How important is the focus in fellowships?

Ok, now granted I am several years away from this… and lots of things can change… but I’m currently batting around the idea of doing a residency in IM and then doing a fellowship in Allergy/Immunology… A great deal of my volunteer work as well as personal research has been done on autoimmune disorders and I think that that would be a good fit for me as well as a fascinating field to go into… My question is this…
I’m looking at profiles of several fellowship programs and there are VERY few that list any focus on autoimmune disorders… How important would something like this be if/when I choose which fellowships to apply for? Can I make it what I want it to be, or is it something that is really required of the position (the focus on autoimmune) in order for it to be beneficial for me… or to ask in a simpler manner… would “any” fellowship in allergy/immunology give me the basis for a focus on autoimmune (with side research) or would I need to choose a fellowship that really structures its program around that?
LECOM-B Class of 2009

By autoimmune do you mean things like Lupus, Rheumatoid arthritis, scleroderma, dermatomyositis, wegener’s etc? These are usually handled by rheumatologists and much of their training and research is in autoimmune diseases.

Agreed–rheum is more autoimmune than allergy/immunology is. And actually what with the extra musculoskeletal training in osteopathic school, rheumatology might be a perfect match for you.
I personally am irritated that the two specialties split up the immune system in this sort of oddball way–totally a historical artifact. There should be a specialty just called immunology that includes immune deficiencies and autoimmune diseases and immune cell malignancies. A friend of mine and I are thinking we might invent it.

I agree… A few of the fellowship programs that I’ve briefly researched mention autoimmune disorder study… and I would assume that that would mean ALL autoimmune… but again I need to do more research… The reality is that the presence of one autoimmune disorder increases the likelihood of another or multiple others… sending someone with 5 different autoimmune disorders to 5 different specialists to handle those is prohibitive on multiple levels…
I think I’d like to be one of those people… one that handles it all…everything from RA to allergies to Celiac Disease to helping/trying to find links between triggers/the triggers themselves (viral or other stressors) and the development of autoimmune disorders…
It’s all very fascinating to me… I know there’s a good portion of research involved here which is fine… but a lot of clinical as well, since there don’t seem to be a whole lot of “good” treatments for the multitude of autoimmune dysfunction that’s out there…
I think that regardless of whether I specialize or not and what specialty I choose, this will be a LARGE part of what and how I practice…I’m just wondering if choosing a fellowship that explicitly states this will be a deciding factor.

You may want to consider receiving dual training in Rheumatology and Allergy/Immunology. If you go to this website
you can look under either Allergy/Immunology or Rheumatology training requirements and it specifies what you need to do to be trained in both. I think that autoimmune disorders would fall more under Rheumatology, but I like the idea of being able to practice either specialty since they are so closely related. Good luck!

It seems though that each subspecialty (including endocrinology, rheumatology, allergy/immunology and many others) has a sub-focus on some autoimmune disorder… for rheumatology it’s RA… endo, it’s Type I diabetes…
I think I really really really like Joe’s idea of moving them all into one…