Dr Joanna Lukawska has kindly provided the following case study
about her career in Allergy.
I am sitting on a plane flying back from San
Diego in California. I have just been to a work conference where I
presented our research work on allergic asthma. I had a great
time there enjoying the talks during the day and the local bars at
night. The mixture of sunshine, science and mojitos has been good
for the body, mind and spirit.
The in flight entertainment is in full blast
and I have finished my dinner.
I have already watched the “Bridesmaids” and “Last night”.
There is nothing else on the list that I particularly want to see.
The woman sitting on my left has pulled a blanket over her
face and is happily snoring away. The elderly gent on my
right has asked for another G & T. He has already offered
me wine and vodka with tonic, all complimentary from the trolley.
This seems to be an ideal opportunity to get out my ipad and to do
some “how did I get here?” thinking.
Like many doctors in Allergy I “got” into the
specialty “accidentally”. In 2005, which is when I joined the
Department at Guy’s Hospital, nobody had heard about Allergy.
By nobody I mean people I worked and played with. The
specialty had only been in existence for 4 years
then.
I graduated from Bart’s and the Royal London Medical School. I did
my house jobs there and then worked at Chelsea and Westminster for
one year, only to come back to Bart’s and the London to finish my
SHO training. Post MRCP I worked in St John’s Dermatology at
St Thomas’. This is where I heard about the job in Allergy.
I still remember the awful feeling in my gut on my first day
at work, worrying that I may have made a terrible choice. After all
I enjoyed working at St John’s and I have made some good friends
there. One of them said to me that my decision was
inexplicable and thoroughly baffling. Six years later we
still keep in touch and he has warmed up to my career move.
For the last six years I have been very lucky to have a job, which
is both interesting and challenging. I know this is such a cliché
and it is what most medics say about their specialties.
For me, the interest in Allergy comes mainly from the variety of
patients we see. We deal with conditions involving almost every
part of human body, literally from heads to toes, and often the
psyche too. The presence or absence of allergy (in almost
equal measures) is the common denominator. The specialty is
clinic based and in a single clinic you may be examining your
patients’ abdomen, assessing their skin, looking up their nose,
percussing their lungs or just listening to their story.
There is a lot of crossover with other specialties: ENT,
Dermatology, Gastroenterology, Respiratory medicine. But
don’t worry you will not be stepping on anybody’s toes. These
patients are usually referred to us by their respective
specialists. Within the wider field of Allergy there are
several sub specialties such as: Food Allergy, Immunotherapy or
Drug Allergy.
Drug allergy is a new and exciting
discipline. Here we deal with allergy to general and local
anaesthetics, antibiotics and many other drugs. Have you ever
looked after a patient labelled as penicillin allergic? Have
you considered the restrictions this diagnosis puts on you and your
patient? We are able to help by either refuting the diagnosis
or confidently confirming it and offering safe alternatives. Have
you ever dealt with a patient who became allergic to a life saving
/prolonging drug such as rifampicin or platinum based drugs such as
carboplatin. Did you know it is possible for these patients
to undergo a process of desensitisation in order to continue with
the treatment. It is in areas such as these that our
expertise lies.
We are still learning about allergic diseases,
discovering new allergens and possible ways we may be able to treat
our patients. A lot of emphasis is put on research and if you
are at all interested you will be encouraged to contribute,
formally while studying for a research degree such as MD or PhD or
by conducting an independent project.
The challenges in Allergy are somewhat unique
in that the specialty is still very young and trying to establish
itself, mostly in the consciousness of other medical
practitioners. The patients often seem far better informed as
to our existence and practice. This is reflected in the
competitiveness of the specialty and I believe the speciality
offers an opportunity for anyone forward thinking and looking for a
young and fast developing niche.
There are only a few training posts available per year and most are
associated with major teaching hospitals. However as most junior
doctors are not aware of the specialty; the ratio of applicants to
training post is very favourable and hence getting a number in
Alllergy is less competitive than most other non acute, 9 to 5
specialties. Once you have joined you will spend 5 years
training, based mostly at your training centre, but encouraged to
attend relevant clinics (ENT, Dermatology, Immunology,
Paediatrics). In keeping with most other medical specialties
there is likely to be an end of training exit exam, however for
anyone who has been through the MBBS, MRCP etc this is unlikely to
pose too great a problem.
If you are still not convinced, but think you
may have an interest in Allergy and would like to know more before
you commit, you could attend any of the Allergy Academy seminars or
courses. Allergy Academy is an educational establishment
within the King’s College London. Their vision is to provide
a comprehensive educational programme in Allergy for generalists
and specialists alike. Their seminars are exceptionally well run,
practical and inspiring. (http://www.allergyacademy.org/Pages/Home.aspx)
If you are thinking of joining the Allergy
team please feel free to visit us at Guy’s Hospital, 2nd
floor, Bermondsey Wing, general outpatients. We will be glad
to show you around.
Please note the content and
opinions expressed in all case studies are those of the writer and
do not necessarily reflect the views of
www.medicalcareers.nhs.uk