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 A/I inpatient service, we are consultation only.  Generally, we get 4-5 consults per week on average.  Weekday call is from 8AM on Mondays until 8AM on Fridays and weekend call is from 8AM on Friday until 8AM on Monday.  Since we are a large program, we are fortunate to have our consult coverage divided up evenly and reasonably.  First year fellows are responsible for 13-14 weeks of weekday call and second year fellows each have 4 weeks of weekday call each academic year.  Weekends are divided evenly amongst all the fellows for a total of 8-9 weekends each academic year (approximately 1:6).  We see a wide variety of consults from drug desensitizations 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 VASAP 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 8 half-days of clinic and 1 day for admin/research time.  In the spring, there are 7 clinic half-days and 2 half-days for research time.  In the second year, fellows have 2 half-days of clinic in the fall and 3 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 have the opportunity to 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 clinic, usually during a time when the fellow is in clinic there.  Fellows are the first call for any allergy shot or infusion reaction and will help 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 AM and PM shifts with first year fellows responsible for 2 shifts per week and second year fellows 1 shift per week.  Fellows are also responsible for covering the message basket which involves patient phone calls, prescription refill requests, etc.

Immunology class:

This intensive review of the Abbas: Cellular and Molecular Immunology textbook takes place once a week, September – May each year and is mentored by Dr. Peebles.  We review the entire textbook in detail each year, so fellows each go through the book twice during their fellowship, and are subsequently well-prepared for the Allergy/Immunology boards.

Conferences:

Didactic conferences take place every Friday at 1:15pm with a case conference or a current concepts review of a recent journal article followed at 2:00pm by a didactic lecture on a specified topic.  Please see the “conferences and meetings” section for additional information.