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Allergy, Immunology & Rheumatology Fellowship


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Goals of the Fellowship Program

The primary goals are to:

  • Provide state-of-the-art clinical training in allergy and immunology as it pertains to the evaluation and management of associated medical disorders. Emphasis will be placed on atopic disorders, such as asthma, atopic dermatitis, food allergy, eosinophilic esophagitis, rhinitis, and sinusitis. Training in the management of primary immune deficiency and autoimmune disease is included.

  • Develop a solid foundation in the principles of basic immunology fundamental to understanding and managing clinical disorders.

  • Initiate a solid experience in the fundamentals of research, either basic or clinical. This is intended to provide the base for career development in academic medicine and subspecialty clinical practice.

 
 

Overview

Fellows in the University of Colorado Program A in Allergy & Immunology receive most of their experience through 4 different assignments. The fellowship program is primarily based at National Jewish Health (NJH). NJH is a tertiary care medical and research facility that specializes in allergic, immune, and respiratory diseases. For more than 115 years, NJH has been recognized as the leading respiratory hospital in the nation. This reflects our expertise in medical care and research accomplishments in lung, allergic, and immune diseases.
 

Two fellow assignments at NJH are the Pediatric Day Program and Medical Officer of the Day (MOD). The 3rd patient experience is an Adult Allergy Consult Service, primarily based at the University of Colorado Hospital (UCH).  UCH is a full-spectrum academic medical institution, primarily oriented to clinical services for adults.  This assignment provides fellows with consultative experience with adult inpatients, drug allergy, and drug desensitization procedures. Finally, fellows will spend time performing inpatient pediatric consultations, as well as outpatient clinics at Rocky Mountain Hospital for Children (RMHC). RMHC is a full-spectrum, family-focused children’s hospital serving the community of Denver. Under the supervision of NJH allergists and immunologists, the fellows will provide care for patients in this community setting. All assignments are designed to provide pediatric and adult experience in diagnosis and management of allergic and immunologic disorders including the use of pharmacotherapy, allergen immunotherapy, and immune regulation.

Pediatric Day Program: National Jewish Health

Fellows are assigned to this rotation for 4 months of the first year. Pediatric patients, both local and out-of-state, with severe allergic, pulmonary, and immune disorders are admitted to this service for in-depth multi-disciplinary outpatient team evaluations. Fellows are primary providers for these patients, under faculty attending supervision. The disease severity and complexity of the patients admitted to this program are similar to patients seen in an inpatient setting.

 

This rotation provides a primary patient base for the understanding of the diagnosis, treatment, and pathophysiology of, but not limited to:

  • Severe chronic refractory asthma, its detailed differential diagnosis, recognition and evaluation of the iatrogenic aspects of its management, and alternative treatments 

  • Severe allergic disease including chronic rhinosinusitis, nasalpolyposis, food allergy, including the use of double-blind, placebo-controlled food challenges, anaphylaxis, atopic dermatitis, urticaria, allergic bronchopulmonary aspergillosis, eosinophilia, and drug allergy; evere allergic disease including chronic rhinosinusitis, nasalpolyposis, food allergy, including the use of double-blind, placebo-controlled food challenges, anaphylaxis, atopic dermatitis, urticaria, allergic bronchopulmonary aspergillosis, eosinophilia, and drug allerg evere allergic disease including chronic rhinosinusitis, nasalpolyposis, food allergy, including the use of double-blind, placebo-controlled food challenges, anaphylaxis, atopic dermatitis, urticaria, allergic bronchopulmonary aspergillosis, eosinophilia, and drug allergy; evere allergic disease including chronic rhinosinusitis, nasalpolyposis, food allergy, including the use of double-blind, placebo-controlled food challenges, anaphylaxis, atopic dermatitis, urticaria, allergic bronchopulmonary aspergillosis, eosinophilia, and drug allerg  

