The United States is confronting a significant shortage of practicing allergists, jeopardizing timely and adequate care for millions of patients. This shortage is exacerbated by the increasing prevalence of allergic diseases and limited access to specialized treatment, particularly in rural and underserved areas.
Recent data indicates that nearly one-third of U.S. adults and over one-quarter of children reported having a seasonal allergy, eczema, or food allergy in 2021.1 This trend underscores the escalating need for specialized care. As of 2021, there were approximately 6,309 board-certified allergists in the U.S. (only 4,623 participating in maintenance of certification)2, with notable disparities in distribution across states. Confounding these disparities, only 35 states have an accredited Allergy/Immunology fellowship program, leaving 15 states without a training pipeline3, further exacerbating access issues. Nationwide, there are only 102 training programs5, limiting the number of new specialists entering the field each year. Additionally, the allergist workforce is aging, with a significant proportion nearing retirement, which could further strain the availability of care. Moreover, Medicare funding for training fellows has remained stagnant for decades, restricting the ability to expand training opportunities despite increasing demand. In June 2021, a GAO report found that 70% of U.S. teaching hospitals train more residents than Medicare reimburses them for and that most of these hospitals do this at their own expense.4
In the 2024 National Resident Matching Program (NRMP) cycle, despite a high fill rate, 81 highly qualified applicants for allergy and immunology fellowship applicants went unmatched5, highlighting both the competitiveness of the field and the need for additional training positions to meet the rising patient demand.
Compounding these workforce challenges, the shortage of trained allergists has led to an increasing number of physicians from other specialties managing allergic and immunologic conditions. While these providers help address patient demand, they often do so without the same depth of specialized training, which can result in less optimal care for patients with complex conditions. Ensuring that individuals with allergic and immunologic diseases receive expert care from board-certified allergists is essential to improving patient outcomes, reducing unnecessary treatments, and advancing evidence-based management strategies.
Furthermore, the pharmaceutical industry is experiencing rapid growth in the development of biologics and novel respiratory medications, increasing the demand for allergists and immunologists who are uniquely trained to oversee, implement, and optimize these advanced therapies. The expanding landscape of targeted therapies underscores the critical role of specialists in guiding treatment strategies and ensuring appropriate patient selection for these innovative drugs.
By providing financial support to accredited programs, we can expand training opportunities, increase the number of practicing allergists, and strengthen the specialty’s future. This initiative is crucial for addressing workforce shortages, ensuring equitable access to care, and meeting the evolving needs of patients nationwide.
References
1. Ng AE, Boersma P. Diagnosed allergic conditions in adults: United States, 2021. NCHS Data Brief. 2023;(460). National Center for Health Statistics. doi:10.15620/cdc:122809
2. American Board of Allergy and Immunology. Diplomate Statistics. Published February 18, 2021. Accessed 2/5/25 https://www.abai.org/statistics_diplomates.asp
3. American Academy of Allergy, Asthma & Immunology. Allergy/Immunology Fellowship Training Programs. Accessed 2/5/25. https://www.aaaai.org/professional-education/program-directors/allergy-immunology-fellowship-training-programs
4. U.S. Government Accountability Office. Physician Workforce: Caps on Medicare-Funded Graduate Medical Education at Teaching Hospitals. GAO Publication No. 21-391. Published 2021. U.S. Government Printing Office.
5. National Resident Matching Program. 2025 Specialties Matching Service (SMS) Results and Data Report. Published 2025. Accessed 2/20/25. https://www.nrmp.org/match-data/2025/02/results-and-data-specialties-matching-service-2025-appointment-year
