Allergy/Immunology Fellowship Program

The first year of fellowship is highly weighted toward clinical training. Fellows will receive an introduction to all practical aspects of allergy/immunology, including: allergy skin testing, immunotherapy, and pulmonary function testing, elective training in relevant aspects of ENT, dermatology, pulmonary disease, and drug allergy.    

Training begins with the Introduction to Clinical Allergy (jumpstart series). 

During the month of July, faculty and senior allergy fellows review key clinical topics with incoming first year fellows including rhinitis, sinusitis, asthma, atopic dermatitis, chronic urticaria, food allergy, drug allergy, immunodeficiency, stinging insect hypersensitivity and anaphylaxis.  

The goal of this course is to provide new first year fellows the broad basic knowledge base necessary to effectively take care of their clinical patients. This broad overview also provides the foundation on which they will build their expert knowledge base over the next two years of clinical and research training.    

Another key course in the program is the basic immunology course, an intensive review is mentored by Dr. Stokes Peebles. Fellows review the Abbas text under Dr. Peebles' direction during each academic year. This affords fellows the opportunity to formally review the core curriculum in immunology twice during their training.   

The clinical experience consists of seeing patients with a variety of IgE and non IgE-mediated disorders ranging from anaphylaxis to urticaria, angioedema, adverse drug reactions, rhinitis, and asthma. Less common disorders such as systemic mastocytosis, eosinophilic diseases, complement deficiencies, immune deficiencies, and vasculitides are also evaluated.

Fellows gain inpatient experience through consultations, which provide a unique opportunity to assess difficult and challenging cases, to maintain clinical skills, and to interact with the hospital staff. 

Fellows assist in evaluation and management of inpatients and outpatients with drug allergies requiring desensitization for therapy of underlying diseases such as infections, cancer, and autoimmune conditions. 

Consult call:   

Fellows are responsible for covering the on-call pager for the adult and pediatric on-call consult service and after-hours answering service. Vanderbilt does not have an Allergy/Immunology inpatient service, we are consultation only. We receive four to five consults per week on average. 

First-year fellows are responsible for 13-14 weeks of weekday call and second year fellows each have four weeks of weekday call each academic year. Weekends are divided evenly among all the fellows for a total of eight to nine weekends each academic year. We see a wide variety of consults from drug desensitization and reactions to anaphylaxis to immunodeficiencies.  

Clinic schedule:   

During fellowship at Vanderbilt, fellows have a roughly 50/50 balance between adult and pediatric clinic time. This allows for a well-rounded and balanced training in all aspects of adult and pediatric allergy and clinical immunology. Clinics are held at the Vanderbilt Asthma, Sinus, and Allergy Clinic  on West End, the 100 Oaks clinic, and at the local Veterans Affairs hospital adjacent to the main Vanderbilt hospital. All fellows have Friday afternoons off from clinic for conferences.   

During the fall of the first year, fellows have eight half-days of clinic and one day for admin/research time. In the spring, there are seven clinic half-days and two half-days for research time. In the second year, fellows have two half-days of clinic in the fall and three half-days in the spring, with one half-day at the Veterans Affairs clinic.  

The remainder of the time in the second year is devoted to research. Fellows can perform rhinoscopy as well as skin prick and patch testing, methacholine challenges, oral food challenges, read sinus CTs, prescribe allergen immunotherapy, omalizumab, mepolizumab, and other biologics, as well as intravenous immunoglobulin therapy, and also perform drug testing and oral challenges in clinic.  

Shot call:   

In addition to consult call, fellows are responsible for covering the shot room and infusion room at the VASAP usually during a time when the fellow is in clinic there. Fellows are the first call for any allergy shot or infusion reaction and with attending physician back-up will instruct the nurses on proper medications to administer. There is an attending backup who is the attending of the day on call in the clinic as well.  

Shot call is divided into morning and afternoon shifts with first year fellows responsible for two shifts per week and second year fellows one shift per week. Fellows are also responsible for covering the message basket which involves patient phone calls, prescription refill requests, etc.

