Your Allergy ST3 Application starts here, and if you’re aiming for a 2026 start, you’re applying to one of the smallest and most competitive Higher Specialty Training programmes in UK medicine. Allergy is entered at ST3 as an uncoupled programme after Internal Medicine Training (or an equivalent core route) with MRCP(UK), and is recruited nationally through NHS England’s Physician Higher Specialty Training process, leading to a CCT in either Allergy and Clinical Immunology (ACI) or Allergy, Clinical and Laboratory Immunology (ACLI).

This guide walks you through eligibility, the recruitment timeline, self-assessment scoring, portfolio evidence and how to build a competitive application. The interview itself is summarised briefly and covered in depth on the Allergy ST3 Interview Question Bank. Let’s start with the headline facts.

Key Facts at a Glance

• Competition ratio (2025): 9.67:1 (29 applications, 3 posts)
• Entry point: ST3, uncoupled
• Training length: Indicative 4–5 years to CCT (ACI pathway, subject to ARCP progression)
• Core requirement: Full MRCP(UK) or MRCPCH by offer date
• Prior training: IMT, ACCS-IM or paediatrics core training
• Recruitment platform: Oriel, coordinated by PHST
• Interview date (2026): 12 February, with offers by 31 March 2026

Table of Contents

• What Is Allergy ST3 Higher Specialty Training?
• Is Allergy ST3 Competitive and What Is the Lifestyle Like?
• Allergy ST3 Eligibility Criteria and Entry Requirements
• How to Apply for Allergy ST3 National Recruitment
• Allergy ST3 Recruitment Timeline and Key Dates (2026)
• Allergy ST3 Competition Ratios and Application Trends
• How Allergy ST3 Applications Are Scored (2026)
• Allergy ST3 Self-Assessment and Portfolio: How to Maximise Your Score
• The Allergy ST3 Interview: A Brief Overview
• Allergy ST3 Offers, Preferencing and What Happens Next
• Frequently Asked Questions About Allergy ST3 Application
• Allergy ST3 Useful Resources

What Is Allergy ST3 Higher Specialty Training?

Allergy higher specialty training in the UK is an uncoupled programme entered at ST3, after you’ve completed a core route such as Internal Medicine Training (IMT), ACCS-IM or paediatrics and hold MRCP(UK) or MRCPCH by the offer date. Since August 2021, training has followed the GMC-approved Allergy and Clinical Immunology (ACI) curriculum, with a sister Allergy, Clinical and Laboratory Immunology (ACLI) pathway for those wanting a stronger lab immunology focus.

The programme is overseen by the Joint Royal Colleges of Physicians Training Board (JRCPTB) through its Specialty Advisory Committee, with national recruitment run by NHS England under the Physician Higher Specialty Training (PHST) process. Training is built around general allergy clinics covering the breadth of allergic disease (food allergy, drug allergy, anaphylaxis, venom immunotherapy, asthma and respiratory allergy, urticaria and angioedema), alongside paediatric exposure and, in many programmes, dual accreditation with General Internal Medicine.

Key facts – Programme: Allergy and Clinical Immunology (ACI), 2021 curriculum – Entry point: ST3, uncoupled from core training – Indicative length: around 4–5 years (ST3 to CCT), subject to ARCP progression – End qualification: CCT in Allergy, leading to entry on the GMC Specialist Register – Oversight: GMC (curriculum), JRCPTB and the Federation of Royal Colleges of Physicians (delivery), NHS England (recruitment)

Allergy is a small specialty, only a handful of national posts each year, hosted by a limited number of deaneries, so while entry criteria are uniform UK-wide, local rotations vary meaningfully between centres. Exact CCT length for the ACI pathway should be confirmed against the JRCPTB Allergy curriculum page, as durations are quoted as indicative.

Is Allergy ST3 Competitive and What Is the Lifestyle Like?

