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Gastroenterologist

The doctor for everything between the mouth and the other end. Fourteen years of training, and one of the best paid jobs in medicine.

Typical pay
$265,930a year
Time to qualify
13 to 15 yearsafter high school
Demand
Moderate
License needed
Yesregulated job

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  1. 1.MoneyWhat you earn and what it costs to get there.5 screens
  2. 2.EducationThe exact path from high school to qualified.5 screens
  3. 3.OptionalThings you don't need, but that help.3 screens
  4. 4.ExtrasDay to day, pros and cons, where you'd work.4 screens
  5. 5.FactoidsThings people don't tell you.4 screens

Quick answers

How much does a gastroenterologist make in the United States?

The median pay is about $265,930 a year. Across everyone in the job it runs from about $69,170 at the lower end to about $452,360 at the upper end. The source is listed under Sources at the end of this page.

How long does it take to become a gastroenterologist in the United States?

13 to 15 years after high school, on the usual route.

What does it cost to become a gastroenterologist?

$190,000 to $340,000 all in for tuition, fees, exams and kit. Living costs are not counted.

Do you need a license to work as a gastroenterologist in the United States?

Yes. It is a regulated job, so you need a license or registration before you can work.

What is the job outlook for a gastroenterologist in the United States?

Moderate demand nationally, from government outlook data. Demand varies by region, so check your area.

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Gastroenterologist salary in the United States

What you earn and what it costs to get there.

What the wage survey shows

Median for the group

$265,930

Bottom tenth

$69,170

Top tenth

$452,360

The federal wage survey has no gastroenterology category. It files the specialty under Physicians, All Other, a mix of specialties. In the 2025 federal wage survey that group's median is $265,930 a year, the bottom tenth earn $69,170 or less and the top tenth $452,360 or more. These figures describe the whole group, not this specialty alone, and they count only physicians paid a wage, so doctors who own their practice are largely missing.

While you are training

$91,211 to $100,382

Resident pay in years 1 to 4 at UC San Diego (University of California San Diego), 2025 to 2026

Residents and fellows are salaried hospital employees for all 6 years of training, and each hospital sets its own scale. It is real money for long hours, and you are paying interest on medical school debt the whole time. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.

The top quarter of the group

$378,770 or more

What the best paid quarter of physicians in the Physicians, All Other group earned in 2025

Procedure-heavy specialties like this one tend to sit toward the top of the group. The federal survey only counts employed physicians, so doctors who are partners in a practice or own an endoscopy center are largely missing from it.

What it costs to get there

Four-year bachelor's degree, in-state public
Roughly $11,000 a year in tuition and fees
Medical school, four years
Commonly $40,000 to $70,000 a year all in, less at a public school in your own state
The MCAT (medical school admission test), applications and interviews
$3,000 to $7,000 once you count travel and applying to twenty schools
Licensing exams
Three steps of the United States Medical Licensing Examination, roughly $1,000 each, plus board certification exams later

Roughly, all in

$190,000 to $340,000

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

The low end is four years at an in state public university, then a public medical school in your own state, plus the MCAT (Medical College Admission Test), applications and the three steps of the national licensing exam. The high end is a private or out of state medical school at up to $70,000 a year all in, with no in state discount anywhere. The residency and fellowship years after medical school are paid jobs, so they add no tuition to this figure. What the numbers hide is interest, which is serious on a balance this size, and Public Service Loan Forgiveness, which can cancel the rest after ten years of payments at a nonprofit hospital.

Most graduates borrow, and the debt is large. Two things blunt it: Public Service Loan Forgiveness, where residency and fellowship years at a nonprofit hospital count toward the ten years, and the fact that this specialty earns enough afterward to clear the rest quickly.

How the money actually arrives

  • Hospital or health system salary

    The most common arrangement now, often with a production bonus.

  • Private group partnership

    Join a gastroenterology group, become a partner after a few years, and share in the practice's profit.

  • Endoscopy center ownership

    Partners in a procedure center earn from the facility as well as the professional fee.

  • Call pay

    Covering nights and weekends for bleeding emergencies is paid separately in most contracts.

  • Signing bonuses and loan repayment

    Rural and underserved hospitals offer large recruitment packages because they cannot find specialists.

How to become a gastroenterologist in the United States

The exact path from high school to qualified.

The path to becoming a gastroenterologist, step by step

One of the longest training routes on this site. Fourteen years from high school to practicing on your own is normal.

  1. 1

    High school

    Grades 11 and 12

    Top grades in biology, chemistry, physics and math. You need a strong average to get into a competitive undergraduate program.

  2. 2

    Bachelor's degree

    4 years

    Any major is allowed if you finish the science prerequisites. Keep the GPA high, get clinical and research experience, and sit the MCAT (medical school admission test).

  3. 3

    Medical school

    4 years

    Four years for either the MD (doctor of medicine) or the DO (doctor of osteopathic medicine). Two years of science, then two years of clinical rotations. Admission is competitive, and many applicants are not admitted anywhere.

  4. 4

    Internal medicine residency

    3 years

    Matched through the national residency match. Three years of paid hospital training in adult medicine before you can even apply to specialize.

  5. 5

    Gastroenterology fellowship

    3 years

    Three more years, matched separately and highly competitive. This is where you learn endoscopy, liver disease and the procedures the job is built on.

High school courses that help you become a gastroenterologist

  • Biology and chemistry

    Required for every pre-medical route, and the base of everything that follows.

  • Physics

    Tested on the medical school admission exam and useful for understanding scopes and imaging.

  • Calculus and statistics

    Statistics especially. Reading medical evidence is a daily skill.