The laboratory research experience is central to the allergy program and is the focus of the second year of training. Most postdoctoral fellows participate in the laboratories focused on processes directly pertinent to allergic diseases. 

Fellows participate in regular research conferences including: 

Division research conference:  

This weekly conference is a showcase for faculty research in allergy, pulmonary, and critical care medicine. The conference features our own faculty research as well as speakers from other divisions and departments within VUMC and from other institutions.  

Fellows research conference:  

This conference is designed for fellows and faculty performing clinical and translational research.  One or two times per month, a journal club, using the McMaster analytical format, is presented by one of our fellows.  

Fellows are expected to regularly attend divisional allergy and immunology conferences.  

Allergic Disease Conference:  This weekly CME conference covers clinical as well as basic science topics. Presentations are given by faculty and fellows on a rotational basis. Periodically, invited national level speakers will also present at this conference.  

Fellows' Conference:  This Friday afternoon meeting rotates among topics including case presentations, journal club, board review/core curriculum and clinical trials conference.  

Division Research Conference:  This weekly conference is a showcase for faculty research in allergy, pulmonary, and critical care medicine. The conference features our own faculty research as well as speakers from other divisions and departments within VUMC and from other institutions.  

Fellows Research Conference:  This conference is designed for fellows and faculty performing clinical and translational research. One or two times per month, a journal club, using the McMaster analytical format, is presented by one of our fellows.   

Didactic Conferences:  Didactic conferences take place every Friday at 1:15 p.m. with a case conference or a current concepts review of a recent journal article followed at 2 p.m. by a didactic lecture on a specified topic.  

Monthly conference schedule:

In addition to the above conferences, fellows are encouraged to attend select divisional pulmonary conferences when possible.  

American Academy of Allergy, Asthma and Immunology annual meeting:  

Considered by many to be the premier international scientific meeting in allergy and immunology, this yearly meeting is held in early spring in a major U.S. city. Participants from across the country and around the world present research abstracts in poster and oral presentation sessions. Also, an extensive offering of basic science and clinical CME sessions is available to participants.  

Vanderbilt Allergy and Immunology fellows are expected to submit a research abstract for presentation at the meeting during the second year of training.  

American College of Allergy, Asthma and Immunology annual meeting:  

This yearly meeting is held in the fall each year in a major U.S. city. The focus of the meeting is primarily clinical. Fellows often find this meeting of great value as they build their knowledge base in clinical allergy and immunology. 

Southeastern Allergy, Asthma and Immunology Society:  

Fellows are invited to submit an abstract and attend this annual fall meeting where they are exposed to national speakers as well as local and regional allergists/immunologists. This meeting serves as an additional opportunity for learning cutting edge knowledge as well as a platform for networking with the regional allergy and immunology community.  

Tennessee State Allergy and Immunology Society Meeting:  

Fellows are invited to submit an abstract and attend this annual, late-summer meeting where they are exposed to national speakers as well as local and regional allergists/immunologists.  

We are pleased to offer residents from internal medicine, pediatrics, and combined internal medicine-pediatrics a two- to four-week outpatient elective in Allergy and Clinical Immunology.  

The elective is based at the Vanderbilt Asthma, Sinus, and Allergy Clinic. As both a general allergy clinic and a tertiary referral center attracting patients from seven states, the Vanderbilt allergy and immunology patient population includes common asthma and allergic rhinitis as well as rare immunodeficiencies. Rotators will therefore see a broad range of allergic and immunologic conditions during the elective. Along the way, they will gain experience with procedures including allergy skin testing, lung function testing, specialized drug allergy evaluations, and patch testing for contact dermatitis. Rotating residents are also invited to join all academic conferences held by the Allergy/Immunology section during their elective.  

This elective experience is open for enrollment to Vanderbilt residents. We also consider applications from residents at outside training institutions on a case-by-case basis.  

Director of Resident Education: Basil Kahwash, MD 

Michael Beasley 

Fellowship Program Coordinator 

michael.t.beasley@vumc.org