Allergy is one of the smallest specialties in UK higher specialty training, and that shapes everything about it. In 2025 there were just 3 national posts for 29 applicants (around 9.7:1 according to community-collated recruitment data), so while absolute applicant numbers are modest, the squeeze for places is real. You’ll also be choosing between two GMC-approved pathways introduced in August 2021, Allergy and Clinical Immunology (ACI) and Allergy, Clinical and Laboratory Immunology (ACLI), and entering from either the physician route (MRCP(UK)) or the paediatric route (MRCPCH).

Lifestyle. Allergy is consistently described by deaneries and BSACI as one of the better specialties for work-life balance. Day-to-day work is predominantly outpatient (skin prick testing, IgE interpretation, food and drug challenges, immunotherapy) with standard weekday hours and minimal specialty-specific on-call. The caveat: trainees on the dual ACI + General Internal Medicine pathway will still do GIM on-calls, so the rota feels heavier than career-promotion material suggests. Less-than-full-time training is well supported and open to any trainee under current NHS England Category 3 arrangements.

Pay. There’s no Allergy-specific scale; you’ll sit on the standard NHS resident doctor pay points. At ST3 entry in England (nodal point 4) that’s around £61,825 basic (2024/25), rising through ST grades to roughly £76,500, plus London weighting and any GIM banding.

Career trajectory. CCT leads to consultant posts in a small, tertiary-centre-based specialty (Cambridge, a handful of London centres, and other regional hubs). Many trainees supplement training with BSACI courses, an MSc, or Allergy Academy overseas fellowships (3, 6 or 12 months) to strengthen their consultant CV.

Allergy ST3 Eligibility Criteria and Entry Requirements

Allergy is one of the few higher specialty programmes you can enter from two different parent specialties (internal medicine or paediatrics), so the eligibility rules look slightly different depending on which route you’re coming from. The essential criteria are set out in the NHS England person specification for Allergy ST3 2026, which applies UK-wide across England, Scotland, Wales and Northern Ireland. Always verify against the current person specification before you submit, as wording can shift year to year.

Here’s what you need to have in place by the relevant deadlines:

• Primary medical qualification: MBBS or equivalent, with full GMC registration and a licence to practise by the post start date.
• Physician route exams: MRCP(UK) Part 1 passed at the time of application, and the full MRCP(UK) diploma by the offer date. Alternatives accepted include eligibility for the GIM specialist register, or completion of Irish Basic Specialty Training with the full MRCPI.
• Paediatric route exam: Full MRCPCH by the offer date if you’re applying from paediatrics.
• Core training competences: For physician applicants, completion of Internal Medicine Training or 36 months of equivalent core medical experience, with competence sign-off evidenced through ARCP. IMGs need JRCPTB international level 3 accreditation (or equivalent) to demonstrate parity with UK IMT.
• Foundation competences: Successful completion of UK Foundation Training (see our Foundation Programme guide) or equivalent must be signed off.
• Right to work: Eligibility to work in the UK by the post start date. Note that 2026 introduces immigration-status prioritisation under the Medical Training (Prioritisation) Bill, which materially affects IMG applicants.
• English language: Where required by the GMC, IELTS Academic 7.5 overall (7.0 in each section) or OET grade B in each sub-test.

There’s no MSRA or specialty aptitude test for Allergy. The in-training ACICE exam is taken later. There’s also no formal cap on post-foundation experience, but your career progression should be consistent with the stage you’re applying for.

How to Apply for Allergy ST3 National Recruitment

Allergy ST3 is recruited annually as a Group 1 physician specialty through the Physician Higher Specialty Training (PHST) process, coordinated by the JRCPTB Recruitment Office (hosted by the Yorkshire and Humber Deanery) and submitted via the Oriel portal. For full procedural detail, always cross-check the current PHST applicant handbook and the NHS England Allergy ST3 person specification. These are the definitive sources for the cycle you’re applying in.

