Curriculum

Clinical Training
During the clinical year of the Allergy & Immunology Fellowship, the instructional emphasis is on understanding the etiology, physiology, pathogenesis and investigative procedures of three major areas: allergic diseases, immunodeficiency and immunologic disorders.

Rotation Descriptions

Allergy and Immunology Consultations (Pediatric and Adult)
During this rotation you will divide your time between outpatient consultations and inpatient consultations at Mayo Clinic's two Rochester hospitals. 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. You will see patients with common problems in allergy as well as highly complex problems in allergy and immunology.

You will also work in the Allergic Diseases Clinical Laboratory, where specialized procedures are conducted (e.g., broncho-provocation, spirometry, immediate type hypersensitivity testing and immunotherapy). The faculty provides one-on-one supervision and teaching throughout the rotation.

Both the internal medicine trained fellows and the pediatric trained fellows will 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.

Research
During this fellowship you will have the opportunity for nine uninterrupted months of research. Most fellows conduct a laboratory-based project.

Before starting your research assignment, you will interview investigators from several of Mayo Clinic's allergy and immunology laboratories to evaluate your opportunities for assisting them with their research projects. Many research projects are multidisciplinary, involving collaboration with clinical and basic science research colleagues in thoracic diseases, dermatology, pathology, general medicine and/or pediatrics. Most of our fellows complete two or more research projects during the training program, including both clinical and bench research.

You will be expected to present your research at national or regional meetings and publish your results in peer-reviewed journals. You may use elective time to extend your research experience if you wish.

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.

Subspecialty Rotations
You will have three months of subspeciality rotations time during the fellowship, allowing you to tailor the curriculum to your specific career goals. Each assignment may last from two to eight weeks, and each is arranged individually. Popular rotations include:

• Dermatology
• Laboratory medicine
• Otolaryngology
• Pulmonary Function Laboratory
• Thoracic diseases
• Primary immunodeficiency
• HIV disease
• Transplantation infectious diseases
• Pediatric intensive care

Electives
You can use the three-month elective rotation to conduct laboratory-based or clinical research. You can take electives in allergy and immunology to supplement the cross-training experience. Many fellows arrange additional subspecialty rotations, such as rheumatology or clinical immunology.

Didactic Training
Didactic training includes:

• A weekly basic science/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
• Graduate level courses in statistics
• Computer skills courses
• A national allergy conference

Mayo offers these and other didactic training opportunities to complement your clinical and research activities. For example, a Monday lunch conference is designed to help you learn about basic science fundamentals and the wide clinical spectrum of allergy and immunology medicine.

While many of our conferences are led by faculty and fellows in the division, invited speakers from Mayo's basic science departments and clinical subspecialties (e.g., dermatology, otorhinolaryngology) also participate.

Clinical experiences and conferences require that you have a detailed knowledge of the immune system and the principles involved in assessing the humoral and cellular competence of patients with immunologic and hypersensitivity diseases. You should also understand the immunological aspects of other diseases, such as infectious and parasitic diseases, neoplasia and connective tissue diseases. You need to become familiar with:

• Diagnosis and management of a wide variety of allergic and immunologic diseases
• Principles and practice of allergy testing
• Pulmonary function and bronchoprovocation testing
• The preparation and standardization of allergenic extracts
• Immunotherapy for allergic diseases

During the clinical year, the instructional emphasis is on understanding the etiology, physiology, pathogenesis and investigative procedures of three major areas: allergic diseases, immunodeficiency and immunologic disorders.

Call Frequency
The fellowship does not include in hospital call. Fellows are on call from home once every four weeks.

Teaching Opportunities
Opportunities are available for teaching rotating residents and medical students.

Evaluation
Evaluations are performed on a quarterly basis by the program director.