  • Immunodeficiency diseases and mmunodeficiency diseases and pediatric pulmonary diseases, such as chronic pneumonias and pneumonitis, aspiration, hypersensitivity pneumonitis, bronchiolitis, bronchitis, congenital pulmonary anomalies, obstructive pulmonary disease, interstitial lung disease, bronchopulmonary dysplasia, cystic fibrosis, vocal cord dysfunction, bronchiectasis, and immotile cilia syndrome. This rotation also has a strong focus on understanding and helping to manage the psychosocial aspects of chronic disease together with behavioral therapists that are seen by every patient and their families. The development of specific allergy and immunology specialist clinical skills, such as complex disease management, patient education, home management strategies, and interacting with the referring physicians and tertiary consultants, will be a focus of these months.  Expertise in methods and interpretation of pulmonary function testing, pH and impedance probe studies for gastroesophageal reflux, and various allergen, food and airway provocation challenges will be acquired. The basic application of rhinolaryngoscopy and bronchoscopy will also be addressed during this rotation.

 
 

MOD (Medical Officer of the Day): National Jewish Health

Fellows are assigned to this rotation for 4 months of the first year. Acutely ill pediatric patients with allergic, respiratory, and immune disorders are seen by the fellow in an urgent care setting, under faculty attending supervision. Most of the pediatric patients seen in this rotation have exacerbations of their asthmatic, respiratory, allergic, and/or immune disorder(s) that benefit from specialty care. Some of the patients evaluated in urgent care require hospitalization at NJH, and continue to be followed by the admitting fellow and attending. During these 4 months, the fellow will also continue to care for patients in the Pediatric Day Program, but will not attend the adult allergy continuity clinic.

 

Rocky Mountain Hospital for Children

Fellows are assigned to this rotation for 4 months of the first year. The emphasis during this rotation will be on outpatient and inpatient Allergy & Immunology, within a dedicated children’s hospital. The fellow will participate in pediatric allergy clinics at RMHC and staff inpatient consultations at RMHC with supervision by NJH attending physicians.  During this rotation, fellows will continue to participate in their adult and pediatric continuity clinics and the immunology clinic at NJH. Time will also be reserved during this rotation to begin preparing a research project to be undertaken in the second year.

 
 

Outpatient Clinics

     
  • Pediatric Allergy and Immunology Continuity Clinic: The objective for this rotation is to focus on the outpatient diagnosis and management of asthma and allergic disease similar to the profile described for the Day Hospital rotation. This will be accomplished through a Pediatric allergy continuity clinic, one-half day per week, for the first 2 years of the fellowship, and through one-to-one mentoring with an allergist during this rotation. These clinics will facilitate development of a number of required skills for allergists including the interpretation of epicutaneous skin testing and spirometry.  Patient continuity allows for the development of expertise in the management of chronic disease processes over time, including implementation of step-up and step-down asthma guideline-based care, allergen immunotherapy, and application of evidence-based management of atopic dermatitis, and food allergy.

  • Adult Allergy Continuity Clinic: The major objective of this clinic is to provide experience with the diagnosis and management of adult allergy and asthma.  This experience is obtained one-half day per week for 8 months in the first year and 12 months in the second year, thus providing a thorough cross-training experience in adult allergic and asthmatic diseases.  Fellows will gain expertise in managing conditions more commonly encountered in adult patients, such as aspirin exacerbated respiratory disease fixed airway obstruction, mixed COPD/asthma phenotypes. 

  • Immunodeficiency Clinic: Exposure and familiarization with all aspects of primary and secondary immunodeficiency as well as the use and interpretation of clinical immunologic laboratory testing are the major objectives of this clinic.  During this clinic, Fellows develop expertise in the long-term management of patients with immunodeficiency and immune-mediated diseases.  Fellows also acquire experience with therapeutic modalities, such as administration of intravenous gamma globulin (IVIG) and pulse steroids. Fellows participate in this clinic one-half day per week during both years of their fellowship.

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*Fellows generally attend one national specialty meeting during the first year and the ACAAI Board Review Course, which is offered every other year.

