Allergy

This page provides useful information on the nature of the work, the common procedures/interventions, sub-specialties and other roles that may interest you.

Nature of the work

Allergic disorders are wide ranging including anaphylactic shock, respiratory [1] allergy, skin allergy, food allergy, drug allergy and allergy to latex rubber and venom. Specialists deal with conditions that range from mild to life-threatening.

Some people have allergic responses if one or more of the following are ingested through the lungs (eg extrinsic allergic alveolitis), the skin (eg eczema, contact dermatitis), the stomach or mucous membranes such as the lining of the eye:

• pollen
• house-dust mite faeces
• the saliva and skin of pets
• mould spores
• bee and wasp venom
• milk
• eggs
• peanuts
• food additives
• antibiotics

Allergists treat conditions such as:

• asthma
• hay fever
• dermatitis
• eczema
• urticaria [2]
• angioedema [3]

“We deal with conditions involving almost every part of human body, literally from heads to toes” Dr Joanna Lukawska Consultant in allergy medicine Guy's hospital London.

Read Joanna’s story [4]

Common procedures and interventions

Common procedures and interventions include:

• skin prick, RAST (blood), patch and food tests to identify what is triggering the individual’s allergy
• desensitisation treatments
• corticosteroid treatments to suppress allergic reactions such as vasculitis (chronic inflammation of the blood vessels)
• prescription of antihistamines to treat urticaria (skin rashes)
• injection of adrenaline to treat anaphylaxis (an immediate and potentially life-threatening allergic reaction)
• treatment of allergic rhinitis with antihistamine drugs
• intramuscular adrenaline and antihistamine treatment for angio-oedema (build-up of fluid beneath the skin)
• lung x-rays, blood tests and lung function tests to assist in the diagnosis of extrinsic allergic alveolitis (resulting from prolonged exposure to animal and vegetable dusts)

Sub-specialties

It is possible to sub-specialise in adult or paediatric allergy medicine.

Find out more about:

• working in allergy medicine [5]
• the [5]entry requirements [6] and training and development [7]
• two first-hand accounts of life:
  • as a consultant in allergy [4]
  • as a clinical lecturer in paediatric allergy and clinical immunology [8]

• Pay and conditions

  Expand / collapse

  This section provides useful information about the pay for junior doctors (doctors in training), specialty doctors, consultants and general practitioners.

  Find out more about the current pay scales for doctors [9], and there's more information on the BMA website [10].

  NHS employers [11] provides useful advice and guidance on all NHS pay, contracts terms and conditions.

  Medical staff working in private sector hospitals, the armed services or abroad will be paid on different scales.

• Where the role can lead

  Expand / collapse

  Read about consultant and non-consultant roles in allergy, flexible working and about wider opportunities.

  Consultant roles

  You can apply for consultant roles six months prior to achieving your Certificate of Completion of Training [12] (CCT [13]). You will receive your CCT [13] at the end of your allergy training.

  Managerial opportunities for consultants include:

  • clinical lead - lead NHS consultant for the team
  • clinical director - lead NHS consultant for the department
  • medical director - lead NHS consultant for the Trust

  Most NHS consultants will be involved with clinical and educational supervision of junior doctors.

  Here are some examples of education and training opportunities:

  • director of medical education - the NHS consultant appointed to the hospital board who is responsible for the postgraduate medical training in a hospital. They work with the postgraduate dean to make sure training meets GMC standards.
  • training programme director - the NHS consultant overseeing the education of the local cohort of trainee doctors eg foundation training [14] programme director. This role will be working within the LETB/deanery
  • associate dean - the NHS consultant responsible for management of the entirety of a training programme. This role will be also be working within the LETB/deanery

  SAS doctor roles

  There are also opportunities to work at non-consultant level, for example as a SAS (Specialist and Associate Specialist) doctor. SAS doctors are non-training roles where the doctor has at least four years of postgraduate training, two of those being in a relevant specialty. Find out more about SAS doctors roles [15].

  Other non-training grade roles

  These roles include:

  • trust grade
  • clinical fellows

  Flexible working

  This specialty is highly suitable for flexible training, and allergy training is enjoyably varied.

  Academic pathways

  If you have trained on an academic allergy pathway or are interested in research there are opportunities in academic medicine.

  For those with a particular interest in research, you may wish to consider an academic career in allergy. Whilst not essential, some doctors start their career with an Academic Foundation post. This enables them to develop skills in research and teaching alongside the basic competences in the foundation curriculum.

  Entry into an academic career would usually start with an Academic Clinical Fellowship (ACF) and may progress to a Clinical Lectureship (CL). Alternatively some trainees that begin with an ACF post then continue as an ST trainee on the clinical programme post-ST4.

  Applications for entry into Academic Clinical Fellow posts are coordinated by the National Institute for Health Research Trainees Coordinating Centre (NIHRTCC). [16]

  There are also numerous opportunities for trainees to undertake research outside of the ACF/CL route, as part of planned time out of their training programme. Find out more about academic medicine. [17]

  The Clinical Research Network [18] (CRN) actively encourages all doctors to take part in clinical research.

• Job market and vacancies

  Expand / collapse

  This page provides useful information about the availability of jobs, finding vacancies and where to find out more.

  Job market information

  Allergic disorders are on the increase, including a rise in co-morbidity (multiple expressions of allergy in the same patient) and the complexity and severity of diseases. This has created a greater need for allergists.

  Allergy is one of the smaller specialties with 14 consultants and 7 medical registrars in England (NHS Digital, 2016 [19]). Women make up 55% of the consultant workforce, 58% of higher specialty trainees in the UK (2014/15 RCP census, 2016 [20]).

  Allergy and some non-acute specialties lost consultant posts in 2011. This is probably the result of NHS trusts needing to cope with increases in emergency medical admissions. (Source: BMA 2011 Census). It is expected that the number of posts will increase modestly over the next few years to meet some unmet needs. Their location may depend on where high quality training can be provided.

  The shortage of allergy posts means that consultants from other specialties work in allergy as well including immunologists, dermatologists, clinical pharmacologists and respiratory [1] medicine specialists.

  Allergy specialists who work with adults may in some cases also see children; but paediatric allergy is evolving as a separate subspecialty with a number of training and consultancy posts.

  Less than whole-time working is common in this specialty. 

  In 2016, the competition ratio for for CT1 Core Medical Training was 1.53 and for ST3 specialty training in allergy medicine it was 7.00 (NHS specialty training 2016). [21]

  On this section we have information for England only. For information regarding Scotland, Wales and Northern Ireland please click on the links below.

  NHS Scotland medical and dental workforce data [22]

  NHS Wales medical and dental workforce data [23]

  Department of Health, Social Services and Public Safety workforce information for Northern Ireland [24]

  Where to look for vacancies

  All candidates apply through the online application system Oriel [25].

  All jobs will be advertised on NHS Jobs [26].

• Further information

  Expand / collapse

  Organisations

  Royal College of Physicians [27]

  Royal College of Physicians of Edinburgh [28]

  Royal College of Physicians and Surgeons of Glasgow [29]

  British Society for Allergy and Clinical Immunology (BSACI) [30]