Here’s the step-by-step shape of the process:

1. Register on Oriel. Set up your account on the Oriel portal well before applications open. There’s no application fee, though you’ll need to budget for MRCP(UK) exam costs and interview-related travel.
2. Check eligibility against the person specification. For 2026 entry you need MRCP(UK) Part 1 passed at the time of application, with the full diploma achieved by the offer date (MRCPCH full diploma by offer date for the paediatrics route). GMC registration, evidence of foundation competences and core training completion are also essential.
3. Open your Oriel application during the PHST window. For the 2026 cycle, applications open at 10am on Tuesday 28 July 2026 and close at 4pm on Thursday 13 August 2026. Don’t leave submission to the final hour, as Oriel slows down close to deadlines.
4. Complete the form sections. You’ll work through personal details, qualifications, employment history, fitness-to-practise declarations, referee details (typically three clinical supervisors from the last two years; references are sought later, not at submission), and the self-assessment domains that drive your shortlisting score.
5. Upload supporting documents. Evidence for your self-assessment claims (qualifications, publications, presentations, teaching, QI, leadership) is uploaded via Oriel or a linked PHST document upload system. Originals are verified later at interview and pre-employment stages.
6. Rank your locality preferences. Allergy has very few posts nationally (3 in both 2024 and 2025), so geographic flexibility matters. Rank realistically.
7. Submit and track. Once submitted, monitor your Oriel dashboard for longlisting outcomes, shortlisting decisions and interview invitations.

There’s no overall cap on how many different specialties you can apply to in a single round, provided you meet each post’s eligibility. Many Allergy candidates also apply for Immunology ST3 in parallel, given the shared infrastructure.

Reapplication. If you’re unsuccessful, you can reapply in a future cycle and request feedback (including self-assessment and interview score breakdowns). Appeals are restricted to procedural grounds only. Scoring decisions themselves can’t be appealed, with the narrow exception of the self-assessment appeals route. Candidates who have previously held an NTN in a higher specialty training programme must submit a ’support for reapplication’ form signed by their Training Programme Director and Postgraduate Dean.

Allergy ST3 Recruitment Timeline and Key Dates (2026)

Allergy ST3 is recruited through Physician Higher Specialty Training (PHST) via Oriel, with one national interview each February. The 2026 cycle is unusual in that allergy and immunology candidates sit a joint interview panel, so the dates below apply to both pathways (ACI and ACLI). Allergy sits in the PHST summer HST window rather than the October/November Round 1 timeline used by other specialties. Confirm dates against the PHST Allergy specialty page and your Oriel vacancy once published.

Because posts are few (only 3 nationally in 2025), the timeline is tight and every deadline matters, particularly the separate evidence upload window, which catches people out.

Stage	Date (2026 cycle)
Applications open (Oriel, PHST summer window)	10am, 28 July 2026
Applications close	4pm, 13 August 2026
Evidence/self-assessment upload window	Published per-specialty by PHST after applications close
Shortlisting outcomes / interview invitations	Issued at least 7 days before interview
Interview date (2026 cycle, Round 1 cohort)	12 February 2026
First offers issued (Round 1 schedule)	By 31 March 2026

Sources: NHS England national interview schedule and PHST Recruitment. Allergy sits in the PHST summer HST window rather than the October/November Round 1 cycle; dates can shift slightly year on year.

A couple of practical points worth flagging. The evidence upload window for PHST cycles often sits across holiday periods, so get PDFs ready well before applications close. And if you’re a paediatric trainee finishing ST3 in the September/March cycle, the standard August start may be flexed. Flag this with PHST early rather than at offer stage.

Allergy ST3 Competition Ratios and Application Trends

Allergy is one of the smallest higher specialty programmes in the UK, with just three national posts in recent rounds, which makes the headline ratios feel sharper than they might in larger specialties. NHS England publishes the official figures on its Medical Hub Competition Ratios and Fill Rates pages, and PHST Recruitment corroborates them for Allergy specifically.

Here’s how recent cycles have looked:

Year	Applications	Posts	Ratio	Fill rate
2021	21	4	5.25:1	—
2024	30	3	10.00:1	100% (3/3)
2025	29	3	9.67:1	100% (3/3)

Specific applicant figures for 2022 and 2023 weren’t published in a form we could verify, so we’ve left those years out rather than guess.

