Specialty Content

Immunology specialty

Clinical Immunology covers autoantibodies, complement, immunodeficiency screening, transplant immunology, and allergy.

Where the content lives

• Interview page — /immunology-interviews — Band 2 through Band 8 questions
• Result Interpretation (immunology) — open /result-interpretation and click the Immunology card — autoimmune serology, complement, flow cytometry patterns
• Specialist Portfolio (Immunology) — /portfolio → Specialist Portfolio → Immunology
• Cross-references — flow cytometry overlaps with Haematology; HLA matching overlaps with Transplant

Key competencies covered

• Autoantibody testing — ANA (HEp-2), ENA panel, ANCA, anti-dsDNA, anti-CCP, rheumatoid factor
• Immunofluorescence — IIF pattern interpretation
• Complement — C3, C4, total complement (CH50), complement deficiency screening
• Immunoglobulins — IgG/IgA/IgM, paraprotein detection (electrophoresis + immunofixation, free light chains)
• Allergy testing — specific IgE, total IgE, food/environmental panels
• Cellular immunology — lymphocyte subsets (CD4, CD8, CD19, NK)
• Immunodeficiency screening — primary and secondary
• Transplant immunology — HLA typing, antibody screening (often a separate H&I lab)
• Flow cytometry — gating strategies, panel design

Bands progression

• Band 5 (£32,073-£39,043) — qualified BMS performing routine autoantibody, complement, immunoglobulin assays
• Band 6 (£39,959-£48,117) — specialist interpretation of complex patterns, validation, training; usually requires Specialist Portfolio in Immunology
• Band 7 (£49,387-£56,515) — section lead, clinical interpretation sign-off, advanced flow panels, MDT contribution

Standards alignment

• British Society for Immunology (BSI) — clinical guidance
• Royal College of Pathologists — immunology guidelines
• EFI (European Federation for Immunogenetics) — transplant immunology / H&I
• UK NEQAS Immunology, UK NEQAS for H&I
• ISO 15189:2022 quality framework
• MHRA for clinical immunology devices

Common interview question themes (Band 5-7)

• "Walk me through your ANA-positive workflow — what would you do next?"
• "How do you interpret a high IgG with low IgA — what investigations follow?"
• "What does a 'rim' pattern on IIF suggest, and what confirmatory tests would you do?"
• "How would you set up a flow cytometry panel for primary immunodeficiency?"
• "Describe how you would investigate a discrepant complement result"

A good preparation stack: Result Interpretation → Practice Tests filtered to Immunology + your Band → AI Interview Coach. The flow-cytometry gating component benefits from time on the Virtual Lab if available.