As a medical student, do you ever wonder what it’s like to specialize in gastroenterology (GI)? Meet Jennifer Jorgensen, MD, an gastroenterologist and a featured doctor in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in gastroenterology might be a good fit for you.
The AMA Specialty Guide simplifies medical students’ specialty selection process, highlights major specialties, details training information, and provides access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.
Learn more with the AMA about the medical specialty of gastroenterology.
“Shadowing” Dr. Jennifer Jorgensen
Specialty: Therapeutic gastroenterology.
Practice setting: Multispecialty group affiliated with a health system.
Employment type: In private practice with Wenatchee Valley Medical Group, which is affiliated with Confluence Health, in Central Washington. Confluence Health is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Years in practice: 27.
A typical day and week in my practice: My days vary a lot—that is part of the beauty of GI. Also, I split my time between clinical practice and administration. Regarding the clinical work, most GI physicians spend a lot of time doing procedures. On any given day, I could spend all of it doing procedures or split the day between clinic and procedures. We spend seven to eight hours per day seeing patients, and some days we have meetings before or after work.
Because I do therapeutic GI, I do endoscopic ultrasound and endoscopic retrograde cholangiopancreatography, so I see a lot of patients with cancer. Therefore, once a week, I participate in our tumor board. This is a great conference where the surgeons, oncologists, radiation oncologists, radiologists, pathologists, social workers and other specialists meet to discuss how to best treat patients with cancer.
I also participate in a pancreas conference twice a month, where we discuss complicated patients with benign pancreatic and biliary diseases. Our GI group meets monthly for an educational conference or quality conferences. Even though we are not an academic center, our group is intellectually curious and, in addition to these formal, scheduled conferences, we also discuss cases with each other and with our nonphysician providers.
I really enjoy the collegiality of my GI group, as well as that of the larger multi-specialty group. Another great thing about GI is the variety of patients. We follow some patients longitudinally, such as patients with cirrhosis and inflammatory bowel disease (IBD), but sometimes we just consult or do a procedure and send them back to their primary care physicians, such as patients with GI bleeds or common bile duct stones.
We spend about 35 hours per week seeing patients. We also spend about five hours per week doing in-basket work and a couple hours doing education. We are on call roughly every sixth to eighth week so we get to round in the hospital, but we are mostly an outpatient specialty.
The most challenging and rewarding aspects of gastroenterology: The most challenging aspect for me is diagnosing patients with cancer. Because I do therapeutics, I spend a fair amount of time diagnosing and staging pancreatic, esophageal, biliary and gastric cancers.
There are so many rewarding aspects. I was an internist for 10 years before doing fellowship, so I thought I would miss my longstanding patients, but in GI I get to see my cirrhotic, IBD and chronic pancreatitis patients about every six months.
The impact burnout has on gastroenterology: It’s about the same in GI as in other specialties. In general, we are a pretty happy bunch, but we all work hard, and the balance of being a physician and a mom is challenging for me. Our calls can be busy and stressful but also fun and rewarding.
How Confluence Health is reducing physician burnout: For starters, we have a provider experience committee, which focuses on physician wellness. As an organization we talk about physician and employee wellness and prioritize it. Confluence Health’s vision includes “enabling joy and pride in our work” as one of our four pillars. Our strategic plan also includes initiatives that focus on this priority.
Wenatchee Valley Medical Group (WVMG), the largest medical group affiliated with Confluence Health, has a generous time-off policy. Physicians working five days per week are required to work 205 days per year, wherein a day of work is considered seven hours of patient-facing care. Physicians who work four days per week are required to work 184 days per year, wherein a day of work is considered eight hours of patient-facing care.
Although they do not get paid for time off, these allowances provide our physicians the flexibility to take time off if they choose. WVMG has a culture of working hard and playing hard. We value time to decompress and refresh, and we encourage it.
We were also just awarded Washington State Medical Association’s 2024 Apple Award for our wellness-centered leadership and clinician engagement efforts, alongside our work to put the joy back in medicine by supporting a culture of wellness, efficiency of practice and personal resilience.
How my lifestyle matches, or differs from, what I had envisioned: I didn’t think too much about work-life balance until I had kids during residency. I’ll be honest, work-life balance is something I struggle with. I love my work, and I also love spending time with my family.
We work hard in GI and call can be busy, but we rarely get called in the middle of the night. Our medical group is focused on improving work-life balance and physician wellness while still making patient care our No. 1 priority. The teamwork within my GI department and throughout the organization helps. We get a lot of vacation time, and we support each other in taking vacation so we can relax and enjoy our time away.
Skills every physician in training should have for gastroenterology but won’t be tested for on the board exam: We are a procedural-heavy specialty, so you need to have good hand-eye coordination. You also have to be able to multitask well on call and enjoy collaboration with other physicians and specialties. We work closely with oncology, surgery, interventional radiology and primary care to take care of our patients.
One question physicians in training should ask themselves before pursuing gastroenterology: Does poop gross you out? Seriously. Most patients have good bowel preps, but some don’t. It’s not always a glamorous job. I always found sputum more gross than stool.
Books, podcasts or other resources every medical student interested in gastroenterology should be reading: I don’t have any books specific to GI to recommend, but there are several books that should be beneficial to anyone who wants to have strong team dynamics and improved self-awareness:
- The Five Dysfunctions of a Team, by Patrick M. Lencioni.
- Insight: The Surprising Truth About How Others See Us, How We See Ourselves, and Why the Answers Matter More Than We Think, by Tasha Eurich.
- Grit: The Power of Passion and Perseverance, a TED Talk by Angela Duckworth.
Additional advice I would give to students who are considering gastroenterology: It’s a really interesting and diverse specialty. GI docs don’t take themselves too seriously, for obvious reasons, which makes for fun-loving colleagues. And patients are appreciative. Do a rotation to see if you like it.