The trend is clear enough: demand has roughly doubled since 2021, while post numbers have drifted down from four to three. That’s pushed the ratio from around 5:1 to close to 10:1, and every post has been filled in the last two cycles, so shortlisters aren’t short of strong candidates to choose between.

A practical point on geography: because there are usually only three posts spread across the UK, NHS England doesn’t publish deanery-level breakdowns, and your “regional” choice is really a question of which trusts advertise a post in that particular round. Check the PHST Allergy page early in the cycle to see where posts are sitting before you finalise preferences.

How Allergy ST3 Applications Are Scored (2026)

Allergy ST3 recruitment runs through the Physician Higher Specialty Training (PHST) office, which sets the scoring framework that ranks candidates for offer. Based on published PHST data for comparable physician specialties (Respiratory Medicine is the documented example), the weighting is likely interview 80% / self-assessment 20%. Your raw interview score (out of 40) is doubled to give a weighted total out of 80, and your application score (out of 40) is multiplied by 0.5 to give a weighted total out of 20, combining to a final ranking score out of 100. The exact split for Allergy is not numerically confirmed on the PHST Allergy page, so confirm against the current applicant handbook before you apply.

That weighting matters. Allergy is a tiny specialty (single-digit national posts each round), so margins between appointable candidates are thin, and the interview is where most of the differentiation happens. The self-assessment, though, is what gets you into the interview room in the first place. It’s the shortlisting gate.

The scored domains

The Allergy ST3 self-assessment is structured around eight domains, each capped at 1–5 points, verified against uploaded evidence and adjustable up or down by the panel at interview. Check the current PHST Allergy applicant handbook to confirm the exact domain list and point allocations for the 2026 round, as scoring details can shift between cycles.

Domain	What it captures
Postgraduate degrees & qualifications	MSc, MD, PhD (intercalated degrees are typically excluded)
Publications	First-author PubMed-cited papers score highest; co-authorship lower
Presentations & posters	International/national oral > regional oral > poster
Teaching experience	Sustained programmes, formal feedback, teaching qualifications
Quality improvement & audit	Leadership role plus completed re-audit cycle scores best
Leadership & management	Formal roles with demonstrable impact
Commitment to specialty	Allergy-specific exposure, courses, taster experiences
Additional achievements	Prizes, grants, distinctions

Within the application component, domains carry equal maximum weight, so a strong showing across several beats a single standout entry. Note that PHST historical shortlist data references a 0–60 range from earlier rounds; the current published framework is the /40 application total described above, so use that as your planning anchor.

How exams feed in

Unlike some ST3 specialties, Allergy doesn’t use the MSRA. MRCP(UK) (or paediatric/Irish equivalents) is a threshold requirement at application or offer rather than a scored domain. You either have it or you can’t apply. Your exam result doesn’t give you points, but missing it ends the application entirely.

We unpack each self-assessment domain (what counts, what doesn’t, and where candidates lose easy marks) in the next section.

Allergy ST3 Self-Assessment and Portfolio: How to Maximise Your Score

Because Allergy is a small physicianly specialty without an operative logbook, your Allergy ST3 application stands or falls on the self-assessment portion of the Oriel form and the evidence you upload to back it up. Recruitment is run by PHST, and in recent years the shortlist score has sat on a 0–60 scale across domains set out in the applicant handbook. Treat the handbook as your scoring rulebook: every point you claim must map to a document you can produce.

What the self-assessment actually scores

For Allergy ST3, the scored domains cover postgraduate degrees and qualifications, presentations and posters, publications, teaching experience and teaching qualifications, quality improvement and audit, and leadership/management achievements. Commitment to specialty also sits within the self-assessment and, according to PHST guidance, is the one domain where a minimum threshold applies at shortlisting. Score poorly here and a strong total elsewhere may not save you. Evidence ranges from MRCP(UK) onwards: think postgraduate certificates, abstract acceptance emails, full publication citations with DOI/PubMed IDs, formal teaching feedback forms, and supervisor sign-off for QI projects.

