Gastroenterology offers a varied mixture of patients and day to day work. Traditionally gastroenterologists have treated all comers but a change in training schedule means that this will no longer be the case. Already, additional training for specialist registrars in hepatology means that this is now a separate specialty from gastroenterology. In a district general hospital, however, a gastroenterologist still manages viral hepatitis and inpatients with acute liver problems. The training structure is changing once again so trainees will be able to choose either luminal gastroenterology (functional bowel disease or inflammatory bowel disease, for example), endoscopy, or academic gastroenterology. Luminal gastroenterologists will still be trained in upper and lower gastrointestinal endoscopy but will not undertake endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasound (EUS), and the more technically difficult aspects of upper and lower gastrointestinal endoscopy. Gastroenterologists usually continue to take part in the acute medical rota.
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