Knowledge guide

LG 12: Scientific foundations of gastroenterology

Epidemiology, Pathophysiology, and Clinical sciences

Advanced Trainees will have in-depth knowledge of the topics listed under each clinical sciences heading.

For the statistical and epidemiological concepts listed, trainees should be able to describe the underlying rationale, the indications for using one test or method over another, and the calculations required to generate descriptive statistics.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis, management, and outcomes.

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  • Anatomical changes and physiological effects of surgery/endoscopy, including:
    • hepatopancreatobiliary
    • lower gastrointestinal
    • upper gastrointestinal
  • Anatomy, including embryology of the gastrointestinal tract
  • Causes and management of gastrointestinal neoplasia
  • Normal and abnormal histopathology of the gastrointestinal tract
  • Normal and abnormal physiology of the gastrointestinal tract, including processes underlying digestion, absorption, and metabolism
  • Principles of genetics, including molecular markers of gastrointestinal disease
  • Principles of health economics (e.g. screening)
  • Principles of nutrition (see KG10)
  • Principles of pharmacology and pharmacotherapy
  • Principles of public health (e.g. bowel cancer, fatty liver, viral hepatitis)

PCH

  • Development of the gastrointestinal system
  • Common embryological and congenital defects/disorders of the gastrointestinal system (e.g. biliary atresia, TOF/OA)
  • Anorectal physiology studies
  • Capsule endoscopy
  • Endoscopic retrograde cholangiopancreatography
  • Endoscopic ultrasound
  • Enteroscopy
  • Gastrointestinal radiology:
    • diagnostic, including intestinal ultrasound
    • interventional
  • Liver stiffness measurement
  • Nuclear medicine studies
  • Oesophageal physiology studies
  • Principles of gastrointestinal endoscopy:
    • electrosurgery and safety
    • indications for endoscopic procedures
    • lower gastrointestinal endoscopy
    • risks and complications of gastrointestinal endoscopic procedures
    • therapeutic endoscopy
    • understanding of endoscopic equipment and its use, including image enhancement and analysis and artificial intelligence software
    • upper gastrointestinal endoscopy
  • Recognition of pathology (macro and micro)
General management considerations
  • Goals of therapy
  • Impact of comorbidities on diagnosis and management
  • Individual patients’ clinical indications to determine patients’ needs, and the most appropriate approach to investigations and care
  • Patient demographics, including geographical location, socioeconomic status, ethnicity, or cultural background, and the considerations when managing and following up these patients (e.g. travel from rural to metropolitan areas)
  • Psychosocial aspects of gastrointestinal disorders
  • The timing of decisions and risks for individual patients