Where candidates lose easy points

• Teaching qualifications. You don’t need a PGCert to score. A short accredited “teach the teacher” course can lift you off the bottom band. Many applicants leave this point on the table.
• Commitment to allergy. Generic medical experience doesn’t cut it. Allergy-specific tasters, BSACI courses, allergy audits and clinic attachments are what move you up.
• Publications and posters. Claim only what you can verify with a citation, DOI or programme page. Verifiers cross-check ruthlessly.
• Late uploads. Evidence arriving after the upload window simply isn’t scored. No exceptions.

Build evidence before applications open

If you’re 6–12 months out, prioritise: an allergy taster or clinic week, a completed audit cycle with allergy relevance, a teaching series with structured feedback, and a presentation (regional counts) you can cite. If you came in via paediatrics with MRCPCH rather than MRCP(UK), make sure your evidence demonstrates adult/paediatric breadth. Your parent specialty shapes how assessors read your portfolio.

Upload everything as PDFs, named clearly, well before the deadline. When you’re moving on to interview prep, the Allergy ST3 Interview Question Bank walks through how the same portfolio evidence gets probed at interview.

The Allergy ST3 Interview: A Brief Overview

If you’re shortlisted, the Allergy ST3 interview is run nationally through the PHST recruitment process as an online, multi-station panel, typically held jointly with Immunology ST3 given how closely the two specialties sit together. Each station runs for around 20 minutes, with two scoring interviewers per station, and the full interview takes roughly 45–50 minutes including transitions between stations.

That’s the high-level shape. The station-by-station breakdown, the domains assessed, scoring approach and worked example answers all live on our dedicated interview resource.

Preparing for the panel? The Allergy ST3 Interview Question Bank walks through each station with scenario questions and model answers written by recent high-scoring trainees, plus a structured plan to work through before your interview date.

Allergy ST3 Offers, Preferencing and What Happens Next

Allergy and Clinical Immunology (ACI) is one of the smallest physician higher specialties, historically just a handful of national posts each year, so the offers stage moves quickly and geographical choice can be tight. Here’s how the process generally runs from interview to start date:

1. Interview and ranking. PHST Recruitment scores your interview, combines it with your self-assessment where applicable, and produces a national rank list across all Allergy ST3 candidates (both MRCP and MRCPCH routes feed into the same list).
2. Initial offer on Oriel. If you’re appointable and within the number of available posts, you’ll receive an offer through Oriel tied to one of your ranked location preferences. Make sure you preference every location you’d genuinely accept. With only a few posts nationally, missing a preference can mean missing out entirely.
3. Hold-down period. You’ll have a fixed window (typically around 48 hours) to accept, hold, decline or accept-with-upgrades. “Hold” lets you wait briefly while considering other offers; missing the deadline withdraws you automatically.
4. Upgrades. If you opt in, NHS England will automatically upgrade your post to a higher-ranked preference if one becomes available as others decline. No contact is made first; the upgrade just lands. The upgrade deadline is set out in the PHST HST timeline (for the 2026 HST round, this is indicatively 4pm on Thursday 23 April 2026, but the precise Allergy ST3 upgrade end date should be confirmed against the Oriel vacancy listing when published).
5. Reserve list and start date. If posts remain unfilled, an appointable reserve list may be used without re-advertising. Successful candidates typically start the following August. Always confirm exact dates against the current PHST applicant handbook.

Frequently Asked Questions About Allergy ST3 Application

How competitive is Allergy ST3 in the UK?

Allergy ST3 is one of the smallest higher specialty training programmes in the UK, which makes it consistently competitive. NHS England figures show 29 applications for 3 posts in 2025 (a ratio of 9.67:1) and 30 applications for 3 posts in 2024 (10.00:1). Demand has risen since 2021, when the ratio was 5.25:1, while post numbers have stayed in low single digits.

Who is eligible to apply for Allergy ST3?

