Subspecialty Careers: Allergy and Immunology

The Discipline
Allergy is derived from the Greek word allo, meaning "other or different" and ergon, meaning, "work." In this sense, allergy is something that "works differently" from normal. Immunity is derived from the Latin word immunitas, meaning "an exemption from taxes or public or military service." In the late 19th century, when knowledge of toxins and infection evolved, the meaning was extended to persons "exempt from" or protected against the onslaught of foreign substances and were said to be "immune."

Allergy and immunology involves the management of disorders related to hypersensitivity or altered reactivity caused by the release of immunologic mediators or by activation of inflammatory mechanisms.

Procedures
Important procedural skills include spirometry and spirometric response to irritant challenges and bronchodilators, rhinoscopy, drug desensitization protocols, immediate skin tests for IgE-related reactions, patch tests, and prick and intradermal skin tests.

Training
Allergy and Immunology fellowship training requires two years of accredited training beyond general internal medicine residency in an accredited Allergy and Immunology fellowship training program.

Dual certification can be obtained in the specialties of Rheumatology and Allergy and Immunology after a minimum of three years of training following the general internal medicine residency program. At least one year must be devoted to full- time clinical Rheumatology training in an accredited program. At least 18 months must be devoted to full-time allergy/immunology training in an accredited Allergy and Immunology fellowship-training program. Weekly attendance for 18 consecutive months in an ambulatory care program supervised by Rheumatology faculty must be included in the program.

Certification

The American Board of Allergy and Immunology offers certification in this specialty.

Training Positions

For the 2011-2012 academic year, there are 72 ACGME-acredited training programs with 298 trainees. Last year, there were 73 ACGME-accredited training programs in Allergy and Immunology with 294 trainees. Sixty percent of the trainees were female, and 80% were U.S. medical graduates.

Major Professional Societies