Thirteen years of training for one of the calmest schedules in medicine.
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Pay, the path, pros and cons and the facts on one printable page. Counsellors: send it to a student from your own email in one click.
Programs in the fields this career usually comes through. Each has its own page: what it takes to get in, the courses you need and what it costs.
The median pay is about $265,930 a year. Across everyone in the job it runs from about $69,170 at the lower end to about $452,360 at the upper end. The source is listed under Sources at the end of this page.
13 to 14 years after high school, on the usual route.
$190,000 to $340,000 all in for tuition, fees, exams and kit. Living costs are not counted.
Yes. It is a regulated job, so you need a license or registration before you can work.
Moderate demand nationally, from government outlook data. Demand varies by region, so check your area.
Or read the whole thing here
What you earn and what it costs to get there.
Median
$265,930
Bottom tenth
$69,170
Top tenth
$452,360
The federal wage survey has no separate line for allergists and immunologists. These are the 2025 figures for the group they are counted in, physicians, all other: a median of $265,930 a year, with the bottom tenth earning $69,170 or less and the top tenth $452,360 or more. The group mixes many specialties, so treat it as a rough guide for this one.
$78,949 a year
First-year resident pay at Temple University Hospital in Philadelphia, 2026 to 2027
It rises each year, to $88,367 in the fourth. Each hospital sets its own scale. You are paid through 3 years of residency and 2 of fellowship, but your medical school loans usually grow at the same time. Nationally, the AAMC (Association of American Medical Colleges) survey of 345 teaching hospitals puts the average first-year stipend at $68,166 as of July 1, 2025, and about $81,807 in the fifth year. Read from the AAMC's data, downloaded in a browser with Claude in Chrome on 6 November 2026, because aamc.org refuses our checker.
$454,550 a year
The median for the wider physicians, all other group in North Dakota, the highest of any state
Montana ($438,850) and Maine ($419,410) come next. The group mixes many specialties, and partners who own a private allergy practice are not counted at all.
Roughly, all in
$190,000 to $340,000
Tuition, fees, exams and kit. Not rent, food or travel
The low end is the cheap undergraduate route, community college credits then an in-state public university, followed by an in-state public medical school. The high end is a private medical school at around $65,000 a year in tuition. Both figures include the MCAT (Medical College Admission Test), roughly $3,000 to apply and interview, plus the USMLE (United States Medical Licensing Examination) steps at about $700 each. The residency and allergy fellowship that follow are paid jobs rather than tuition, so those years cost time, not money.
Most graduates borrow, and the debt is large. If you work for a nonprofit hospital, Public Service Loan Forgiveness (PSLF) can cancel the remainder after 10 years of qualifying payments.
Malpractice insurance paid
Employers almost always cover it.
Signing bonuses
Common in underserved areas, sometimes with loan repayment attached.
Predictable hours
Clinic-based, largely scheduled, with very little overnight call compared with most specialties.
Retirement and health coverage
Standard hospital or group practice benefits, usually generous.
The exact path from high school to qualified.
The longest route on this site. Thirteen years after high school, minimum.
High school
Grades 11 and 12
Top grades in biology, chemistry and math. You need a strong grade point average to be competitive for medical school later.
Bachelor's degree
4 years
Any major, but you must finish the pre-medical science courses. Keep your grades high and take the Medical College Admission Test (MCAT).
Medical school
4 years
Two years of classroom science, two years of clinical rotations. You graduate as a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO).
Residency
3 years
Internal medicine or pediatrics. This is where you learn to be a doctor rather than a student. Paid, supervised, and long hours.
Allergy and immunology fellowship
2 years
A further subspecialty training program, then the certifying exam from the American Board of Allergy and Immunology.
Biology
The immune system is the whole specialty.
Chemistry
Required for every pre-medical track in the country.
Physics and calculus
Both appear on the Medical College Admission Test (MCAT).
Statistics
Reading research properly is a daily part of medicine.
Every state licenses physicians through its own medical board, and you move your license when you move states. The national part is the exam sequence: the United States Medical Licensing Examination (USMLE) for medical doctors, or its osteopathic equivalent. Board certification in allergy and immunology comes from the American Board of Allergy and Immunology, which is run jointly by the internal medicine and pediatrics boards. Certification is technically voluntary but employers and insurers expect it.
There are medical schools in most states, public and private.
Public medical schools
Much cheaper if you are a resident of that state. Many strongly prefer in-state applicants.
Private medical schools
No residency preference, but tuition is far higher.
Osteopathic schools
Award a Doctor of Osteopathic Medicine (DO) degree and train alongside medical doctors in the same residencies.
Fellowship programs
Allergy and immunology fellowships are small, with few spots in each program.
Things you don't need, but that help.
Food allergy and oral immunotherapy
Slowly feeding patients tiny, increasing doses of the food they react to. One of the fastest-changing areas in the field.
Primary immunodeficiency
Patients born with immune systems that do not work properly. Often lifelong relationships.
Severe asthma
Managing the patients other doctors could not control, usually with newer biologic drugs.
Drug allergy evaluation
Testing whether a recorded penicillin allergy is real. Most are not, and clearing them changes patient care.
Research experience
Immunology research helps a lot when you apply for a fellowship later.
Clinical volunteering
Consistency over years beats a single impressive summer.
Spanish or another language
Useful everywhere in American clinical practice.
A rural or underserved background
Many state medical schools weigh this in admissions.
Academic allergists work at university hospitals, see complicated cases, teach fellows and run research. Private practice allergists run a clinic, do skin testing and allergy shots, and as partners they share the profit and the risk. A middle option is employment by a large hospital system, which hands the business headaches to someone else.
Day to day, pros and cons, where you'd work.
Clinic from about 8am. A morning of appointments: a child with new asthma, an adult whose hives will not stop, a family deciding whether to start food immunotherapy. Skin testing happens in the room, so you get answers the same visit. Afternoon: more clinic, a stack of results to interpret, prior authorization forms for expensive biologic drugs, and notes. You go home. Emergencies in this field are rare.
The good
The hard parts
Things people don't tell you.
About 10% of people in the US report a penicillin allergy, but the Centers for Disease Control and Prevention says fewer than 1% are truly allergic. Clearing a false label lets doctors use cheaper, safer antibiotics.
In 2021, 5.8% of American children had a diagnosed food allergy, 10.8% had eczema and 18.9% had a seasonal allergy, according to a national health survey. All three are allergists' work.
The American Academy of Allergy, Asthma and Immunology has more than 7,000 members. Compare that with hundreds of thousands of American physicians overall. Nearly everyone in the field ends up knowing everyone else.
Immunotherapy retrains the immune system by injecting tiny amounts of the thing you react to, increasing slowly. A full course usually runs three to five years, so patients become very familiar faces.
Every list is built from the same numbers shown above, so you can see where this career sits next to the others.
Doctors first, then the rest of the field. See every career in health.
Last checked November 2026. Pay figures are typical full-time annual amounts in United States dollars, based on Bureau of Labor Statistics wage data and published pay scales. They vary by state, employer and experience. Tuition is for in-state students at public schools unless the card says otherwise. How every figure on this site is sourced and checked.
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