Diversity of allergy and clinical immunology reunified by training at the EU level

Allergology and Clinical Immunology represent a peculiar specialty, because, whereas the majority of other specialties are, in general, organ or system-oriented, this specialty is patient-oriented. In fact patients with immune-mediated syndromes typical of the specialty may have a simultaneous or consecutive involvement of different organs and/or systems (varying from skin to lungs, from ear, nose and throat to bronchi, from eye to kidney, liver and so on). This peculiarity, on the contrary, can be seen as a kind of weakness because other organoriented specialties involved in immune-mediated syndromes, during the years, because of their longer tradition, have been largely involved the fields of Allergology and Clinical Immunology from clinical, formation and training. Concerning Allergology, this relates to specialties like Pneumology, ENT, Dermatology, Ophthalmology, Paediatrics and for Clinical Immunology Rheumatology, Immunohaematology. The reality at the beginning of 2000 is that Allergology and Clinical Immunology, although it has been one of the areas of the medicine with the greatest advancement in scientific research and the largest increase of patients (they are, in Western countries, usually over 30% of the total population), has not yet reached the appropriate place among other recognized specialties and is not yet recognized in an unanimous and uniform way by EU National Health Authorities. This problem is not only in Europe but all around the world. In Europe, in 1958, 1 year after the Treaty establishing the European Community in Rome, the European Union of Medical Specialists (whose acronym is Union Européenne des Medecins Specialistes from the French version at that time adopted) was constituted and since then it represents the official organization including all the specialties recognized in European countries. The goal of UEMS is to harmonize the training and the formation of the specialists in Europe, regulate the free circulation of the doctors in the Union and keeping the official relationships with the European Council, Commission and Parliament and with national governments for every problem concerning the specialties. Every UEMS specialty has a Section, including in general two members for each country of EU, coming from Professional Associations where they are existing or ad hoc designed by other Societies or Associations, and a Board, including two members from Scientific and Academic Societies for each country. So there is a Section/Board for each specialty, with one President and one Secretary elected by the various members for the terms chosen by each Section/Board. The right of voting is only for the members belonging to the Section and one country has only one vote. The Section/Board of Allergology and Clinical Immunology stands on the Charter on Training and Training Formation, present in the Chapter 6 of UEMS documents from 1994; since then it has been modified by various amendments till June 2003 in Paris. The Charter indicates the rules for the institutions, teachers, trainees and the duration of training. These rules have been declared on theoretical principles but when a survey is performed among EU countries concerning Allergology and Clinical Immunology training, it reveals that every country has its individual training programme different from the others. Moreover, some countries recognize the specialty as a full specialty (e.g. Italy, Spain, Greece, Portugal, Switzerland), whereas in some countries it is a sub-specialty (for instance of Dermatology as happens in German-speaking countries, or of Internal Medicine, S. G. Del Giacco, H. J. Malling Dipartimento di Medicina Interna, Policlinico Universitario, Cagliari, Italy