A career in allergy medicine
Authors: Erika Harnik
Publication date: 11 Dec 2017
Erika Harnik explores why you would choose a career in allergy through the perspectives of three clinicians who have pursued very different paths
Allergy is a small but growing specialty in both adult and paediatric medicine. The increasing prevalence of allergy has created new career opportunities in a rapidly expanding and changing discipline.
As a multi-system disorder, allergy encompasses a range of specialties, making the training unique and varied. There is a shortage of allergists in the UK so the outlook for consultant posts is positive.
Allergy is mostly an outpatient based specialty. The job offers huge variety, from diagnosis and using immunotherapy to actively manage life threatening allergies, to providing specialist care of patients with severe asthma or allergic skin disorders. There is ample opportunity to pursue clinical research and deliver teaching alongside clinical responsibilities.
If you are thinking about a career in allergy, speak to your local allergy service to arrange a taster week. Some medical schools offer a student selected component. The Allergy Academy and the British Society of Allergy and Clinical Immunology also hold regular courses and conferences.
Entry into allergy training is possible after successful completion of both a foundation and a core training programme (core medical training or acute care common stem, acute medicine). In paediatrics, entry into allergy training is possible following successful completion of both a foundation programme and levels 1 and 2 paediatric training.
“A young, dynamic specialty”
Shuaib Nasser, consultant in allergy and asthma at Cambridge University Hospitals NHS Foundation Trust, says, “I was interested in a young, dynamic speciality which taught me to manage a growing number of patients with a disorder that few doctors were able to treat. My combined training with respiratory medicine further expanded my area of interest into asthma and drug allergy, both of which are priority areas for the NHS.
“Each week is different and it is the diversity that I relish. I do five to six clinics a week, including specialist asthma, drug allergy, anti-immunoglobin E, and immunotherapy clinics. I spend time on undergraduate and postgraduate education and encourage research. I am interested in audit—I was instrumental in setting up a national audit of asthma deaths.
“My other time is spent on clinical trials using novel monoclonal antibodies in asthma, NICE appraisals, and medico-legal work. I almost always have an article that I am writing for publication.
“Allergy is the most enjoyable and rewarding career if you enjoy taking a forensic clinical history and have a sharp logical mind. You must love talking to people and finding out about their problems.
“The best allergist is one who understands the interplay between the environment and multi-system clinical presentations, and then manages each system separately and the patient as a whole.”
“The small size of the specialty is a blessing and a curse”
Adam Fox, paediatric allergist at Guy’s and St Thomas’ NHS Foundation Trust, says “I was attracted to allergy as it clearly had so far to go—it was, and still is, in its infancy. It’s exciting to be involved in the evolution of allergology as it has come from the fringes into the mainstream.
“I used to do four clinics a week and also supervision of day cases, with additional sessions to run an education academy and clinical research. I recently dropped much of my clinical time, however, to become clinical director for all the specialty outpatient areas of my trust. This was a great way to take what I had learnt as the lead for allergy, into other specialities.
“The small size of the specialty is a blessing and a curse. It’s relatively easy to steer change nationally and get consensus on important issues, but it also limits our capacity to make major impact on patient outcomes.
“With my colleagues and friends, I set up a new paediatric allergy service from scratch, which has grown to be the largest of its kind in Europe. It’s a great job, with so many interesting and varied opportunities—clinically, academically, educationally, and commercially.”
“The excitement of discovery is in full bloom”
Hasan Arshad, professor of allergy and clinical immunology at University Hospital Southampton NHS Foundation Trust, says, “I developed an interest in allergy because of my research interests in allergic asthma. There is still so much unknown in allergy that the excitement of discovery is in full bloom.
“I am investigating genes, gene-environment interactions, and the role of epigenetics in the development of asthma, allergy, and lung function. My research in allergy prevention has helped formulate international guidance.
“Alongside my clinical responsibilities, my week involves managing research projects, writing grants and papers, teaching university students and healthcare professionals, and helping national and international bodies to form policies for patient care.
“The future of the specialty is very bright. Allergy has led the way for a holistic, patient focused approach to disease management.”
Allergy Academy (allergyacademy.org)
British Society of Allergy and Clinical Immunology ( [Link] )
Joint Royal Colleges of Physicians Training Board ( [Link] )
Royal College of Paediatrics and Child Health ( [Link] )
Competing interests: I have read and understood BMJ’s policy on declaration of interests and declare the following: EH is the Junior Member’s Representative of the British Society of Allergy and Clinical Immunology
Erika Harnik year six specialty trainee in paediatrics Great Ormond Street Hospital, London, UK