How to Get Into: Allergy and Clinical Immunology ST4

Courses & Conferences to Attend

As a CMT, my primary goal is to achieve my general medicine competencies and pass the MRCP examinations. Attending a PACES course was valuable for seeing rarer clinical presentations. To enhance my teaching skills, I obtained a ‘Doctors as Educators’ accreditation from the RCP.  During my PhD time, I also attended a course on ‘Introduction to Flow Cytometry’.

Just prior to starting my ST3 year, I attended a FOCIS Advanced Immunology Course, which I found useful. However, if youn’t have a research/basic science background, I think it would be ideal to do this after the ST3 year, after gaining some knowledge and experience of the specialty. 

Allergy and Immunology is a rapidly evolving specialty, and attendance at meetings, conferences, and courses is encouraged for candidates to keep abreast of new developments.

There are post-graduate courses in Allergy, with online modules, offered by multiple UK universities (https://www.bsaci.org/education-and-events/postgraduate-courses). These require significant time and cost commitment, but offer an opportunity to acquire a formal degree/qualification. You may be interested in doing an MSc in Immunology.

The British Society of Immunology (BSI) and British Society of Clinical Allergy and Immunology (BSACI) both run an annual conference and regular courses. Alternatively, there are several stand-alone online webinars accessible for those who purchase society membership. The BSI tends to feature relatively more basic science/ translational research. Whilst the conference costs are expensive, they often have incentives to encourage junior doctor attendance, such as the BSACI ‘Medical Scholarships Scheme’. A successful application would not only help with the conference expenses, but it would also be an ‘award’ to list on your CV. Often, Immunologists encounter rare/complex cases, and submission of case reports is encouraged. This is an excellent way to potentially present at conferences, even if you do not have much background experience in lab research or clinical trials.

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How to Maximise Your Portfolio

My advice would be to review the scoring criteria closely, well ahead of application,s to address any deficiencies in your CV in time. You may not have much free time outside of work for this, and so strategy is key. For example, you get five points for doing ‘all aspects of two cycles of an original quality improvement project, where you can demonstrate leadership capacity by supervising other members of the team’. If you were to do a single project that covered this, you would get maximum points. If you were to do multiple projects that did not meet these criteria, your score would still be lower. Similarly, to score maximal points in the ‘publications’ section, you need to have to be first author, joint-first author, or corresponding author on a publication. Even if you have several publications as a middle author, whilst they would likely be beneficial in other ways, you would not score the maximum points on the application form. 

It is a self-scoring system, and evidence needs to be submitted to support each score. Make sure you have sufficient evidence for every single point you are claiming, or else your score may be downgraded by the panel. There are also two points on the written application just for organising your evidence neatly, so don’t miss out on those.

Whilst the portfolio is important, remember that the majority of points come from the interview. Within the interview, there is a ‘Clinical Scenario’. This would be relatively straightforward for somebody who already has some experience working in Allergy and Immunology. However, for others, I would recommend speaking to doctors in Allergy and Immunology to get a better idea of the common clinical scenarios they deal with in everyday practice. I would also recommend gaining some basic understanding of what kind of tests are done by Allergy and Immunology laboratories, and methods of quality control and service improvement. 

There are a lot of points, within both the written application and interview, for commitment to the specialty. In addition to attendance at relevant courses and conferences, I would advise organising a ‘taster week’ if at all possible. I did this prior to my application, and it was invaluable for getting some insight into what the job involves. I had the opportunity to attend an MDT, sit in outpatient clinics, and look around the Allergy and Immunology labs. I was taken aback by just how helpful the consultants were who I approached to organise this, even though I hadn’t known them before.

Making the Most of Your Day Job

Making the Most of Allergy and Clinical Immunology ST4 Placements

If you are fortunate enough to have the opportunity to work in Allergy and Immunology prior to the application, it would set you apart from many candidates. Try to identify opportunities for presentation at local/regional meetings, of which there are many in this specialty. This will help you practice in preparation for cases and give you confidence in public speaking. There is so much knowledge to acquire in this specialty, it is sometimes difficult to know where to start! I would recommend that if you are seeing outpatients, you try to read a bit around each case. Try to observe the different aspects of the specialty, i.e., in addition to outpatient clinics, observe venom and pollen immunotherapy, administration of immunoglobulin replacement therapy, and 

Try to make time to go to the labs as well as outpatients, to understand why particular tests are requested, and how they are done. From speaking to other trainees, the lab aspects of the job trainees often found more challenging to grasp.

What About Non-Allergy and Clinical Immunology ST4 Placements?

Allergy and Immunology spans multiple clinical specialties, particularly Haematology, Gastroenterology, Respiratory Medicine, Rheumatology, Dermatology, and Renal Medicine. A solid foundation of general medical knowledge and experience is crucial to being well-prepared for training in Allergy and Immunology. Further, engaging in projects in such specialities would still be highly relevant to an application for training in Allergy and Immunology. For example, when I was working in gastroenterology, projects relating to coeliac disease, autoimmune liver diseases (e.g., PSC), or IBD would all have been potentially useful for an application to Allergy and Immunology.

Additionally, I would suggest that you practice presenting patients at MDT and preparing case presentations and journal club presentations, as this is something that you will likely be doing a lot of as a specialist trainee in Allergy and Immunology.

Top 3 Tips for Getting Into Allergy and Clinical Immunology ST4