July 10, 2025
Written By
Michael Minh Le
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Something about gastroenterology caught your eye. Maybe it was the intellectual challenge, the procedural hands-on work, or maybe you just really liked your shadowing experience with a GI doc. Whatever it was, it has you wondering how to become a gastroenterologist.
In this article, we’ll break down exactly what a gastroenterologist is (and isn’t), walk you step-by-step through the full journey, and give you an honest look at salary, lifestyle, and whether this path is right for you.
The first step to becoming a gastroenterologist is creating a strong premed foundation. That’s why at Premed Catalyst, we created a free 2-hour video workshop. It’s a full-length guide that walks you through how AdComs think, what actually matters in your application, and the exact steps to take now to become a standout, competitive premed.
Get your free resource here.
A gastroenterologist is not just a “stomach doctor.” That’s what most people think.
A gastroenterologist is the detective of the digestive system. They’re the doctor who gets called when there’s something deeper going on than heartburn or a bellyache.
They’re the ones who figure out why you’ve had diarrhea for six months straight, why your mom’s been losing weight without trying, or why your grandpa keeps throwing up blood. They scope, biopsy, and read patterns that don’t show up on your standard blood test. They find cancers. They stop bleeds.
They also talk to people about poop. A lot. So if you’re not ready to have a straight face when someone tells you theirs has looked like tar for the last three days, this may not be the specialty for you.
That’s what a gastroenterologist really is. Not just a specialist. A pattern hunter. A problem solver. A patient’s last hope when nothing else has worked.
Becoming a gastroenterologist happens because you made deliberate moves at every stage, from undergrad all the way through fellowship. It's a long road, and if you walk it without a map, you’ll waste years.
Here’s your map.
This is where you start building your identity. Yes, you need to ace the prerequisites—chem, bio, physics, all of it. But that’s the bare minimum. What really separates you is how your experiences align.
Want to go into GI? Then find ways to connect the dots. Maybe you volunteer at a digestive health clinic. Maybe you shadow a GI doc and start research on colon cancer screening in underserved populations. Maybe you lead a nutrition awareness campaign in your community. Every move should build your story, one that says, this wasn’t random.
By the time you apply to med school, your application shouldn’t be a list of things you did. It should be a story only you could tell.
Here’s where everything you’ve built gets tested on paper first, and then in person.
You’ve probably heard of the AMCAS. It’s the centralized application for most med schools. You’ll list your courses, grades, activities, and honors. It’s your entire academic life boiled down to character limits and drop-down menus.
It also includes your personal statement. This is your opportunity to tell the story you built in your premed years. It’s the thread connecting all of your experiences.
After you submit your primary application, you’ll get into the secondary essays. Most schools will send you 3-10 extra prompts. This is where mission fit becomes everything. Every med school has a personality. Some are research-heavy. Others focus on primary care, social justice, underserved communities, or global health. Your responses need to show that you’ve actually read their mission and that who you are lines up with who they are.
Then there’s the letters of recommendation. Ask early. Ask wisely. A lukewarm letter from a big-name researcher is worse than a glowing one from a TA who actually knows you. At minimum, you need two science profs and one non-science. Worked closely with a GI physician or in a GI-related lab? That letter can be gold.
Finally, the interview. AdComs aren’t just assessing your knowledge. They’re assessing your maturity, your mission-fit, your consistency from the person they met in your essays.
So what’s medical school actually like?
Each medical school has its own curriculum, but generally, the first two years are mostly classroom and book work. You’ll take courses like anatomy, physiology, pharmacology, microbiology—all the core sciences, just at warp speed. It’s dense, fast, and unforgiving. You’ll be studying more than you ever have.
If you’re already thinking about GI, start paying attention early. Digestive physiology. The microbiome. Hepatitis.
Years three and four are clinical. You’ll rotate through internal medicine, surgery, OB/GYN, pediatrics, psych, family medicine, and more. This is where the idea of being a doctor becomes real. You’ll be in hospitals, talking to patients, writing notes, and working on teams. You’ll get to see GI in action. Think scopes, consults, liver disease, and IBD flare-ups.
During this time, you’ll also take Step 2, apply for residency, and build the next version of your application. So it’s not just about surviving. It’s about making strategic moves toward internal medicine and eventually, GI.
If you want to become a gastroenterologist, you have to go through internal medicine first. No shortcuts. No exceptions.
So what does that actually mean?
