GASTROENTEROLOGY AND HEPATOLOGY
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SUPERVISING COMMITTEE

Definition

GENERAL PRINCIPLES

COMPONENTS OF TRAINING

Core Training

Non Core Training

Research

Training Sites

SPECIAL SOCIETIES

 Vocational Training
 Gastroenterology and Hepatology
Supervising Committee
SAC in Gastroenterology.

Definition of Specialty
Gastroenterology and hepatology are branches of paediatric 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
  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 and that trainees spend no more than 2 years in one training position. 6 months of core training can be completed in adult gastroenterology and at least one year of advanced training needs to be undertaken in Australia(for Australian trainees).
    For New Zealand trainees, much of their training will need to be taken overseas in a number of centres in order to accumulate experience in the different aspects of gastroenterology and hepatology.
  2. At the completion of advanced training, trainees are required to have achieved levels of consultative and technical skills which will allow independent practice as a gastroenterologist and/or hepatologist.
  3. All subspecialty paediatric trainees must complete the community and child health requirements for paediatric training.
    Note that the guidelines differ between Australia and 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 paediatric 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 and functional illnesses;
  • acid-peptic disease;
  • diseases of the pancreas and gastrointestinal hormones;
  • neonatal gastrointestinal disease;
  • gastrointestinal inflammatory disorders including idiopathic inflammatory bowel disease and disorders caused by infection including those associated with congenital and acquired immunodeficiency;
  • malabsorption syndromes including breath gas analysis;
  • gastrointestinal malignancy and pre-malignant 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, particularly biliary atresia, and liver biopsy;
  • metabolic liver disease;
  • gastrointestinal endoscopy and gastrointestinal bleeding;
  • clinical nutrition;
  • imaging of the gastrointestinal and hepatobiliary systems including performance of abdominal ultrasound examinations;
  • liver transplantation.

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. Attainment of technical competence will usually require completion of a specified number of procedures with appropriate success rates under supervision. These must be recorded in a logbook, which will be used to help plan further training.

In addition to technical proficiency, trainees must 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 sterilisation 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, the 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. Experience with gastrointestinal motility testing and oesophageal pH monitoring is desirable but not essential.

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.

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This page was last edited: 5 November 2003