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.


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.

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 (ST4/general enquiries)

[email protected]  

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 not be assessing your commitment to specialty as part of the shortlisting process and will score your application purely via the self-assessment scoring framework. Commitment to specialty will be assessed as part of the interview.

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.

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 - 8


22/12/23 - 05/01/24

18, 19, 20, 21, 22 March 2024

East of England

0 - 3



0 - 12


Kent, Surrey and Sussex

4 - 7


North East

0 - 2


North West 

0 - 2


North West Mersey 0 - 1


South West


0 - 3




Thames Valley

0 - 2



0 - 2


West Midlands

0 - 1


Yorkshire & Humber

2 - 4



9 - 11



0 - 1


*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 be split across two separate stations with a separate pair of interviewers scoring you on the areas within their station. There will be 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. The headings below show the question areas and in which station they will be covered, along with information about what will be assessed.

Each station will last 15 minutes, so including the time between stations, the interview will be approximately 40 minutes.

Please note that this is subject to change, and will be confirmed by the date of interview.

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:






















not considered appointable


area for concern

performed below the level expected from a core level trainee applying to the specialty;
possibly unappointable, subject to discussion and performance in other areas



performed at the level expected of a core level trainee applying to the specialty;
the candidate is suitable for a higher specialty training post



above average ability;
the candidate is suitable for a higher specialty training post



highly performing trainee;
the candidate is suitable for a higher specialty training post

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.


Raw interview score (RIS)

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 post 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






Max score


Station 1 - Question 1

Clinical scenario

/ 5

/ 5




/ 5

/ 5



Station 1 - Question 2


/ 5

/ 5



Station 2 - Question 1

Suitability & commitment

/ 5

/ 5



Station 2 - Question 2
Medical registrar suitability / 5 / 5 1.5 15
Raw interview score  / 50

Interview score (w weighting)

/ 80

 Application score

/ 50


/ 20

 Total score

/ 100