Internal medicine is a three-year residency where you train to become the kind of doctor who manages adult patients with complex, often chronic conditions. It’s not just general medicine. It’s the foundation of nearly every subspecialty, including GI, cardiology, oncology, and more.
You’ll work in hospitals and clinics, taking care of patients with everything from pneumonia to diabetes to multi-organ failure. You’ll learn to think critically, manage chaos, write orders, lead a team, and advocate for your patients.
And here’s the key: this is your launchpad for GI.
You’ll do GI rotations where you scrub into procedures, present cases to attendings, and maybe even publish research. Your performance here matters. Fellowship directors are watching. Your mentors are forming opinions. And your application for GI fellowship is already being written through your actions, not just your words.
This is the stage where you stop being a generalist and become a true specialist. Gastroenterology fellowship typically lasts three years, and it’s one of the most competitive internal medicine subspecialties, so getting here means you stood out in residency.
The fellowship is split between clinical work, procedures, didactics, and often research.
You’ll learn to master core procedures like:
But GI isn’t just about scopes. You’ll manage IBD, GI cancers, liver disease, pancreatitis, esophageal disorders, malabsorption syndromes, and more. You’ll follow complex cases over time and become the consultant that everyone else calls when the gut doesn’t behave.
Some programs let you focus on a niche like hepatology, nutrition, or motility. You’ll also attend conferences, present research, and maybe even teach residents and med students. And yes, there’s a big emphasis on scholarship. Many fellows present posters at major GI meetings like ACG or DDW.
By this point, you’ve made it through undergrad, med school, residency, and fellowship. One last hurdle stands between you and officially practicing as a gastroenterologist: certification and licensure.
Step one: Board Certification.
After fellowship, you’re eligible to take the Gastroenterology Board Exam through the American Board of Internal Medicine (ABIM). It’s a rigorous test that assesses everything you've learned from clinical reasoning and diagnostic skills, to procedural knowledge.
Expect in-depth questions on:
Every physician must be licensed by the state in which they plan to practice. Requirements vary, but usually include:
Many states also require continuing medical education (CME) hours to maintain your license, and MOC (Maintenance of Certification) exams or activities to keep your board certification current.
Becoming a gastroenterologist is expensive. The average med student graduates with over $200,000 in debt. Add in three years of residency and three years of fellowship where you're earning a resident's salary, which is around $60,000–70,000 a year, and the financial sacrifice feels massive.
But here’s the other side of that coin: gastroenterologists are some of the highest-paid physicians in internal medicine. According to recent surveys, the average GI doctor makes between $450,000 and $600,000 per year, depending on setting and location. Some partners in private practice break $1 million annually.
So yes, you start behind financially. But the ROI (return on investment) is real. You’ve trained for nearly a decade to master a high-demand, high-skill specialty. You do procedures that save lives and generate real revenue for hospitals and practices. And once you're board-certified and practicing, the payback is fast.
Let’s be honest: gastroenterology is a demanding specialty. You’re doing procedures, managing complex patients, and handling unpredictable calls. But it’s also one of the few high-skill specialties where many physicians still find room to live outside the hospital.
The Cons
Not every specialty is for everyone, and GI is no exception. The worst mistake you can make is chasing prestige, salary, or someone else’s dream without asking if the day-to-day actually fits you.
So let’s be clear: here’s who probably shouldn’t go into GI.
But most importantly, if you’re not genuinely curious about this system, these patients, and this kind of medicine. Don’t force it. GI is too long, too hard, and too personal to fake your way through. You’ve got to want it, or it’s not worth it.
If you're thinking long-term, and you should be, GI isn't just a smart specialty now. It's one that's positioned to grow. Here’s what’s coming:
Gastroenterology is a powerful field, but it’s not the only path to a fulfilling, high-impact medical career. If you’re still exploring or wondering how your interests align with other specialties, you’re not alone.
We’ve broken down other top specialties with the same level of brutal honesty, so you can figure out what fits your skills, values, and long-term vision.
If you’ve read this far, then something about gastroenterology spoke to you. Maybe it was the mix of procedures and medicine. Maybe it was the impact. Maybe it just felt right. But here’s the reality: none of it happens if you don’t first get into med school. And that’s where most students stumble.
That’s exactly why at Premed Catalyst we created a free 2-hour video workshop. It walks you through how top applicants think, what really moves the needle in your application, and how to start laying the groundwork now, whether you're a freshman or already knee-deep in orgo.
This is the resource we wish we had at the start. And it’s yours, free.
Get your free workshop here.
