ImageHealth Education England, working across the East of England: Allergy Medicine

Allergy is a rapidly expanding specialty with the  increasing  prevalence and diagnosis of allergic disease. There is therefore a corresponding need for an expansion in the numbers of suitably trained specialist in area . There is a burgeoning knowledge base, but much remains to be learned so there are many research opportunities, particularly in clinical areas. 

Clinical knowledge and skills across a wide spectrum of systemic and organ specific pathophysiology are essential and contribute to the challenges of this specialty. It includes the application of a variety of interesting diagnostic techniques, challenge tests and treatments including immunotherapy, and monoclonal antibodies. Novel therapies are constantly in development.

 

 

 

Training Programme

 

The East of England Allergy training programme is delivered at the Cambridge Unversity Hospitals NHS Foundation Trust. The programme has high academic expectations of its trainees and research towards an MD or PhD is encouraged.

Essential Qualifications for Entry & Personal Qualities

 

 

  • Good general medical experience; preferably including respiratory medicine
  • Excellent clinical skills
  • An inquiring mind
  • Dynamic and enthusiastic personality
  • The ability to work in a multi-disciplinary team
Developments

Allergic disease has increased substantially in the last three decades — the so -called 'Allergy epidemic'. At least seven million people have severe or multi-system allergic disease. Yet the specialty is small and there is much unmet need. There are therefore opportunities for service development. Allergy has been the subject of three independent national reviews, Royal College of Physicians 2003House of Commons Health Committee 2004 and House of Lords Science and Technology Committee all recommending an increase in allergy services and a review by the DH 2006. It is expected that there will be expansion in consultant staff in coming years.

Further Advice & Useful Links

Further Advice

Position

Location

Dr Pamela Ewan

Training Programme Director,
Training Committee Chair,
Regional Adviser & Allergy Consultant

Cambridge University Hospitals
NHS Foundation Trust
Dr Fraz Mir Head of School of Medicine 

HEEoE​

Information is available from the JRCPTB website giving detailed guidance on the Allergy ARCP assessment blueprints and curriculum.

Useful links

ALLERGY MEDICINE FROM A TRAINEE PERSPECTIVE by Dr Priya Sellaturay (Trainee Representative)

Allergy

Dr Priya Sellaturay (Trainee Representative)

 

Allergy is an exciting specialty with a huge demand, incorporating a wide range of disorders including food allergy, drug allergy, venom allergy, latex allergy, urticaria, difficult asthma, allergic rhinitis and immunotherapy. Allergy is mainly outpatient based, with some ward involvement when investigating patients with particular drug allergies.

 

Advantages of Allergy as a speciality

  • Outpatient based specialty
  • No on calls
  • Varied clinical work - each day and clinic is different (immunotherapy, drug challenge, general allergy, difficult asthma)
  • Incorporates many different specialties-immunology, respiratory, ENT, paediatric, dermatology, gastroenterology
  • MDT approach - working with specialist nurses and consultants from other specialties
  • Management of acute medicine e.g. treating anaphylaxis and exacerbation of asthma
  • Single centre training- therefore do not have to rotate during the 5 years
  • Part of training involves experience through short attachments in other specialties such as dermatology and immunology which may be at other centres
  • Research - trainees are encouraged to take part in clinical research (writing papers  and higher degrees) and in teaching
  • High demand - there is an increase in the incidence of allergic disorders and the need for specialists is increasing, which should mean increased training numbers and consultant posts in the future. New consultant posts are being created. 
  • Job satisfaction- a large part of choosing a field is to have job satisfaction. Patients are very grateful as allergic disorders such as food allergy affect the activities of daily living.

 

Disadvantage of allergy medicine

The biggest disadvantage is that there is little exposure to Allergy during training, and many trainees are unaware of the speciality.  Therefore it is important if you are interested to find out more about the speciality by contacting the head of the allergy department. The best way to find out more, is by visiting the department and sitting in on clinics.

 

Specialty from a trainee perspective

 

Training is based in a single centre, normally a teaching hospital. In the east of England, trainees are based in Addenbrooke’s Hospital. From a trainee’s point of view, this is one of the best centres to train in the UK, as it is a centre of excellence, with consultants who are leaders in the field of allergy, but are supportive and easily approachable. As a trainee you are encouraged to be involved in research, and gain a lot of experience in different fields of allergy.

 

Typical timetable:

 

Day of week

Morning

Afternoon

Monday

Food challenge clinic

Admin/ research/ audit

Tuesday

Venom immunotherapy clinic

Drug challenge clinic/ general anaesthetic allergy

General allergy clinic

Wednesday

Difficult asthma clinic/pollen immunotherapy clinic

General allergy clinic

Thursday

Venom clinic/ drug allergy clinic/ joint allergy, asthma and ENT clinic

Admin/ research/ audit

Friday

General allergy clinic/ drug challenge clinic

Admin/ research/ audit

 

 

Curriculum

The allergy curriculum covers 14 topic areas: fundamental immunological knowledge, relevant laboratory experience, asthma, rhinitis, atopic dermatitis, food allergy, drug and vaccine allergy, insect venom allergy, urticaria and angioedema, anaphylaxis, latex allergy, allergen immunotherapy, paediatric allergy, unconventional therapies and immunodeficiency.

The curriculum is available here http://www.jrcptb.org.uk/sites/default/files/2010%20Allergy.pdf

 

 

E portfolio and ARCP

This helps to record your progress during the year, the main way of demonstrating evidence of progress in allergy is with case based discussion, mini CEX, teaching observation, audit assessment, multi consultant report and multi-source feedback forms.

There is a yearly ARCP, which is normally carried out near the end of the year.

The ARCP decision aid is available here

http://www.jrcptb.org.uk/sites/default/files/2010%20Allergy%20ARCP%20Decision%20Aid%20%28revised%202014%29.pdf

 

Useful contacts

Training Programme Director / head of allergy department at Addenbrooke’s Hospital Dr Pamela Ewan (pamela.ewan@addenbrookes.nhs.uk )

Allergy consultant/ president of The British Society for Allergy & Clinical Immunology (BSACI) Dr Shuaib Nasser (shuaib.nasser@addenbrookes.nhs.uk)

Trainee representative Dr Priya Sellaturay (priya.sellaturay@addenbrookes.nhs.uk)

E portfolio contact: Victoria Theobald (victoria.theobald@nhs.net)

 

Reading List

The BSACI allergy guidelines  are available here

http://www.bsaci.org/Guidelines/bsaci-guidelines-and-SOCC

There are also NICE guidelines for several topics in allergy.

 

Diary

3rd of February 2016 – BSACI training day on mastocytosis, hereditary angioedema, urticaria at Guys and St Thomas

11th-15th June 2016- The European Academy of Allergy and Clinical Immunology (EAACI) international conference in Vienna Austria

6th of May 2016- Quality control in diagnostic testing, allergy relevant laboratory diagnostics in Sheffield hospital

 

29thSeptember-1st October 2016 BSACI national conference in Telford 

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