by Carensa Cezar, MD
Congratulations! You have matched into one of the most coveted specialties of internal medicine. Long gone will be admission orders and discharge summaries that may have haunted you during your residency years. However, new challenges will arise. This includes the decision to continue as a general gastroenterology (GI) practitioner or obtain additional training in one of the many subspecialties our field has to offer. Here are a few tips to navigate that decision; however, always reach out to your program director and mentors for more detailed advice!
- Know thyself. The beauty of GI starts with how diverse it can be, even down to your career path within the field. From day one, it is important to think about what you value most in your career. Do you prefer procedures over clinic? Do you like research? These and other questions should be answered based on your preference for your values and goals. If you like advanced GI but also know that you do not like emergencies, long procedures or long hours, you may want to take a step back and reevaluate your priorities. You do not want to come this far just to be miserable in the end, so it is important to pick a career that aligns closely with what is most important to you.
- Exposure is key. Fellowship programs can vary, and not all will have adequate exposure to all subspecialties. If, for example, transplant hepatology is your goal and your program does not have a transplant center, then explore options as a visiting fellow at other institutions. This route can be considered for any subspecialty. Your program director would be a good start for navigating this option, as they typically have connections at various institutions.
- Explore the job market. Understand what the demand in a specific subspecialty looks like. For example, advanced GI is a growing field, but any given institution may only need one or two, making it a smaller job market (whereas general GI is typically needed in higher volume). Transplant hepatologists and inflammatory bowel disease (IBD) specialists are usually in an academic setting, as research is typically vital for these career paths, and any hospital or clinic may only need one to two. Overall, you should be aware of the different settings and requirements within the job market to ensure you are pursuing what will fit your needs.
- The generalist is key! While every subspecialty has an increasing need, always remember that they typically require referrals from general GI. If you are simply exploring your options, do not write off general GI too soon, as they will always get to manage a little of everything! There are also various options in job settings, like inpatient, outpatient, academics, private, etc. The generalist is always in demand.
- If you know you know. If you are one of the lucky ones with a plan already, network as often as possible. GI is a small world and making meaningful connections will be key to obtaining the job of your dreams!
Carensa Cezar, MD, is a Mississippi native who completed her Internal Medicine training at the University of Miami and is currently a third-year fellow at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. After fellowship, she will continue as a general GI physician with plans to work in a community setting. Dr. Cezar has served on ASGE’s Diversity and Inclusion Committee, Pathways Subcommittee and currently serves on ASGE’s Membership Engagement Committee.