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1. What makes an allergy, immunology and infectious diseases paediatrician?

An allergy, immunology and infectious diseases (PAIID) specialist is a clinician who works across all paediatric age groups to investigate, diagnose and manage infectious, immunological and allergic disorders. They work in both inpatient and outpatient settings, with acute and chronic presentations of disease, and provide specialist regional advice in a model of shared care with local hospitals.

Most specialists will have one primary area of interest (allergy, immunology or infection), but will have core training in all three areas. PAIID paediatricians usually practice in multidisciplinary teams (MDTs) in centres with co-located specialty disciplines, including paediatric intensive care units (PICU) and adult allergy, immunology and infectious disease (AIID) specialists, and supporting services, e.g. immunology, microbiology and virology laboratories.

At the tertiary level, PAIID paediatricians have developed detailed knowledge of the developing immune system and its role in infection and allergic disease in children. Furthermore, they are knowledgeable about interpreting microbiological and immunological investigations and have had laboratory experience in a tertiary centre.

They are involved in treating primary and secondary immunodeficiency, human immunodeficiency virus (HIV) infection and infection in the immunocompromised host, as well as administering allergen-specific immunotherapy.

2. A day in the life of a allergy, immunology and infectious diseases paediatrician

By Dr Stephanie Cross,��Consultant in Paediatric Allergy in Southampton

"My job keeps me challenged with a mixture of clinical medicine, service development, education and research. All of this, with the flexibility to work around family commitments, and no nights or on-calls.��

"I am currently working as a consultant in paediatric allergy at Southampton Children’s Hospital, a large specialist tertiary allergy centre. I completed my training in PAIID and studied for an MSc Allergy at the University of Southampton at the same time. I am faculty and module leader on the MSc Allergy, which has gained international recognition and is an excellent way to learn about it.��

"Paediatric allergy is an outpatient-based, multidisciplinary specialty involving doctors, nurse specialists, dietitians and psychologists. Day to day clinical work focuses on the diagnosis and management of allergic disease including food allergy, eczema, asthma, allergic rhinitis, chronic urticaria and drug allergy. On our day ward we perform food challenges and drug provocation tests, and many centres now offer food desensitisation. Allergen immunotherapy is a busy part of the service, treating patients with pollen, dust-mite and venom allergies.

"Paediatric allergists work closely alongside general paediatric teams and other specialties including dermatology, respiratory, gastroenterology, ENT and ophthalmology. There
is plenty of opportunity for collaborative working with joint clinics, as well as shared care with teams in local and regional centres. There are many opportunities to become involved with clinical research at local, national and international levels."��

3. How and where to experience paediatric allergy, immunology and infectious diseases in your early medical career

We can offer a wide range of placements and opportunities to provide exposure to paediatric allergy, immunology and infectious diseases, which helps to nurture interest and foster a passion for a career in paediatric allergy, immunology or infectious diseases.

For medical students we can offer special study modules, selectives in advanced medical practice, electives, seminars, workshops, student research projects and talks to medical student societies.
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For foundation doctors, we can offer PAIID taster placements, and opportunities to attend outpatient clinics, allergy challenge clinics, ward rounds and microbiology bench rounds.

For core trainees, we can offer PAIID rotations to offer specialist experience prior to applying for sub-specialty training, and research training fellowships at clinical academic departments.

4. Applying to a paediatric allergy, immunology and infectious diseases programme

Obtaining a training post in PAIID is often competitive and thus any edge you can give yourself when applying for sub-specialty training will be beneficial.

Key aspects to consider are:

• Your motivation for having a career in PAIID
• “Direct” clinical experience in PAIID e.g. seeing PAIID patients in various settings
• “Indirect” clinical experience in PAIID e.g. teaching, audit, research
• General experience that is transferrable to a career in PAIID e.g. leadership, management

Ways to cover these aspects include:

• Talk to people in the PAIID field to find out what it is “really” like
• Join the British Paediatric Allergy, Immunity and Infection Group (BPAIIG)
• Clinical placements (as part of training or out of training- UK or abroad)
• Research experience e.g. fellow post, lab work, MSc, PhD, etc.
• Teaching experience e.g. short teaching course, PgCert, fellow post
• Presentations/publications (submit abstracts to conferences)
• Attend relevant courses or conferences
• Apply for prizes or small grants (you’ll be amazed how few people often actually apply and so your chances of “winning” are much better than you think!)
• Quality Improvement Projects (e.g. audit, guidelines) in a PAIID topic
• Management experience e.g. rota co-ordinator, department trainee representative
• Leadership experience

Some trainees will become general paediatric consultants with a special interest in the sub-specialty, with the option of further developing their career to include more sub-specialty work.

If you aren’t successful in getting a training post in the sub-specialty, there is the option of completing a special interest (SPIN module), which could mean that you would have the skills and knowledge to be the local lead and part of the clinical network providing for children who need specialist paediatric care.

5. Information for��paediatric allergy, immunology and infectious diseases trainees

Once you’ve completed training, most people choose to work as a specialist in a tertiary centre, where you will have opportunities to work alongside other allied subspecialties. Many pursue careers which include both clinical work and research, as well as undergraduate and postgraduate medical education.

If you would like more advice on how to gain relevant experience, navigating training pathways, and answering specialty enquiries, contact the trainee representatives within the CSAC. They can also signpost you to WhatsApp groups with updates on educational opportunities such as teaching days and conferences.

Other trainee representatives you can contact include the British Society for Allergy & Clinical Immunology (BSACI) ��and

External links

To find out more about paediatric allergy, immunology and infectious diseases, the CSAC recommend the following websites as useful resources: