An allergist, formally known as an allergist/immunologist, is a physician who specializes in diagnosing and treating diseases related to the immune system. This includes conditions involving allergic reactions, asthma, and various immunologic disorders. These specialists dedicate many years to education and clinical practice to gain the necessary expertise to manage these complex diseases.
The Foundational Medical Degree
The path to becoming an allergist begins with a foundational medical degree. Aspiring allergists must first complete four years of medical school after earning a bachelor’s degree, culminating in either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree.
This four-year period is dedicated to learning human anatomy, physiology, pathology, and pharmacology, alongside gaining foundational clinical skills. Receiving an MD or DO degree signifies that the individual is a licensed physician, though not yet specialized. This stage is uniform for all future physicians.
Specialized Training and Board Certification
After medical school, physicians begin specialized training spanning five to six years. This training starts with a three-year residency program, most often in Internal Medicine or Pediatrics. This residency provides broad clinical experience in the care of adult or pediatric patients before focusing on a subspecialty.
Following residency, the physician must secure a competitive fellowship in Allergy and Immunology. This specialized two-to-three-year program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). The fellowship is dedicated to the in-depth study of allergic disease mechanisms, immune responses, and clinical applications for both adult and pediatric patients.
The final step is achieving certification through the American Board of Allergy and Immunology (ABAI). The ABAI is a conjoint board of the American Board of Internal Medicine and the American Board of Pediatrics. Certification requires passing a comprehensive examination, which assures the specialist possesses the requisite knowledge and experience for high-quality care.
Core Scope of Practice
Allergist/immunologists manage a wide array of conditions resulting from immune system dysfunction. A primary focus involves common allergic diseases such as chronic asthma, severe seasonal and perennial allergic rhinitis, and allergic conjunctivitis. They are experts in identifying the specific environmental or food triggers that cause these symptoms.
The specialist’s expertise extends to various skin conditions, including the management of moderate-to-severe atopic dermatitis (eczema), chronic hives (urticaria), or swelling (angioedema). They are the primary providers for diagnosing and treating all forms of hypersensitivity reactions, such as severe food, drug, and venom allergies. Diagnostic tools include skin prick and intradermal tests to pinpoint specific allergens, and they conduct monitored oral food or drug challenges to confirm a diagnosis.
The “immunology” part of their title refers to their ability to diagnose and treat complex immune system disorders, including primary immunodeficiency disorders. These conditions involve a weakened immune system, often requiring specialized treatments like immunoglobulin therapy. For patients with chronic allergies, allergists provide disease-modifying treatments like allergen immunotherapy (allergy shots), which help the body build tolerance to specific triggers.