You’ll need MBBS or equivalent, GMC registration with a licence to practise, and the right core training behind you. Physician-route applicants need MRCP(UK) Part 1 at application and the full MRCP(UK) diploma by the offer date, plus completion of Internal Medicine Training (IMT) or 36 months of equivalent experience. Paediatric-route applicants need full MRCPCH by the offer date. Alternative routes via the GIM specialist register or Irish BST plus MRCPI are also accepted.

How does the Allergy ST3 application process work?

Recruitment is fully centralised. You apply through the national Oriel portal, with the process coordinated by the JRCPTB’s Physician Higher Specialty Training (PHST) office on behalf of NHS England and the devolved nations. A single person specification covers England, Scotland, Wales and Northern Ireland, and allergy and immunology applicants attend a joint interview panel rather than applying hospital by hospital.

What scores well on the Allergy ST3 self-assessment?

The PHST self-assessment uses domains scored 1–5, giving a raw application score on the published scale. Higher-tier points typically go to candidates with completed postgraduate degrees (MD, PhD), peer-reviewed allergy or immunology publications, national-level presentations, completed quality improvement work with measurable outcomes, formal teaching qualifications, and leadership roles. Every claimed point must be backed by verifiable evidence at interview.

Do I need a teaching qualification to score points?

A formal qualification isn’t essential, but it helps. The person specification treats evidence of training in teaching as essential, and a short accredited “teach the teacher” course meets that bar. For the top tier of teaching-domain points, a higher qualification such as a PGCert, PGDip or Masters in Medical Education tends to score best in equivalent physician HST matrices.

When are Allergy ST3 interviews and offers in 2026?

For the 2026 cycle, NHS England has scheduled Allergy ST3 interviews for 12 February 2026, with allergy and immunology assessed via a single joint panel. Round 1 first offers for posts starting August 2026 are expected by 31 March 2026, with the indicative upgrade deadline shortly after (around 4pm on Thursday 23 April 2026 per the PHST HST timeline).

How does the offer upgrade system work?

If you accept an offer and opt into upgrades on Oriel, you’ll automatically be moved to a higher-preferenced post if one becomes available as other candidates decline. NHS England confirms no contact is made before the upgrade is applied. After the published upgrade deadline, no further movement between posts happens, so your ranking order on the application really matters.

Can I reapply if I’m not successful first time?

Yes. Allergy ST3 has no formal cap on reapplications, and many successful candidates apply more than once. Use the gap year to publish allergy-relevant work, complete a QIP with measurable outcomes, take on a leadership role, or finish a teaching qualification. Each of these directly lifts self-assessment scores in domains where small gains decide outcomes in a 9–10:1 field.

Allergy ST3 Useful Resources

We’ve pulled together the key links you’ll want to bookmark for your Allergy ST3 application. Treat the official sources as your single source of truth and use everything else as supporting reading.

Official recruitment and curriculum documents

• NHS England Allergy ST3 2026 Person Specification: the definitive eligibility document.
• PHST Recruitment Allergy specialty page: process timelines, contacts and specialty-specific guidance.
• PHST application scoring guidance: how the self-assessment is verified and scored.
• GMC-approved 2021 ACI curriculum and the Federation Rough Guide to the 2021 curricula.

Professional bodies and education

• BSACI training for trainees: the four annual workshops plus PGCert/PGDip/MSc signposting.
• BSACI ACI vs ACLI pathways explainer.
• RSM Clinical Immunology & Allergy Section: open to trainees and a useful network in such a small specialty.

Medibuddy guides

• Allergy ST3 Interview Question Bank: scenario questions and model answers for the interview itself.
• MRCP guidance and the Medibuddy blog for cross-specialty portfolio and application tips.

Allergy ST3 is a small, competitive round, but the good news is that the path is well-defined: meet the person specification, build evidence against the self-assessment domains, and get your portfolio in order well before applications open. If you’ve worked through the eligibility, MRCP requirements and scoring detail above, you’re already ahead of most applicants.

When you’re ready to turn that foundation into interview performance, the Allergy ST3 Interview Question Bank has scenario questions with model answers, written by trainees who’ve scored well at National Selection. Good luck. You’ve got this.