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A & I Fellowship - Program Competencies

Go to: General Competencies | Allergy and Immunology-specific Competencies | Personal and Professional Competencies

General Competencies

Fellows must demonstrate the following general competencies to begin the independent practice of this specialty:

    Patient Care Skills

  1. Caring and respectful behavior
    1. Provide care that is sensitive to each patient's age, gender, culture, and socioeconomic circumstance
  2. Interviewing
    1. Obtain complete allergy & immunology focused history
    2. Obtain complete environmental history
    3. Obtain complete occupational history when indicated
  3. Informed decision-making
    1. Synthesize clinical history, physical examination findings and laboratory results to arrive at a correct diagnosis
  4. Develop and carry out patient management plans
    1. Provide written action plans for patients with asthma or their families
  5. Counsel and educate patients and families
    1. Provide allergic/immunologic disease specific education on pathophysiology, medication effects, adverse effects
    2. Allergen avoidance
    3. Inhaler technique
    4. Proper use of self-injectable epinephrine
  6. Perform medical procedures
    1. prick and intradermal skin testing
    2. rhinolaryngoscopy
    3. desensitization for drugs, venoms, inhalants
    4. oral challenges for foods and drugs
    5. pulmonary function testing and methacholine challenge
    6. immunotherapy
    7. IVIG therapy
    8. Immunomodulatory therapy
    9. Patch testing
  7. Preventive health services
    1. Recommend appropriate vaccinations
  8. Work within a team
    1. Make appropriate referrals for specialists including ENT and Pulmonary
    2. Appropriate use of asthma educators, social workers, pharmacists, and other health professionals

    Medical Knowledge

  9. Investigatory and analytic thinking
    1. Actively participate in the design and/or implementation of a clinical or basic research project
    2. Present research project and updates at A/I Research Conferences and National Meetings
    3. Present at teaching conferences
  10. Knowledge and application of basic sciences
    1. Understand the pathophysiology of inflammation and its relation to asthma, allergic rhinitis, chronic sinusitis, atopic dermatitis and other allergic disorders and its application in anti-inflammatory therapies
    2. Understand the pathogenesis for primary immunodeficiencies and its application for therapy using IVIG, BM transplant, gene therapy and other therapies about established and evolving biomedical, clinical, and cognate (epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.

    Practice-based Learning and Improvement

  11. Analyze own practice for needed improvement
    1. Use evaluations by faculty and others to improve practice
  12. Use of evidence from scientific studies
    1. Incorporate new (or novel) pharmacologic agents and treatment programs into treatment of allergic/immunologic diseases
    2. Incorporate diagnostic and management decisions based on the Allergy & Immunology Practice Parameters
  13. Application of research and statistical methods
    1. Develop statistical methods for research project(s) in conjunction with statisticians
    2. Carry out planned research projects with presentation of results and development of manuscript if able
    3. Critically review allergy & immunology literature at journal club
  14. Use of information technology
    1. Use Medline, PubMed, UpToDate or other databases for information to improve patient care, teaching, or research
  15. Facilitate learning of others
    1. Teach medical students and fellows in outpatient clinics and with in-patient consults
    2. Perform teaching conferences at core curriculum conference, teaching rounds, journal club and research conferences

    Interpersonal and Communication Skills

  16. Creation of therapeutic relationship with patients
    1. Ensuring that patients understand their asthma medications and action plan
    2. Ensuring patients understand treatments for other allergic/immunologic diseases including immunotherapy
  17. Listening Skills
    1. Enabling patients to be comfortable asking about their disease or medications


  18. Respect and altruism
    1. Accept responsibility for continuity of patient care
    2. Respect patient's privacy and autonomy
  19. Ethically sound practice 1. Consistently demonstrate high standards of ethical behavior
  20. Sensitivity
    1. Demonstrate respect for the dignity of patients and colleagues as persons
    2. Demonstrate sensitivity to individuals regardless of age, culture, disabilities, ethnicity, gender and sexual orientation

    Systems-based Practice

  21. Knowledge of practice and delivery systems
    1. Participate in quality management projects for Allergy or Immunology Clinics
    2. Possess basic economic and business knowledge to function effectively in academic and private-practice environments
  22. Practice cost-effective care
    1. Demonstrate knowledge of formulary drugs for asthma and allergic diseases
    2. Know the costs for different tier level asthma/allergy medications on formulary
    3. Ask patients how they pay for their medications
  23. Advocate for patients within the health care system
    1. Work to assure access to Allergy and Immunology clinics for patients in need of specialty care
    2. Work to provide other consultative services for allergy/immunology patients with other medical needs

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Allergy & Immunology-Specific Competencies

Fellows must be able to expertly and appropriately demonstrate the following allergy and immunology specific competencies to begin the independent practice of this specialty:

  1. Conduct a comprehensive and detailed medical interview with children and adults who present with suspected allergic and/or immunologic disorders.
  2. Perform a physical examination appropriate to the specialty.
  3. Select, perform, and interpret diagnostic tests or studies.
  4. Assess the risks and benefits of therapies for allergic and immunologic disorders (e.g., drug therapy, allergen immunotherapy, immunomodulatory therapy).
  5. Counsel and educate patients about diagnosis, prognosis, and treatment.
  6. Consult with and educate other physicians and health care providers.
  7. Apply basic and clinical science to the clinical care of patients.
  8. Coordinate the care of patients, including the use of consultations.
  9. Analyze medical and other scientific literature.
  10. Design, conduct, write, and present research in either laboratory-based or clinical investigation in allergy/immunology.
  11. Personal and Professional Competencies

    Fellows should demonstrate the following personal and professional characteristics:

  12. Caring, altruistic, and compassionate behavior.
  13. Honesty, integrity, and professionalism in relating to patients and other healthcare providers.
  14. Acceptance of the need for a lifelong pursuit of excellence, self-directed learning and continuing education.
  15. Ethical management of real and perceived conflicts of interest.

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