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Specialty spotlight – clinical immunology

Dr Rohit Ghurye, ST4 clinical immunology at the Royal London Hospital, discusses clinical immunology, what working and training in the specialty involves, and what it takes to be a successful clinical immunologist. 

Introduction to immunology

Immunology is the branch of medicine concerned with the body’s defence system known as the immune system. Clinical immunologists are doctors who specialise in the care of patients with failure of the immune (defence) system (immunodeficiency) and heightened immune reactivity (allergy and autoimmunity) due to infections, allergic reactions, vasculitis and transplants.

Clinical immunologists in the UK undertake a range of clinical and laboratory duties, but their core activities are in the clinical management of patients. Their clinical work is largely outpatient based and involves:

  • primary immunodeficiency
  • allergy
  • autoimmune rheumatic diseases and systemic vasculitis
  • joint paediatric clinics for children with immunodeficiency
  • immunoglobulin infusion clinics for patients with antibody deficiency.

Their laboratory work underpins the diagnosis and monitoring of immunological diseases. They have responsibility for clinical liaison, interpretation and validation of results and quality assurance and assay development. 

A minority of immunologists (less than ten percent) also provide laboratory support for transplantation, histocompatibility leukocyte antigen (HLA) and tissue typing.

Immunologists provide support for the diagnosis and management of conditions such as:

  • autoimmune diseases such as Type-1 diabetes or rheumatoid arthritis or inflammatory bowel disease
  • human immunodeficiency virus (HIV)
  • other severe/systemic infections
  • multiple sclerosis
  • tuberculosis.

Dr Richard Herriot, consultant immunologist at Aberdeen Royal Infirmary:

Immunology is a complex and stimulating area of practice in which scientific understanding and clinical progress is constant. There is no opportunity to be bored or complacent. The job brings you into contact with a wide range of professional colleagues across many disciplines and with patient groups who are, for the most part, highly engaged with their place in contributing to good care outcomes.

Training and working in clinical immunology

Immunology resources

RCP resources