Due to the increasing shortage of physicians, the proportion of internationally recruited professionals in gastroenterology in Germany is rising. At the same time, physicians with a migration background repeatedly report hostility, discrimination and racism. Systematic data on the impact of these aspects on work-related well-being are still limited. This study aimed to assess the prevalence and impact of hostility and discrimination on occupational‑related well‑being among gastroenterologists in Germany.

We conducted an anonymous online cross-sectional survey among gastroenterologists working in Germany (June–July 2025). Sociodemographic and professional characteristics, migration experience, frequency and burden of hostility from various actor groups and work-related well-being were recorded using a shortened German version of the ’’Thriving from Work’’ questionnaire.

430 individuals completed the questionnaire (response rate 10.4%); 32% reported a migration background (19% first generation). In the past 24 months, 91.6% of participants with and 90.3% without a migration background reported at least one experience of hostility; a job change due to hostility was reported significantly more often by individuals with a migration background (20.6% vs. 5.7%). In the regression model (adjusted R²= 0.49), older age (β =0.08; p< 0.05) and first-generation migration background (β= 1.84; p = 0.03) were associated with higher work-related well-being. Conversely, higher burden from hostility (β= –10.42; p< 0.001), cumulative hostility experiences (β= –0.22; p< 0.001) and lower knowledge of coping strategies (β= –0.98; p< 0.05) predicted lower well-being.

Hostility is a widespread problem in the daily work of gastroenterologists in Germany and is closely linked to work-related well-being. Despite higher exposure, first-generation migrant physicians report comparatively higher well-being. Clinics and practices have a clear mandate to establish structural prevention and support measures to reduce discrimination and strengthen the retention of an increasingly international medical workforce. Endoscopy units could represent a particularly vulnerable setting, as physicians are exposed to high procedural demands, time pressure and complex patient interactions. These conditions may amplify the impact of hostility and discrimination on professional well‑being and team dynamics. While the general problem of workplace hostility in gastroenterology is beginning to be recognized, specific data on endoscopy units remain limited, therefore further targeted research is needed to better understand the prevalence, mechanisms and consequences of hostility in this environment, but also to offer structural prevention and support measures.