Paediatric gastroenterology, hepatology and nutrition - sub-specialty

A paediatric gastroenterologist supports children with disorders that affect the gastrointestinal tract (stomach and intestines). A paediatric hepatologist works with children with liver diseases. Access the current syllabus for training in PGHAN, as well as the revised syllabus coming in August/September 2021.

What makes a paediatric gastroenterologist or hepatologist?

A paediatric gastroenterologist is a clinician who provides tertiary services for the diagnosis and long-term management of rare disorders and complex cases of more common disorders that affect the gastrointestinal tract. Gastroenterologists provide nutritional support for patients, including those with temporary or permanent intestinal failure, and manage services for home parenteral nutrition.

Paediatric hepatologists provide both tertiary and national hepatology services in designated centres. They diagnose and manage paediatric liver diseases, such as acute and chronic liver failure, and are co-located with transplant services to provide care for liver and small bowel transplantation patients.

Paediatric gastroenterologists and hepatologists often provide specialist advice in a model of shared care. They are co-located in regional units with key services such as paediatric surgery and paediatric intensive care. They understand the indications, benefits and risks of procedures for diagnostic evaluation and possess specialised skills in performing and interpreting the results of tests, such as gastrointestinal endoscopy and liver biopsy.

RCPCH Progress curriculum and syllabi for level 3 training

Since August 2018, trainees in this sub-specialty use the RCPCH Progress level 3 generic syllabus alongside the RCPCH Progress paediatric gastroenterology, hepatology and nutrition sub-specialty syllabus. Download both documents below

In addition to the generic learning outcomes for level 3, PGHAN trainees must fulfil the following sub-specialty learning outcomes:

In gastroenterology

  • Diagnoses, assesses and coordinates the management of inflammatory bowel disease (IBD) in all aspects of its care as part of a multidisciplinary team (MDT).
  • Diagnoses, assesses and manages both congenital and acquired conditions that may result in intestinal malabsorption and associated clinical disorders, as part of an MDT.
  • Manages the assessment of gastrointestinal bleeding, its risk stratification and safe, effective management as part of both a gastroenterology network and an MDT.
  • Demonstrates the confident management of a range of gastroenterology conditions, distinguishing functional gastrointestinal disorders from other gastrointestinal disease and providing safe and effective care.
  • Performs high-level clinical and technical skills and procedures, while demonstrating understanding of the role of endoscopy, both diagnostic and therapeutic, in the management of children with gastrointestinal disorders.

In hepatology

  • Competently manages children and families throughout the transplantation process.
  • Manages children in the peri-transplant and post-transplant periods.
  • Competently manages children with acute liver failure.
  • Provides expert advice at a national level on the initial management for children with acute liver failure.
  • Competently manages children with chronic and end-stage liver disease and the associated complications, alongside an MDT.
  • Competently manages different conditions of infantile cholestasis and has an awareness of the rare disorders associated with infantile cholestasis.
  • Stabilises and safely manages children with acute gastrointestinal bleeding secondary to bleeding varices and portal hypertension.
  • Demonstrates the technical skills required for the diagnosis and management of children with liver disease.

In nutrition

  • Manages all aspects of reversible and irreversible intestinal failure in children.
  • Manages children with complex nutritional needs requiring nutritional support.

Revised syllabus coming in August/September 2021

We spoke with clinicians working in this sub-specialty, and agreed some enhancements to the sub-specialty syllabus. The revised version is approved by the General Medical Council (GMC) for use as of August/September 2021. Download the revised syllabus below

A summary of the changes:

  • The introductory statement has been amended, and a paragraph added at the end.
  • Learning Outcome (LO) 1, Key Capability (KC) has been amended where the term ‘judges the suitability of’ has been replaced with ‘is aware of’.
  • LO 5 the term ‘Gastroscopy and Colonoscopy’ has been added and KC updated by replacing ‘gastrointestinal endoscopy’ with ‘Gastroscopy’ and a new KC added.
  • Illustration 11 has also been updated by replacing ‘upper gastrointestinal endoscopy’ with ‘Gastroscopy’. 
  • The Assessment Grid has been updated to reflect changes to the KCs.

You can find out more about the updates to this and other sub-specialty syllabi. If you have any questions contact us on qualityandstandards@rcpch.ac.uk.