Second-Year Training Assignments

 
  • Research and Scholarly Activity: A high quality research experience takes the major portion of effort in the 2nd year. Fellows routinely present at several national meetings each year
  • Adult Allergy Consult Service: In-patient adult allergy consult experience at UCH, for 1 month in the second year.
  • Pediatric Allergy and Immunology Continuity Clinic, and Adult Allergy Continuity Clinic: Are continued throughout the 2nd year, as previously described in Year 1.
  • Dermatology, Rheumatology, GI, Pulmonology, and ENT Clinics: Familiarization with these related specialty disciplines can be obtained on an elective basis during the second year of fellowship.
 
 

Third-Year Training Assignments

For fellows seeking a career in academic medicine, funding opportunities for continued training are available subject to approval by the faculty.

 

Teaching Conferences

As part of their training, fellows regularly attend the following conferences held at NJH (most conferences run from September to May):

  • Denver Allergy Rounds, a weekly, city-wide conference in allergy and immunology
  • A weekly board review course that is shared with the adult fellows
  • A weekly Pediatric Department Noon Conference consisting of case presentations, formal clinical and research presentations, and a pediatric journal club
  • A weekly Pediatric Allergy and Immunology lecture series focusing on skills needed to conduct and understand clinical research methods, including a biostatistics course
  • A monthly allergy journal club that is shared with the adult faculty and fellows
  • An optional, weekly Adult Allergy Case Conference
  • There is also an introductory “boot camp” lecture series held in July and August to provide a broad overview of basic adult and pediatric allergy and immunology topics

Application Process: Pediatrics Allergy and Immunology Fellowship Program

The ACGME-accredited University of Colorado Denver Program in Allergy & Immunology is based at National Jewish Health.  Applications are accepted through the Electronic Residency Application Service (ERAS).

Application Checklist

  • ERAS application
  • Personal Statement
  • Curriculum Vitae
  • USMLE Part 1, 2, and 3 scores if taken
  • Medical school transcripts
  • Three letters of recommendation
  • Next Positions Available: 2

The timeline for the selection process will be as follows:

  • July 1st: ERAS open to submit applications
  • July 15th: Programs begin to receive applications
  • August 15th: Deadline to apply
  • August 16th - October 20th: Interviews are offered
  • November 5th: Match Day for A-I Fellowships
  • Beginning of July: Fellowship begin

Program Director
Stanley J. Szefler, MD
National Jewish Health
1400 Jackson Street
Denver, CO 80206

Program Coordinator
Nancy Hafer
National Jewish Health
1400 Jackson Street, K-731
Denver, CO 80206
email:hafern@njhealth.org

Phone: (303) 398-1245
Fax: (303) 270-2201 

1st-Year Fellows

Dr. Cullen Dutmer
Dr. Bruce Lanser


2nd-Year Fellows

Dr. Angela Sabry
Dr. Carah Santos

Faculty: Pediatrics Allergy and Immunology Fellowship Program

The ACGME-accredited University of Colorado Denver Program in Allergy and Immunology is based at the National Jewish Health

Training Program Director:

Stanley J. Szefler, MD, is the Head of the Clinical Pharmacology Division at National Jewish Health. He is a renowned authority on the pharmacologic management of pediatric asthma. Dr. Szefler is the current Training Program Director and is responsible for the day-to-day management of the Fellowship program.   He organizes meetings with the Training Program Committee and with the Fellows. 


Chairman of Pediatrics at National Jewish Health:

Erwin Gelfand, MD, is also Head of the Division of Allergy, Immunology and Rheumatology for the Department of Pediatrics at the University of Colorado Denver. He is also the Director of the Immunodeficiency Clinic at National Jewish Health. He is a renowned authority in immunodeficiency, mechanisms or asthma, and other aspects of basic immunology. He is committed to assure residency training in immune deficiency disease.


Head of the Allergy/Immunology Division in the Department of Pediatrics at National Jewish Health:

Donald Leung, MD, PhD, is the Head of the Allergy/Immunology Division in the Department of Pediatrics. Dr. Leung is a renowned authority in mechanisms of allergic disease. He has numerous NIH R01 grants, serves as the Co-Director of the NIH-funded General Clinical Research Center at UCHSC and National Jewish Health, and he is the current Editor-in-Chief of the Journal of Allergy and Clinical Immunology, premier journal in the field. Dr. Leung serves on the Training Program Committee. He organizes Combined Allergy/Immunology Grand Rounds and the Quality Assurance Patient Care Conferences. He also supervised Fellows during their Day Program assignment. He also provides Fellows with lectures, rounds and conference discussions, and provides research mentorship.


