GASTROENTEROLOGY AND HEPATOLOGY
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SUPERVISING COMMITTEE

DEFINITION OF SPECIALTY

GENERAL PRINCIPLES

COMPONENTS OF TRAINING

Core Training

Non Core Training

Procedural Skills

Research

Training Sites

SPECIAL SOCIETY

 Vocational Training
 Gastroenterology and Hepatology
Supervising Committee
Specialist Advisory Committee (SAC) in Gastroenterology.

Definition of Specialty
Gastroenterology and hepatology are branches of internal medicine (usually practised together) that are concerned with prevention, investigation and therapy of and research into illnesses involving the intestine, liver and other associated organs.

General Principles of Training
  1. Advanced training in gastroenterology should provide broad experience in as many aspects of gastroenterology and hepatology as possible including management of patients with a wide variety of gastrointestinal disorders; gastrointestinal endoscopic procedures; gastrointestinal and hepatic imaging; pathology and physiological investigations; clinical nutrition, and gastrointestinal surgery. It is desirable that trainees undertake supervised research during their advanced training. The majority or all of advanced training can be undertaken in hepatology. It is desirable that trainees spend no more than 2 years in one training position.
  2. Trainees are required, at the completion of advanced training, to have achieved levels of consultative and technical skills, which will allow independent practice as a gastroenterologist and/or hepatologist.
  3. New Zealand trainees are encouraged to undertake part of their training outside New Zealand.

Components of Training
Core Training
A minimum of 2 years must be spent in full time clinical training positions with responsibility for patient care under the supervision of a trained gastroenterologist. Training should include management of gastrointestinal and hepatological emergencies. A suitable training position should include the care of outpatients (ambulatory care) and inpatients in gastroenterology and hepatology at a training site that provides regular clinical meetings, QA activities and meetings with other departments particularly diagnostic and therapeutic imaging, histopathology and surgical groups.

It is desirable that trainees gain experience and exposure in as many as possible of the following areas:
  • gastrointestinal motility disorders, diverticular disease and functional illnesses including oesophageal motility and intestinal transit studies;
  • acid-peptic disease;
  • diseases of the pancreas and gastrointestinal hormones;
  • gastrointestinal inflammatory disorders including idiopathic inflammatory bowel disease and disorders caused by infection including those associated with human immunodeficiency;
  • malabsorption syndromes including breath gas analysis;
  • gastrointestinal malignancy and premalignant disorders;
  • disorders of the biliary tract and ERCP;
  • viral hepatitis;
  • immunological disorders of the hepatobiliary tract;
  • drug-induced disorders of the liver and gastrointestinal tract;
  • chronic liver disease, portal hypertension and liver biopsy;
  • hepatobiliary malignancy;
  • gastrointestinal endoscopy and gastrointestinal bleeding;
  • clinical nutrition;
  • alcoholism and drug addiction;
  • imaging of the gastrointestinal and hepatobiliary systems including performance of abdominal ultrasound examinations; and
  • liver transplantation.

Non Core Training
The SAC may approve a maximum of one year of non core (elective) training which may be undertaken in clinical training in other disciplines (e.g. psychiatry, general medicine, immunology, microbiology, etc.), or research. In New Zealand the SAC will prospectively approve, on a case by case basis, only those rotations that are closely related to gastroenterology.

Procedural Skills
It is desirable that trainees should become proficient in upper gastrointestinal endoscopy and liver biopsy. Many trainees will also undertake training in colonoscopy and some will undertake training in ERCP.

Trainees must, in addition to technical proficiency, have a clear understanding of the role of endoscopy in patient management achieved by attendance at radiological and histopathological teaching sessions and relevant operations. Trainees must develop an understanding of the principles and practice of disinfection and sterilization of modern endoscopic instruments. Training in gastrointestinal endoscopy is assessed independently by the Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy (CCRTGE), a national committee with representatives of the Gastroenterological Society of Australia, RACP and the Royal Australasian College of Surgeons. Those trainees who satisfactorily complete the requirements of the CCRTGE will normally be given formal recognition at the completion of advanced training. Applications should be addressed to the CCRTGE at the RACP. For New Zealand trainees applications should be addressed to the CCRTGE at the RACP in Wellington.

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This page was last edited: 16 September 2003