As a medical student, do you ever wonder what it’s like to specialize in allergy and immunology? Meet Burcin Fraser, MD, an allergist and immunologist and a featured doctor in the AMA’s “Shadow Me” Specialty Series, which offers advice directly from physicians about life in their specialties. Check out her insights to help determine whether a career in allergy and immunology might be a good fit for you.
The AMA Specialty Guide simplifies medical students’ specialty selection process, highlights major specialties, details training information, and provides access to related association information. It is produced by FREIDA™, the AMA Residency & Fellowship Database®.
Learn more with the AMA about the medical specialty of allergy and immunology.
“Shadowing” Dr. Burcin Fraser
Specialty: Allergy and immunology.
Practice setting: Private practice.
Employment type: Private practice employed by Privia Health, which is a member of the AMA Health System Program that provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.
Years in practice: 12.
A typical day and week in my practice: On a typical day, I come into the office, answer patient cases for 30 minutes, try to finish up some charts, then see 15–22 patients per day. I do shut down the office at lunch to catch up, make some calls, do more charting and sometimes attend a staff meeting for education or practice improvement. I end the day with more cases and charting, then catching up on emails.
My office is open four days per week for patient care. I don’t see inpatients, so there are no hospital rounds. Fridays I usually spend in meetings and catching up on revenue cycle, accounting and other small business items, including writing blogs and reading.
The most challenging and rewarding aspects of allergy and immunology: My patients are actually amazing. The most challenging aspect is the insurance companies—they are always changing the rules, paying less and giving the runaround. We make it work, but the system we have to work in is definitely the most difficult aspect of running the business.
Regarding the most rewarding aspect, luckily most of my patients are healthy! And we try to keep them that way. I try to focus on prevention and using disease-modifying approaches to food allergy, allergic rhinitis and asthma to keep patients feeling their best.
The impact burnout has on allergy and immunology: When I worked in a hospital clinic, I felt burnout significantly because the demand for more work with no pay increase or incentives was persistent. In private practice, I set the pace and do things my way, and although the risk is higher and demands are different, I am so much happier. I might even be working more, but I don’t have burnout.
How Privia Health is reducing physician burnout: When I worked in the hospital clinic setting, they tried to use physician wellness—such as yoga and pizza—to help with burnout. This was completely ineffective. In my own practice, I make sure we only work four days per week in patient care—I make sure we shut down the office on all major holidays and give all staff four weeks of vacation. This reduces our revenue in some aspects, but secondary revenue due to happy staff and lower turnover increases, and we are better rested and able to take care of our patients more authentically.
How my lifestyle matches, or differs from, what I had envisioned: Depending on the setting, the work-life balance in allergy and immunology is a major draw. You can work in the hospital if you prefer academics more, or in private practice if you are more independent. You can also work in research, pharmaceuticals and more. The training in immunology allows you to choose from a really large variety of careers.
Allergists used to make a decent salary, but it is definitely lower now with poorer reimbursement rates in private practice. I still love what I do but things definitely seemed more sparkly when I was in medical school.
Once you have a family, there is a lot more push and pull and guilt when you are at work, as well as guilt when you are at home. This is the life of a physician no matter the specialty you are in, but with allergy and immunology there is enough variety of careers that you can make it look however you want.
Skills every physician in training should have for allergy and immunology but won’t be tested for on the board exam: The most important skill is listening to really hear the patient’s priorities, fears and goals of treatment. You need to be the guide, and it is important to ensure that patients feel empowered to manage their care.
One question physicians in training should ask themselves before pursuing allergy and immunology: Your bread and butter is going to be itchy, sneezy, wheezy people. If this fascinates you and you think immunotherapy is really cool because it is disease modifying and it has been around for 100 years, then you will love allergy and immunology.
Books, podcasts or other resources every medical student interested in allergy and immunology should be reading:
- “Conversations from the World of Allergy” podcast gives you updates on the latest and greatest in allergy.
- “EntreMD” podcast helps you learn about running a business, because they don’t teach you that in medical school.
- “Life Kit” podcast—just because.
Additional advice I would give to students who are considering allergy and immunology: You can enter allergy and immunology through pediatrics or internal medicine, and you will end up being certified to see all ages in the end. The field of allergy and immunology right now is really focused on food allergy and drug allergy—the other conditions we see, such as asthma, allergic rhinitis and eczema, are being seen by other specialties creeping in on our business.
For food allergy, having a pediatric background is very helpful because you need to have a solid intuitive understanding of what is normal in children and also of parent-child dynamics. Drug allergy is more of a major issue in adults, so having an internal medicine background is nice to have there but not totally necessary. Internal medicine-pediatrics is also a good background to have, but it will prolong your training.