Additional faculty in the Pediatrics Allergy and Immunology Fellowship Program:

Dan Atkins, MD, is the Director of Pediatric Clinical Services at National Jewish Health, and the Director of Allergy and Immunology Services at  Children’s Hospital Colorado. He organizes the services where Fellows receive their patient care experiences.  He is a reknowned expert in food allergies.

Allan Bock, MD, is a renowned expert in food allergies, who provides Fellows with lectures, rounds and conference discussions, and also provides research mentorship.

Mark Boguniewicz, MD, is a Pediatric Allergist at National Jewish Health and a renowned expert in Atopic Dermatitis. He provides direct patient care supervision in the Pediatric Allergy and Immunology Continuity Clinic,  Children’s Hospital Colorado Atopic Dermatitis Clinic, and in the Day Program.

Donna Bratton, MD, is an Associate Professor in the Division of Pediatric Allergy and Immunology. She is an authority on inflammatory mechanisms of airways disease. She supervises Fellows in the Pediatric Allergy and Immunology Continuity Clinic, and serves on the Training Program Committee.

Kirsten Carel, MD, is a recent graduate of our training program and a member of the Division of Allergy and Immunology. She conducts outpatient clinics at National Jewish Health and Highlands Ranch Clinic. Fellows can participate in these clinics.

Ronina Covar, MD, is an Assistant Professor in the Division of Pediatric Allergy and Immunology. She has special interests in asthma and steroid response. She supervises Fellows in the Pediatric Allergy and Immunology Day Program.

Pia Hauk, MD, is a graduate of our training program and a member of the Division of Allergy and Immunology. She conducts outpatient clinics at National Jewish Health and supervises immunology consults. Fellows can participate in these clinics.  She conducts research on the early development of asthma.

Andrew H. Liu, MD, is an Associate Professor in the Division of Pediatric Allergy and Immunology.  he has a specific interest in inner city asthma and food allergy.  He supervises Fellows in the Pediatric Allergy and Immunology Continuity Clinic, Day Program, as MOD and serves on the Training Program Committee.

Henry Milgrom, MD, is a senior faculty member in Pediatric Allergy. He provides direct supervision of pediatric patients in the pediatric clinic.

Nathan Rabinovitch, MD, is a pediatric allergist with research interests on the role of environmental exposures in the school-age asthmatic child.

Daniel Searing, MD, is a graduate of our training program and a member of the Division of Allergy and Immunology. He conducts outpatient clinics at National Jewish Health and Highlands Ranch Clinic. Fellows can participate in these clinics.

Joseph Spahn, MD, is an Associate Professor and former Director of the Pediatric Allergy/Immunology Fellowship Program.  He is also a member of the Division of Pediatric Clinical Pharmacology and provides consults in steroid pharmacology. He directly supervises Fellows in specialty outpatient clinics and the Day Treatment Program.


Other Faculty for the Fellowship program

Other faculty members at National Jewish Health, while not necessarily key faculty for the program, provide significant contributions to the education of our Fellows, typically as lecturer, consultants, discussants in conferences and seminars, and research resources. They include the following faculty members:

Rafeul Alam, MD, PhD*
Bruce Bender, PhD
Azzeddine Dakhama, PhD
Stephen Dreskin, MD, PhD
Andrew Fontenot, MD*
Peter M. Henson, PhD
Roger Hollister, MD
Flavia Hoyte, MD*
Hua Huang, MD, PhD*
Rohit Katial, MD*
Mary D. Klinnert, PhD
Christina Leslie, PhD
Joseph Lucas, PhD
Lisa Meltzer, PhD
Harold Nelson, MD*
Tod Olin, MD
Nichole Reisdorph, PhD
David Riches, PhD
James Shira, MD
Richard Weber, MD*
* Faculty in the Department of Medicine University of Colorado Denver Allergy and Immunology - Child