Gastroenterologist

What gastroenterologists make

Job Bank's page for gastroenterologists pools every specialist physician and lists a median of about $311,000 a year. CIHI (Canadian Institute for Health Information) breaks gastroenterology out: average gross payments of about $565,000 a year (2023 to 2024), with a median near $550,000. Those are billings before overhead. Scopes are done in hospitals, so overhead is moderate and most gastroenterologists net roughly $400,000 to $550,000. It varies by province and by how you bill.

During residency

Paid employees with benefits and a union contract. Quebec pays the least, Alberta and Ontario the most.

Scopes pay

Gastroenterologists who spend most of the week in the endoscopy unit earn the most. Clinic-heavy or academic jobs pay less but come with steadier hours.

What it costs to get there

Undergrad degree (3 to 4 years)

$7,000 to $10,000 a year

Medical school, the MD (doctor of medicine), 3 to 4 years

$15,000 to $28,000 a year

MCAT (medical school admission test), applications, interviews

$2,000 to $5,000

Licensing exam (the MCCQE, the national medical exam) and two Royal College exams (internal medicine, then gastroenterology)

$1,500 for the MCCQE, plus two Royal College exam fees of several thousand dollars each

Roughly, all in

$75,000 to $170,500

Tuition, fees, exams and kit. Not rent, food or travel

The low end is three years of undergraduate study at $7,000 a year, a three year medical degree at $15,000 a year, and the exam and application fees, which is close to the cheapest real path in Canada. The high end is four years of undergraduate study and four years of medical school at the top of the tuition range, plus MCAT (Medical College Admission Test) costs, the MCCQE (Medical Council of Canada Qualifying Examination), and two Royal College exams of several thousand dollars each. The five years of residency after medical school are paid work, not tuition. Most people finish medical school owing $80,000 to $150,000, and the interest on that debt is real money this figure does not include.

Typical debt at the end of medical school is $80,000 to $150,000. Five paid residency years help you pay it down.

Benefits

• Pension only if salaried

  Most are self-employed. Ontario residents are in HOOPP (the Healthcare of Ontario Pension Plan) during training.

• Union contract during residency

  Provincial residents' associations negotiate pay, call limits and leave.

• Malpractice coverage

  Through the CMPA (Canadian Medical Protective Association), mostly reimbursed by the province.

• Professional corporation

  Most provinces let doctors incorporate, which lowers taxes on money left in the business.

The path

You become an internal medicine doctor first, then a gut specialist.

1. 1

   High school

   Grades 11 and 12

   Top marks in biology, chemistry, math and English. You need a very high average for a science undergrad.

2. 2

   Bachelor's degree

   3 to 4 years

   Any major works. Keep a GPA (grade point average) above 3.8, volunteer, do research. Write the MCAT (medical school admission test).

3. 3

   Medical school, the MD (doctor of medicine)

   3 to 4 years

   Acceptance rates are 5% to 15%. Classes, then clinical rotations.

4. 4

   Internal medicine residency

   3 years

   Matched through CaRMS (the residency matching service). Hospital wards, the ICU (intensive care unit) and clinics. In year 3 you apply to the subspecialty match.

5. 5

   Gastroenterology residency, then certification

   2 years

   Endoscopy, liver clinics, inflammatory bowel disease and hospital consults. Some programs add a third research year. Pass the Royal College exams to become FRCPC (Fellow of the Royal College of Physicians of Canada) and register with your provincial College of Physicians and Surgeons.

High school courses that help

• Biology and chemistry

  Digestion is chemistry. Required for nearly every pre-med path.

• Calculus and functions

• Physics

  Tested on the MCAT (medical school admission test).

• Anything hands-on

  Steering a scope through a colon is a fine motor skill. Video games, sewing and instruments all count.

Time and money, at a glance

Years after high school

11 to 13

Med school acceptance rate

Roughly 5% to 15%

Subspecialty match

Competitive, one of the most popular internal medicine choices

Total tuition

$90,000 to $150,000

Paid while training?

Only during residency, 5 years of it

Heavily regulated

You need a licence from your provincial College of Physicians and Surgeons to practise, and Royal College certification in both internal medicine and gastroenterology. Both are national credentials, so moving provinces is mostly paperwork. Quebec requires working French. Bowel surgery is done by general surgeons, a separate path; gastroenterologists diagnose, scope and treat with medicine.

Fellowships that change the job

Optional 1 to 2 year add-ons after residency.

• Advanced endoscopy

  Removing large growths, stenting blocked ducts and reaching the pancreas through the stomach. Procedure-heavy and well paid.

• Hepatology

  Liver disease and transplant. Clinic-based, academic, lots of very sick patients.

• Inflammatory bowel disease

  Crohn's and colitis. Long-term patients and fast-changing drug therapy.

• Motility and nutrition

  Swallowing, reflux and gut function disorders. Fewer scopes, more thinking.

Nice-to-haves before med school

• Research experience

  Gastroenterology programs notice publications.

• Steady hands and patience

  A hard colonoscopy can take 45 minutes of careful steering.

• French

  Opens Ottawa, New Brunswick and Quebec programs.

• A strong stomach

  Literally. Bleeding, vomit and bowel prep are daily.

A typical day

Two or three days a week in the endoscopy unit: 10 to 15 scopes, colonoscopies and gastroscopies, looking for polyps, ulcers, bleeding and cancer, removing what you can on the spot. Other days: a clinic of patients with Crohn's, reflux, liver disease or unexplained pain, plus consults from the hospital wards. On call, a bleeding ulcer at 2 a.m. means an emergency scope.

The honest trade-offs

Work life

Typical hours

50 to 60 a week including call

Remote work

Little, some virtual clinics

Physical demand

Moderate, long days standing at the scope

Unionized

Residents yes, attending doctors no

Similar paths

• Internal Medicine DoctorThe hospital doctor for adults with complicated problems, and the gateway to a dozen specialties. Four to five years of residency.
• General SurgeonOperate on the abdomen, breast, skin and trauma cases. About 13 years of training for one of the broadest jobs in medicine.
• DietitianThe regulated food and nutrition expert. A 4-year degree, a hard-to-get internship, then hospitals, clinics or your own practice.

Canada is a world capital of Crohn's

About 1 in 140 Canadians lives with Crohn's disease or colitis, and Canada has among the highest rates of these diseases in the world, according to Crohn's and Colitis Canada. Nobody fully knows why.

Fewer than 1,000 in the country

CIHI (Canadian Institute for Health Information) counted 946 gastroenterologists receiving clinical payments in Canada in 2023 to 2024, for about 40 million people. That is one reason the wait for a non-urgent colonoscopy can be months.

A scope that prevents cancer

Colon cancer usually starts as a small growth called a polyp. During a colonoscopy the gastroenterologist snips polyps off on the spot, so the test does not just find cancer, it stops it from ever forming.

Your gut has its own brain

The digestive tract has its own network of hundreds of millions of nerve cells, sometimes called the second brain. It can run digestion on its own, which is why stress and gut problems are so tightly linked.