Pediatrics Allergy & Immunology Fellowship Program
The ACGME-accredited University of Colorado Denver Program A in Allergy & Immunology based at National Jewish Health
Goals of the Fellowship Program
Rotations at NJH, RMHC and UCH
Research and Other Academic Assignments
Current and Former Fellows
Goals of the Fellowship Program:
The primary goals are to:
Provide comprehensive state-of-the-art clinical training in allergy and immunology with emphasis on evaluation and management of atopic disorders, such as asthma, atopic dermatitis, food allergy, eosinophilic esophagitis, rhinitis, and sinusitis as well as management of primary immune deficiencies.
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 basic and clinical research.
Fellows who successful accomplish these goals will be positioned to pursue future careers in academic medicine or subspecialty clinical practice.
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. Fellows will spend half of their 2 year fellowship program in the clinical rotations described. The majority of clinical rotations will occur in Year 1 of the fellowship.
Clinical assignments include the Pediatric Day Program and Medical Officer of the Day (MOD) at NJH, inpatient consultation and pediatric outpatient clinic at Rocky Mountain Hospital for Children (RMHC) and an Adult Allergy Consult service at the University of Colorado Hospital (UCH).
Clinical Rotations at National Jewish Health
Pediatric Day Program
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: 1) severe chronic refractory asthma, its detailed differential diagnosis, recognition and evaluation of the iatrogenic aspects of its management, and alternative treatments; 2) severe allergic disease including chronic rhinosinusitis, nasal polyposis, food allergy, including the use of double-blind, placebo-controlled food challenges, anaphylaxis, atopic dermatitis, urticaria, allergic bronchopulmonary aspergillosis, eosinophilia, and drug allergy; 3) immunodeficiency diseases; and (4) 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)
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 this time, the fellow will also continue to care for patients in the Pediatric Day Program, but will not attend the adult allergy continuity clinic.
Pediatric Allergy and Immunology Continuity Clinic: These clinics focus on the outpatient diagnosis and management of asthma and allergic disease similar to the profile described for the Day Hospital rotation. Each fellow participates in 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 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: This clinic provides experience in diagnosis and management of adult allergy and asthma. Fellows participate in adult clinic one-half day per week (except when MOD) throughout the 2 years, thus providing a thorough cross-training experience in adult allergic 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.
Rocky Mountain Hospital for Children: 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 is also reserved during this rotation for research and academic endeavors.
Adult Allergy Consult Service: 1 -2 months in the second year of fellowship. These consults are upon request, and they therefore account for ~20% of the time spent during the 2-month period. Consults are performed at the University of Colorado Hospital, and staffed by faculty from the adult allergy division.
*Fellows generally attend one national specialty meeting during the first year and all attend the ACAAI Board Review Course, which is offered every other year.
Research and Other Academic 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.
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.
Procedural Electives: Fellows can elect to spend additional time focused on specific procedures including performing and reading PFTs, rhinolaryngoscopy, patch testing, skin biopsies, and lab experiences.
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
3rd Year Training Assignments
For fellows seeking a career in academic medicine, funding opportunities for continued training and research are available, subject to approval by the faculty.
Learn about the application process.