During the clinical year of the Allergy and Immunology Fellowship, the instructional emphasis is on understanding the etiology, physiology, pathogenesis and investigative procedures of three major areas: allergic diseases, immunodeficiency and immunological disorders.
This is a sample schedule:
|Allergy and immunology consultations (pediatric and adult allergy combined)||9 months|
|Allergy and immunology research||9 months|
|Subspecialty rotations||3 months|
Allergy and immunology consultations (pediatric and adult)
During this rotation, time is divided between outpatient consultations and inpatient consultations at the Saint Marys Campus and Methodist Campus of Mayo Clinic Hospital in Rochester, Minnesota. The allergy and immunology outpatient consultations include self-referred patients and those referred from Mayo Clinic and non-Mayo Clinic physicians.
In addition to the referral practice, this rotation includes a large number of local patients. Fellows see patients with common problems as well as highly complex problems in allergy and immunology.
Fellows also work in the clinical laboratory for allergic diseases, where specialized procedures are conducted, such as bronchoprovocation, spirometry, immediate type hypersensitivity testing and immunotherapy. The faculty provides one-on-one supervision and teaching throughout the rotation.
Both the internal medicine and the pediatric fellows participate in both the internal medicine and pediatric allergy clinics. This cross-training provides clinical background to enable the graduating fellow to sit for the American Board of Allergy and Immunology examination.
During this fellowship, trainees have the opportunity to engage in nine uninterrupted months of research. Most fellows conduct a laboratory-based project.
Before starting a research assignment, fellows interview investigators from several of Mayo Clinic's allergy and immunology laboratories to evaluate any opportunities for assisting them with their research projects. Many such projects are multidisciplinary, involving collaboration with clinical and basic science research colleagues in thoracic diseases, dermatology, pathology, general medicine and pediatrics. Most fellows complete two or more research projects during the training program, including both clinical and bench research.
Fellows are expected to present their research at national or regional meetings and to publish their results in peer-reviewed journals. Elective time may be used to extend a research experience, if desired.
Fellows who are planning a career in clinical medicine usually choose clinical or applied research to supplement their curriculum. The Mayo Clinic Allergic Diseases Research Laboratory is specifically designed for conducting bench research with clinical applications in the field of allergy medicine. The staff in the Allergic Diseases Research Laboratory conducts studies involving human subjects.
Trainees have three months of subspecialty rotation time during the fellowship, which allows the curriculum to be tailored to their specific career goals. Each assignment may last from two to eight weeks, and each is arranged individually.
Popular rotations include:
- Laboratory medicine
- Pulmonary Function Laboratory
- Thoracic diseases
- Primary immunodeficiency
- HIV disease
Fellows can use the three-month elective rotation to conduct laboratory-based or clinical research. To supplement the cross-training experience, trainees can take electives in allergy and immunology. Many fellows arrange additional subspecialty rotations, such as rheumatology or clinical immunology.
The fellowship offers:
- A weekly basic science and clinical correlations conference
- A weekly case conference in allergy and clinical immunology
- A weekly journal club
- General department didactic sessions
- A formal course in immunology given by Mayo Clinic College of Medicine and Science
- Graduate level courses in statistics
- Computer skills courses
- A national allergy conference
Mayo provides these and other didactic training opportunities to complement the clinical and research activities. For example, a Monday conference is designed to help trainees learn about basic science fundamentals and the wide clinical spectrum of allergy and immunology medicine.
While many conferences are led by faculty and fellows in the division, invited speakers from Mayo's basic science departments and clinical subspecialties (such as dermatology, otorhinolaryngology) also participate.
Clinical experiences and conferences require that fellows possess detailed knowledge of the immune system and the principles involved in assessing the humoral and cellular competence of patients with immunological and hypersensitivity diseases. Trainees should also understand the immunological aspects of other diseases, such as infectious and parasitic diseases, neoplasia and connective tissue diseases. Fellows need to become familiar with:
- Diagnosis and management of a wide variety of allergic and immunological diseases
- Principles and practice of allergy testing
- Pulmonary function and bronchoprovocation testing
- The preparation and standardization of allergenic extracts
- Immunotherapy for allergic diseases
The fellowship does not include in-hospital call. Fellows are on call from home once every four weeks.
Opportunities are available for teaching rotating residents and medical students.
To ensure that trainees gain proficiency and develop the corresponding technical skills, individual performance is monitored throughout the Allergy and Immunology Fellowship. Fellows are formally evaluated by supervising faculty members following the completion of each clinical rotation. These evaluations are reviewed at quarterly meetings with the program director. In addition, fellows regularly evaluate the faculty to ensure their educational goals are being met.