20/01/2022 |
22, 23, 24, 29, 30, 31 March 2022 |
| East of England |
1 - 5 |
N/A |
||
|
London and KSS |
Kent, Surrey & Sussex 5 - 10 |
N/A |
||
|
London 2 - 11 |
N/A |
|||
| North East |
2 - 4 |
N/A |
||
| North West |
Mersey 0 |
N/A |
||
|
North Western 2 - 6 |
N/A |
|||
| South West |
Peninsula 0 - 1 |
N/A |
||
|
Severn 0 - 1 |
N/A |
|||
| Thames Valley |
0 - 1 |
N/A |
||
| Wessex |
4 - 8 |
N/A |
||
| West Midlands |
0 - 3 |
N/A |
||
| Yorkshire & Humber |
0 - 1 |
N/A |
||
| Scotland** |
0 - 4 |
TBC |
||
| Wales |
0 - 2 |
TBC |
*English LATs
Please note, English regions do not recruit to LAT posts.
**Scotland post numbers
If you are interested in working in Scotland, a breakdown of post numbers by the four Scottish regions is available on the Scottish Medical Training website. This has details of all specialty training post numbers in Scotland, including specialties which are not part of the nationally-coordinated process.
The SMT website will always be the more accurate one where they differ.
Interview content
The interview will consist of four questions between 5-10 minutes in length. You will be marked on these questions and your communication skills, giving five scored areas in total. You will be scored by two interviewers on each question.
Including time for questioning and scenario reading, the interview will be approximately 40-45 minutes.
Prior to this question you will be given a clinical scenario and a short while to review it. You will then be asked questions relating to this scenario. Your communication skills will also be assessed during this question and marked accordingly. This question will last approximately 10 minutes.
The clinical scenario will be relatively brief (two/three sentences), so once you have read this, the remainder of the reading time will allow some short preparation (just mental preparation - this does not mean making notes, etc.).
Clinical scenario considerations
The scenario will describe a hypothetical clinical situation which has arisen in which you are, or have become, involved. Some points to consider when reviewing the scenario and preparing for discussion are:
- what steps you would take
- any potential treatments possible
- any further information you would gather
- how you would go about communicating with any people (eg patients, family members, colleagues) involved in the scenario
You should also consider any other factors you deem appropriate, using your experience and professional judgement.
Areas for assessment
One mark will be awarded to you based on your suggestions and responses to the clinical scenario. The second mark will be on the communication skills you display.
This will be both an assessment of how you would communicate with patients, colleagues, etc. in the scenario, as well as of how well you communicate with interviewers.
For this question you will need to give a presentation on one of the following topics, for no more than five minutes:
'An interesting case I have been involved in'
OR:
'An interesting recent development in gastroenterology '
Again, we stress you should only present on one of these topics, not both. When preparing your presentation, please bear in mind the points below:
- Clarity & relevance most important - The major purpose of this question is to assess communication skills. Thus, you should select a topic that is relevant to gastroenterology, and which you can present with clarity. This is more important than trying to impress by choosing a subject that is esoteric or complex. The topic should be relevant to your application where possible.
- Five minute time limit - Your presentation must last for no more than five minutes. Please note that you will be stopped after five minutes so as to allow further discussion to take place, so try and get your main points across before then. At the same time, bear in mind that interviewers will be assessing the level, depth and content of your presentation, as well as expecting some structure.
-
No aids/resources allowed – you are not allowed to use any visual representations, such as PowerPoint, when giving your presentation and you must not share your screen. You are welcome to use prompts on small cards, but these should be for your own use only.
Interview nerves will be taken into consideration.
Post-presentation discussion
Once your presentation is finished (interviewers will stop you at the five minute-mark), interviewers will discuss it with you and ask further questions relating to the items you raise and any further points.
This discussion will take place for approximately another five minutes.
Areas for assessment
The area for which you will receive a score will be your presentation and its accompanying discussion; essentially, this mark will reflect your understanding of the subject matter, as displayed via your presentation and the accompanying discussion.
This question will focus on your suitability for and commitment to ST3 training in the specialty and give you opportunity to expand on the information provided in your application form.
This question will last approximately 10 minutes.
This question will explore the non-clinical aspects of being a medical registrar, focusing on two of the Capabilities in Practice (CiPs) from the Internal Medicine Stage 1 Curriculum:
- Managing an acute unselected take
- Managing a multi-disciplinary team including effective discharge planning
This discussion will be prompted by a short question provided by interviewers. This will not be given to you before - this will be given verbally by interviewers once the previous question is finished. This question will last approximately 5 minutes.
Questioning will ask you to draw on your experience of managing a team caring for acute medical admissions by giving examples of how you have managed that type of situation.
Scoring framework
The score of 1-5 an interviewer will award you for each assessment area is judged in relation to how well you perform against an expected level. Below is the framework used to award scores at interview, as well as interpretation of what these scores represent:
|
Mark
|
Rating
|
Assessment
|
|
1 |
poor |
not considered appointable |
|
2 |
area for concern |
performed below the level expected from a core level trainee applying to the specialty; |
|
3 |
satisfactory |
performed at the level expected of a core level trainee applying to the specialty; |
|
4 |
good |
above average ability; |
|
5 |
excellent |
highly performing trainee; |
As shown in the table, for each of the question areas at interview, 3/5 is considered a satisfactory score; and reflects the level of performance that would be expected of a trainee ready to progress to a specialty training programme.
Should your performance go above and beyond this expected level, interviewers can award marks of 4/5 or 5/5 as appropriate.
Conversely, should your interview performance not reach the expected level, then interviewers can award marks of 1/5 or 2/5, as reflects their level of concern over your performance.
Appointability
Raw interview score
The RIS is the sum of all ten scores awarded to you during your interview, but before any weighting is applied.
As each individual score will be between 1 and 5, your RIS will be between 10 and 50.
Appointability requirements
To be classed as 'appointable', you must meet all three criteria below:
- none of your ten interview scores can be 1/5
- no more than two of your ten interview scores can be 2/5
- your RIS must be 30 or above.
If you meet all three requirements, your application will be assessed as appointable, and can progress to be considered for offers.
However, if you fail to meet any of these requirements, your application must then be assessed as not appointable, and it will progress no further in that round.
Total score
After interview, a weighting is applied to the scores in each area, as well as your application score.
These scores are then combined to give your total score which determines your ranking, which will in turn be used to inform how offers are made. The weighting of different sections, as well as the method by which your total score is established, is detailed in the table accessible below:
|
|
Interviewer 1
|
Interviewer 2
|
Weighting
|
Max score
|
|
Question 1 |
||||
|
Clinical scenario |
/ 5 |
/ 5 |
2.5 |
25 |
|
Communication |
/ 5 |
/ 5 |
1.2 |
12 |
|
Question 2 |
||||
|
Presentation |
/ 5 |
/ 5 |
1.8 |
18 |
|
Question 3 |
||||
|
Suitability & commitment |
/ 5 |
/ 5 |
2.5 |
25 |
| Question 4 | ||||
| Medical registrar suitability | / 5 | / 5 | 1 | 10 |
| Raw interview score | / 50 | |||
|
Interview score (w weighting) |
/ 90 |
|||
|
Application score |
/ 58 |
0.35 |
/ 20.3 |
|
|
Total score |
/ 110.3 |
|||