  • English and psychology

    The admission exam has a reasoning section and a behavioral science section, and the job is mostly talking to frightened people.

Time and money, at a glance

Years after high school
13 to 15
Medical school acceptance
Competitive. Many applicants are not admitted anywhere
Typical debt at graduation
Large for most graduates who borrow
Paid while training?
Yes, from residency onward, for six of those years

Licensed by your state, certified by a board

To practice you need a medical license from the medical board of the state you work in. Every state requires the three steps of the United States Medical Licensing Examination, or the osteopathic equivalent, plus completed residency training and a clean record. That license is state by state, so moving means applying again. Separately from the license, the American Board of Internal Medicine certifies you first in internal medicine and then in gastroenterology as a subspecialty. Certification is not legally required to practice, but hospitals and insurers effectively demand it, and you keep it current with ongoing assessment for your whole career.

Where people study

  • Any accredited medical school

    Where you study matters less than how you do there, because every accredited school leads to the same licensing exams.

  • Your own state's public medical school

    In-state tuition is far lower and many public schools give preference to residents of the state.

  • Osteopathic medical schools

    The osteopathic degree is a full medical degree with the same licensing and the same access to gastroenterology fellowships.

  • Where the fellowship is

    Gastroenterology fellowships sit at teaching hospitals. Getting one depends far more on your residency performance and research than on where you went to college.

What helps you get ahead as a gastroenterologist

Things you don't need, but that help.

Sub-specialties inside the specialty

  • Advanced endoscopy

    An extra year learning the hardest procedures, on the bile ducts and the pancreas. Very few people do it and they are in demand everywhere.

  • Hepatology

    Liver disease and transplant medicine. Its own extra training and its own board certification.

  • Inflammatory bowel disease

    Long-term care of younger patients with Crohn's disease and colitis. More relationship, fewer procedures.

  • Motility and functional disorders

    The patients nobody else has been able to help. Difficult, and quietly one of the most valued corners of the field.

  • Pediatric gastroenterology

    A different route entirely: pediatrics residency first, then a pediatric gastroenterology fellowship.

Nice-to-haves along the way

  • Research and publications

    Gastroenterology fellowships are competitive. Research during residency is what separates applicants.

  • Steady hands and good spatial sense

    Endoscopy is a physical skill. Some doctors take to it immediately and some never enjoy it.

  • Spanish or another second language

    Screening conversations go better in a patient's own language, and it matters in most of the country.

  • Time spent in a hospital before you commit

    Volunteer, scribe or work as a technician. Fourteen years is too long to find out late that you dislike the building.

Be honest about the length

You will be in your early thirties before you earn a full salary, while people who picked a trade at eighteen have a house and twelve years of savings. The training years are long, tightly controlled and sometimes miserable. The trade at the end is real: high pay, permanent demand, and work where you find cancers early enough to remove them. But go in knowing the cost, and know that plenty of people are just as happy doing three years of training in a related health career instead.

What being a gastroenterologist is really like

Day to day, pros and cons, where you'd work.

What a gastroenterologist does day to day

Most weeks split between the procedure room and the clinic. A procedure day starts around 7am: eight to fifteen colonoscopies and upper endoscopies back to back, each one 15 to 30 minutes, removing polyps as you find them, dictating between cases. A clinic day is 20 or so appointments: reflux, abdominal pain, liver numbers that came back wrong, inflammatory bowel disease follow-ups. Add hospital consults for bleeding and liver failure, and a call rota where somebody has to come in at 3am to stop a bleed.

The honest pros and cons of being a gastroenterologist

The good

  • Among the best paid work in medicine, with a group median of $265,930 a year (2025)
  • A mix of procedures and long-term patient relationships
  • You prevent cancers, not just treat them
  • Demand outstrips supply in most of the country

The hard parts

  • Thirteen to fifteen years and a large debt
  • Night and weekend calls for gastrointestinal bleeding
  • Repetitive procedure work is hard on your neck, back and shoulders
  • Fellowship is competitive enough that many internal medicine doctors never get in

Work life

Typical hours
50 to 60 a week plus call
Remote work
Some telehealth clinic days, but procedures are in person
Physical demand
Moderate, and hard on the neck and shoulders over decades
Unionized
No, though resident physicians at a growing number of hospitals are

Things nobody tells you about being a gastroenterologist

Things people don't tell you.

Screening now starts at 45

The US Preventive Services Task Force lowered the age to begin colon cancer screening from 50 to 45 in 2021, because the disease kept appearing in younger adults. That single change added millions of people to the screening population.

Your gut has its own nervous system

The wall of the digestive tract contains hundreds of millions of nerve cells that can run digestion without any instruction from the brain. Researchers call it the enteric nervous system, and popular writing calls it the second brain.

A doctor drank the bacteria to prove a point

For most of the twentieth century stomach ulcers were blamed on stress and spicy food. In 1984 an Australian researcher swallowed a culture of the bacterium he suspected, gave himself gastritis, and proved ulcers were an infection. He shared a Nobel Prize for it in 2005, and ulcers became curable with antibiotics.

The scope is a camera on a garden hose

A modern endoscope is a steerable flexible tube carrying a camera, a light, a water jet and a channel for tools. Through that one channel a gastroenterologist can biopsy tissue, snare a polyp, clip a bleeding vessel or place a stent, all without a single incision.

How a gastroenterologist compares

Every list is built from the same numbers shown above, so you can see where this career sits next to the others.

More health careers in the US

Doctors first, then the rest of the field. See every career in health.

Where these numbers come from

Last checked November 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.

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