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About the specialty

Two new training pathways have been developed for Allergy and Immunology:

  • Allergy and Clinical Immunology (ACI) 
  • Allergy, Clinical and Laboratory Immunology (ACLI)

These pathways were implemented in August 2021, following GMC approval of the new curricula.The specialties will continue to be referred to as Allergy (ACI) and Immunology (ACLI) until the specialty name changes have been aprpoved by the Department of Health.  Doctors in training are required to transfer to the new curricula unless in their final two years of training at the time the curriculum was introdced. This is to allow for the development of a new examination which will be available from 2023.

The specialty of Allergy and Clinical Immunology (ACI) is the branch of medicine concerned with the body’s immune system. The clinical practice of this specialty encompasses clinical and laboratory activities dealing with the study, diagnosis, and management of patients with diseases resulting from disordered immunological mechanisms, (both deficient and exaggerated) and conditions in which immunological manipulations form an important part of treatment.

In the last three decades, there has been a significant increase in the requirement for allergy, clinical and laboratory immunology services. This is due to improved case ascertainment and treatment options for patients who have primary and secondary immune deficiencies (especially those caused by increased use of chemotherapy, immunosuppressive drugs and biological agents). There has been a significant increase in the prevalence of allergic conditions and demand for allergy services with new and developing therapeutic intervention options in the fields of both allergy and immunology.  There has been a corresponding requirement for immunology laboratories to provide support for primary care and secondary care in diagnosis and management of both allergic and immunological conditions. 

Physicians in ACI  specialise in the care of patients with heightened immune reactivity (allergy) and failure of the immune system (immunodeficiency). 
As patient-facing clinicians, physicians in ACI are principally responsible for: 

  • Providing specialist allergy care services encompassing the assessment and management of patients with a broad spectrum of common atopic and allergic conditions (such as food, drug and insect venom allergy, anaphylaxis, asthma, eczema, rhino-conjunctivitis, and urticaria and angioedema),   
  • Providing clinical immunology services encompassing the assessment and management of patients with immunological conditions such as primary immunodeficiency and disorders of immune dysregulation
  • Working closely with primary care, paediatricians, and other hospital specialists to manage patients with allergic and immune-mediated disease.

Entry into Allergy and Clinical Immunology training is possible following successful completion of both a foundation programme and one of the following core training programmes:

  • Internal Medical Training (IMT) - two years
  • Acute Care Common Stem - Internal Medicine (ACCS-IM) - three years
  • Paediatrics level 1 training - three years


The curriculum for each specialty defines the process of training and the competencies needed for the award of a certificate of completion of training (CCT). The 2021 curriculum for Allergy and Clinical Immunology and supporting documents are given below. Please see the current Immunology webpage for the curriculum for the Allergy, Clinical and Laboratory Immunology (Immunology) pathway. Please see the sections below for the ARCP decision aid and Rough Guide to the new curriculum.

Allergy (Allergy and Clinical Immunology) 2021 curriculum

Allergy and Immunology mapping of 2021 CiPs to previous curriculum competencies

The 2010 curriculum is given below. Previous versions of the curriculum are no longer available online but copies can be requested from

2010 Allergy.pdf(286.212 KB)

ARCP Decision Aids

ARCP Decision Aids define the targets that have to be achieved for a satisfactory ARCP outcome at the end  of each training year.

ACI Allergy 2021 ARCP Decision Aid

Trainees remaining on the 2014 curriculum should use the decsion aid below

Forms and guidance

Curriculum webinar

A joint JRCPTB and BSACI webinar was held on 30 May and a recording is available via this link.

Rough guide

The joint SAC for Allergy and Immunology has developed a rough guide for implementation of the 2021 curricula. 

Rough Guide to Allergy and Immunology 2021 curricula