30. Defining the spectrum of clinical immunology

Historically, in the development of the subspecialty of clinical immunology, loosely connected groups of transplanters, endocrinologists, gastroenterologists, and many others have existed, each practicing a special form of immunology pertinent to their area of interest. The diversity of interests and separation of efforts, and the absence of educational initiatives in this field, have conspired to prevent most clinical immunologists from receiving the education required and the recognition appropriate for this subspecialty of medicine. What is proposed here is an attempt to collect the wide spectrum and isolated components of clinical immunology-specific practices into a unifying concept centered around four themes that define the field of clinical immunology better than traditional organ or disease based specialties: (1) immunoregulation, (2) immunotherapy, (3) immunogenetics, and (4) immunodiagnostics. This definition of the themes of clinical immunology provides a cross-disciplinary approach to understanding the present spectrum of interests of clinical immunologists and easily incorporates new interests, such as host defense, as the practice of clinical immunology evolves. In the future, through the use of a thematic approach to the training of clinical immunologists, a new, more organized mechanism may evolve for defining this specialty, educating the members, and providing a common pathway of certification.