One of the major aims of the specialty sections of the Union of European Medical Specialists (UEMS) is the harmonization of practice parameters in the specialist medical care of patients throughout Europe. Two major goals of such harmonization are the achievement of greater uniformity in patient care across different European countries and the facilitation of mobility of specialists between these countries. Practice parameters in the field of allergology and clinical immunology vary widely in different European countries. In some areas, specialists in allergology and clinical immunology are based in internal medicine, whereas, in others, the specialty of allergology and clinical immunology is practiced from organ-based specialties, usually dermatology, pulmonology, and/or ENT.

At its inception, the Section of Allergology and Clinical Immunology of the UEMS formulated basic recommendations for training in allergology and clinical immunology, stating that such training should follow from a common trunk of internal medicine and/or pediatrics. The principal motivation for this recommendation was the fact that allergic diseases are systemic disorders often involving multiple organs, and that specialists may best approach this discipline from the broadly oriented medical background that internal medicine and pediatrics provide. This remains the case, and is particularly relevant in situations or areas where the organ-based specialties do not themselves require significant training in internal medicine or pediatrics.

A single recognized specialty of allergology and clinical immunology based in internal medicine and/or pediatrics would improve the efficiency of training and CME (continuing medical education), reduce redundancy in health care, facilitate health-care planning nationally, and facilitate standardization of care between countries. Moreover, new regulations impinging on the practice of medical specialists being developed in most European countries support the need for such a specialty. Programs administered by the national specialist societies designed to ensure and maintain professional competence are becoming increasingly important and will probably be mandatory in the future. Administration of such programs for allergology and clinical immunology by the same specialty societies in different countries would improve standards of clinical practice and contribute to making mobility of allergy specialists between different European countries a real possibility.

Although organ-based specialists will continue to play an important role in the specialist medical care of allergic patients, and recognizing that a transition period may be inevitable in some countries, the Section of Allergology and Clinical Immunology of the UEMS recommends that national organizations work toward the establishment and/or maintenance of a core service of specialist care in allergology and clinical immunology provided by allergists with a training based in internal medicine and/or pediatrics.

  1. * This position statement was unanimously endorsed by the UEMS Section of Allergology and Clinical Immunology and the EAACI Educational and Specialty Committee at their meeting in Cascais, Portugal, on 6 November 1999. Delegates present: Dr F. Braido (on behalf of Prof. Dr G. W. Canonica) (Italy), Dr R. de Beule (Belgium), Prof. Dr S. del Giacco (Italy), Prof. Dr J. G. R. de Monchy (The Netherlands), Dr A. E. J. Dubois (The Netherlands), Dr P. van Durme (Belgium), Dr P. W. Ewan (UK), Dr B. Hornung (Germany), Prof. Dr K. Kontou-Fili (Greece), Prof. Dr D. Kraft (Austria), Dr N. Lindholm (Sweden), Dr J. M. Lopes dos Santos (Portugal), Prof. Dr H.-J. Malling (Denmark), Prof. Dr A. G. Palma-Carlos (Portugal – chairman), Prof. Dr G. Pauli (France), Dr W. Rebien (Germany), Dr J. E. Rosado-Pinto (Portugal), Prof. Dr B. Wüthrich (Switzerland).