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Significant Points & Nature Of Work Training, Other Qualifications, and Advancement
Earnings A Career in Immunology

A Career in Immunology

The pros and cons of a career as an immunologist

Dr Jennifer Lortan

As often happens at social gatherings, one of the first opening questions in conversation with strangers is "what do you do?"; when I reply, "I am an Immunologist," there is usually a long silence as they struggle with this, followed by "ah yes, you immunise people.". Although Immunology began with Edward Jenner's work on small pox that eventually lead on to hugely successful immunisation programmes, I hope to convince you that there is very much more to the clinical practice of Immunology than immunising people

Immunology as a Clinical Specialty

Immunology is one of the smaller clinical specialties in the United Kingdom. Consultant Immunologists usually have a dual role, combining both the provision of clinical care and related laboratory investigation of patients with a wide range of disorders of the immune system. This encompasses patients with immunodeficiency, allergy, autoimmune and vasculitic disorders. Immunology services are often based in Teaching Hospitals and are lead by Consultant Immunologists working in teams that include Specialists Registrars, Immunology Nurse Specialists, Biomedical and Clinical Scientists and administrative staff.

Patient Care Provided by Immunology Consultants

This is usually based in outpatient clinics where patients are assessed, investigated, diagnosed, treated and monitored, often for life-long disorders. The spectrum of clinical problems that are encountered will depend on local factors and to some extent the particular area of expertise of the individual consultant.

Immunodeficiency Clinics

Patients with primary immunodeficiency especially antibody deficiency but also combined T and B lymphocyte deficiency, complement and phagocytic defects, are managed. Children with these disorders are usually dealt with in conjunction with Paediatricians in joint clinics, as most consultant Immunologists are trained in adult medicine. Occasionally Immunologists are directly involved in the care of patients with HIV infection and AIDS but this would be unusual in the United Kingdom.

Consultant Immunologists also participate in Immunoglobulin (IgG) infusion clinics that are often lead by Immunology Specialist Nurses. Most of the patients treated in these clinics receive IgG as replacement therapy for antibody deficiency (both primary and secondary in origin). Some centres have expanded to use high-dose IgG as immuno-modulatory therapy for a limited range of other disorders such as inflammatory neuropathies. Many centres also offer highly successful home therapy programmes where patients, with the help of a partner, are trained to administer the treatment to themselves.

Autoimmune and Vasculitis Clinics

Immunologists with a special interest in connective tissue disease often participate in joint clinics with Rheumatologists where patients with these disorders are diagnosed and managed.
Allergy Clinics

Immunologists often contribute to the provision of allergy services, and depending on local circumstances either provide clinics on their own, with Allergists or jointly with organ-based specialists such as Dermatologists or Chest Physicians.

Laboratory Immunology

Consultant Immunologists lead and provide direction for diagnostic immunology laboratory services, provide clinical liaison, interpretation and validation of results. Working with the Laboratory Manager they are also responsible for quality assurance, assay development and teaching and supervision of Biomedical and Clinical Scientists as well as Specialist Registrars.
Why is Immunology an Exciting Specialty?

It is the variety and complexity of clinical problems encountered, in a field that is ever changing, which provides the greatest intellectual challenge. There are many immunological disorders that remain undefined and new therapies emerging that need evaluating, so there are also many opportunities for clinically related research.

How to Go About Becoming a Specialist in Immunology

The first requirement is a solid grounding in general internal medicine (or paediatrics) and the acquisition of MRCP (or equivalent). You would then need to apply for a specialist registrar training position in Immunology. These training posts are usually for five years, during which time you would prepare for the MRCPath in Immunology, probably undertake some research and finally be awarded a CCST in Immunology and your name be entered onto the specialist register. You would then be eligible to apply for a position as a Consultant Immunologist, which is when the fun really begins! Although this is a small speciality, there has been a sustained expansion in new consultant posts allowing for great optimism for future prospects.

So do we Immunise People?

Well not very often as it happens and when we do, we use immunisation as a tool to test the integrity of the immune response.

Out-of-Hours Duties, On-Call or Having a Life Out-Side Work

If this is something that concerns you, although Immunologists provide full 24 hours a day, 7 days a week cover, there are truly no "Immunological Emergencies" that only you can handle on the spot! So being on call for Immunology usually involves giving advice over the telephone rather than having to go into the hospital at 2 o'clock in the morning.

Significant Points & Nature Of Work Training, Other Qualifications, and Advancement
Earnings A Career in Immunology
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