Direct Patient Care Activities
During years 1 and 2,
the fellow must spend 50% of time in clinical education as direct patient contact in both the outpatient and inpatient settings, clinical care conferences, and record reviews. Clinical training is divided between adult and pediatric allergy/immunology and related subspecialty fields.
The A&I fellow will be able to:
- Define the disease state, its epidemiology and pathophysiology based on current scientific knowledge.
- Differentiate other diagnoses.
- Identify appropriate elements of the history and physical examination and laboratory testing in patient evaluation.
- Formulate a program of management and revise as patients are seen in continued care.
- Identify complications either caused by the disease state or its management.
- Demonstrate competency in appropriate procedural skills including: immediate and delayed hypersensitivity skin testing, allergen immunotherapy, drug desensitization, pulmonary function testing, and intravenous immunoglobulin therapy. Additional optional procedures include: rhinoscopy, nasal smears, patch testing, oral food challenge and immunomodulatory therapy.
- To learn the scientific basis of the methodology, indications, and interpretation of laboratory tests and imaging procedures used in the diagnosis and follow-up of patients with allergic and immunologic diseases.
- Evaluate the impact on a patient’s quality of life and the psychological effects of chronic illness.
- Develop and refine interpersonal skills with patients, families, and professional colleagues.
- To develop skills in the safe practice of immunotherapy.
- To develop skills in communication with referring physicians in written language; to learn the requirements for charting and peer review.
- To learn presentation and communication skills in an ambulatory care setting.
- To learn the preparation and standardization of allergen extracts.
- To describe the means to measure indoor allergens and the institution of environmental control measures in the home and other sites.
- To understand issues regarding vaccines and vaccine adverse reactions
- Become familiar with basic laboratory and clinical laboratory techniques.