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Dr Freshwater trained in general gastroenterology and developed a sub-specialist interest in hepatology (The study of liver disease), which led him to undertake further training at the liver unit and also and a research doctorate at the University of Birmingham investigating viral hepatitis in liver transplant patients. He became a Consultant in 2006, and since then has been based at the Liver Unit at Queen Elizabeth Hospital Birmingham, treating patients with all aspects of liver disease including patients requiring liver transplantation. He also continues to provide services as a Gastroenterologist within the hospital including endoscopy services. He has wide experience in all aspects of liver disease (Including liver transplantation) and also general gastroenterology including inflammatory bowel disease, the investigation of altered bowel habit and irritable bowel syndrome.

Dr Freshwater continues to undertake both diagnostic and therapeutic endoscopic procedures in the upper and lower GI tract, including Oesophago-Gastro-Duodenoscopy, Flexible Sigmoidoscopy and Endoscopic Retrograde Cholangio-Pancreatography. Dr Freshwater has published many research papers in the areas of liver disease and gastroenterology and has written medical book chapters.

He is also an editorial board member for the international journal Digestive and Liver Disease. Dr Freshwater also maintains an interest in clinical teaching and is a GMC registered Educational Supervisor, regularly providing supervision and support to Specialist Registrars and Foundation Doctors. He also regularly holds teaching sessions for junior doctors and is a regular teacher on specialist courses both at home and abroad.