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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 year of training at the time the curriculum was introdced. 

Allergy, Clinical and Laboratory Immunology (ACLI) 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 in 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 ACLI specialise in the care of patients with failure of the immune system (immunodeficiency) and heightened immune reactivity (allergy). As patient-facing clinicians, physicians in ACLI 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.
  • As laboratory physicians, they are responsible for leading the provision and development of diagnostic services for immune-mediated disease spanning multiple specialties and primary care, thus underpinning multiple patient pathways. These responsibilities include:
  • Investigation of disorders affecting autoimmunity, immunochemistry, allergy and cellular immunology.  
  • Immunology laboratory leadership & direction, governance, supervision, quality assurance, clinical interpretation and clinical liaison as per the UKAS Standards (ISO15189).

In addition to these core working elements, physicians in ACLI also provide a range of highly specialised clinical or laboratory services, at regional and national level, which are focused on specific aspects of autoimmune, immune deficiency, allergic or inflammatory diseases. External accreditation processes underpin quality assurance of all the components of immunology services.

Entry into Allergy, Clinical and Laboratory 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
  • Paediatric level 1 training - three years


The curriculum for each specialty defines the process of training and the leaning outcomes needed for the award of a certificate of completion of training (CCT).Please refer to the Royal College of Pathologists’ website for information about  FRCPath examination including guidance for candidates. The 2021 curriculum and supporting documents are given below. Please see the Allergy webpage for the Allergy and Clinical Immunology curriculum. Please see the sections below for the ARCP decision aid and rough guide.

Immunology (Allergy, Clinical and Laboratory Immunology) 2021 curriculum

Allergy and Immunology mapping of 2021 CiPs to previous curriculum competencies

The 2015 curriculum is given below. Previous versions of the curriculum are no longer available online but copies can be requested from

ARCP Decision Aids

The ARCP decision aid for each specialty defines the targets that have to be achieved for a satisfactory ARCP outcome at the end of each training year.

ACLI Immunology 2021 ARCP Decision Aid

Trainees remaining on the 2014 curriculum should refer to the ARCP decision 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