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UNIVERSITY OF ROCHESTER ALLERGY/IMMUNOLOGY & RHEUMATOLOGY DIVISIONCURRICULUM IN ALLERGY AND CLINICAL IMMUNOLOGY

TRAINING PROGRAM MISSION STATEMENT

The mission of the University of Rochester Allergy/Clinical Immunology fellowship program is toprepare specialists to provide expert medical care for patients with allergic and immunologicdisorders, and to serve as consultants, educators, and physician scientists in allergic orhypersensitivity disorders, autoimmunity, immunodeficiency, and other immune-mediateddisorders

OVERALL GOALS AND OBJECTIVES

A !roviding state-of-the-art clinical training in allergy and immunology "mphasis will #e placedon atopic disorders, such as asthma, rhinitis, sinusitis, drug allergy, urticaria and dermatitis, #utthis will #e #alanced with experiences in immune deficiency and autoimmune disease

$ %eveloping a solid foundation in #asic immunology to understand and manage clinicaldisorders This is intended to provide the #ase for careers in academic medicine and clinicalpractice

The goal for the fellows in Allergy-Immunology residency program is to #ecome a competent,certifia#le practitioner in the su#specialty of allergy immunology as measured #y competency in &areas outlined #y the AC'("

) !atient care that is compassionate, appropriate, and effective for the treatment of healthpro#lems and the promotion of health

*istory ta+ing and physical examination s+ills

(edical record +eeping s+ills

!ro#lem solving a#ility

%ifferential diagnosis

Treatment plan

Clinical udgment

!atient communication s+ills, patient education

Competent performance of procedures

*umanistic ualities

. (edical +nowledge a#out esta#lished and evolving #iomedical, clinical, and cognate eg,epidemiological and social-#ehavioral0 sciences and the application of this +nowledge to patientcare

$asic science +nowledge

Clinical +nowledge

1nowledge and clinical application of current literature

2 !ractice-#ased learning and improvement that involves investigation and evaluation of theirown patient care, appraisal and assimilation of scientific evidence, and improvements in patientcare

Analysis and modification of clinical practice in systematic manner

Use of information technology and resources to improve patient care

%emonstration of self directed learning

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3 Interpersonal and communication s+ills that result in effective information exchange andcolla#oration with patients, their families, and other health professionals

Communication that is effective with patients and family

4unction as a team mem#er/leader commensurate with residency year0

5uality of oral presentations

6 !rofessionalism, as manifested through a commitment to carrying out professional

responsi#ilities, adherence to ethical principles, and sensitivity to a diverse patient population 7eadership

"thical conduct

%emonstration of respect, compassion and integrity towards patients and family

%emonstration of on-going professional development

8ensitivity to culture, age, gender and disa#ility issues

& 8ystems-#ased practice, as manifested #y actions that demonstrate an awareness of andresponsiveness to the larger context and system of health care and the a#ility to effectively callon system resources to provide care that is of optimal value

%emonstration of a#ility to utili9e availa#le resources to provide uality medical care

!ractice of cost-effective high uality medical care

%emonstration of understanding of role as allergist in the larger context of the health caresystem

GOALS AND OBJECTIVES FOR EACH YEAR OF TRAINING

) !atient Care 8+illsa Caring and respectful #ehavior

!rovide care that is sensitive to each patient:s age, gender, culture, and

socioeconomic circumstance# Interviewing

;#tain complete allergy < immunology focused history

;#tain complete environmental history

;#tain complete occupational history when indicatedc Informed decision-ma+ing

8ynthesi9e clinical history, physical examination findings and la#oratory results to

arrive at a correct diagnosiso 1styear I!ter"e#$ate #$a%!st$' s($))s

o *!#year + S($)) )e,e) - .ra't$'$!% AI s.e'$a)$st

d %evelop and carry out patient management plans

!rovide written action plans for patients with asthma

!rovide written action plans for patients with atopic dermatitis

e Counsel and educate patients and families

!rovide allergic/immunologic disease specific education on pathophysiology,

medication effects, adverse effects

Allergen avoidance

Inhaler techniue

!roper use of self-inecta#le epinephrine

f !erform medical procedures

pric+ and intradermal s+in testing

o 1styear + '".)ete .r-$'$e!'y

o *!#year + '".)ete .r-$'$e!'y

rhinolaryngoscopy

o 1styear I!ter"e#$ate #$a%!st$' s($))s

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o *!#year Pr-$'$e!'y

desensiti9ation for drugs, venoms, inhalants

o 1styear $!ter"e#$ate s($)) )e,e)

o *!#year a)e t -r"0)ate #ese!s$t$at$! s'2e#0)e a!# $#e!t$-y

a..r.r$ate

oral challenges for foods and drugs

o 1styear $!ter"e#$ate s($)) )e,e)o *!#year .r-$'$e!'y -r #r0% '2a))e!%es a!# s($))s

'""e!s0rate 3$t2 .ra't$'$!% A&I s.e'$a)$st $! re%ar#s t -#

pulmonary function testing and methacholine challenge

o 1styear .r-$'$e!'y $! $!ter.ret$!% s$".)e s.$r"etry a!#

!,$'e$!ter"e#$ate s($)) )e,e) at .er-r"a!'e - "et2a'2)$!e'2a))e!%e

o *!#year .r-$'$e!'y $! $!ter.ret$!% s$".)e s.$r"etry4

$!ter"e#$ate s($)) )e,e) at .er-r"a!'e - "et2a'2)$!e'2a))e!%e4 a!# .r-$'$e!t at $!ter.retat$! - "et2a'2)$!e'2a))e!%e

immunotherapy

o 1styear #e"!strates $!ter"e#$ate s($)) )e,e) $! 3r$t$!% IT

.res'r$.t$!o *!#year + '".)ete .r-$'$e!'y $! 3r$t$!% IT .res'r$.t$!

I=I' therapy

o 1styear + #e"!strates $!ter"e#$ate s($)) )e,e) $! #s$!% IVIG

a!# (!3)e#%e - a#,erse e--e'tso *!#year #e"!strates s($)) )e,e) '""e!s0rate 3$t2 t2e

.ra't$'$!% a))er%$st $! #s$!% IVIG a!# (!3)e#%e - a#,ersee--e'ts

Immunomodulatory therapy

o 1styear + #e"!strates $!ter"e#$ate s($)) )e,e) $! #s$!%4

.te!t$a) $!#$'at$!s4 a!# a#,erse e--e'ts - $""0!"#0)atrya%e!ts

o

*!#

year + #e"!strates $!ter"e#$ate.r-$'$e!t s($)) )e,e) $!#s$!%4 .te!t$a) $!#$'at$!s4 a!# a#,erse e--e'ts -$""0!"#0)atry a%e!ts

!atch testing

o 1styear + #e"!strates $!ter"e#$ate s($)) )e,e) $! .er-r"a!'e

a!# $!ter.retat$! - .at'2 test$!%o *!#year #e"!strates $!ter"e#$ate.r-$'$e!t s($)) )e,e) $!

.er-r"a!'e a!# $!ter.retat$! - .at'2 test$!%g !reventive health services

Recommend appropriate vaccinations

h >or+ within a team

(a+e appropriate referrals for specialists including "?T, %ermatology,

'astroenterology, and !ulmonary

Appropriate use of asthma educators, social wor+ers, pharmacists, and otherhealth professionals

. (edical 1nowledgea Investigatory and analytic thin+ing

Actively participate in the design and/or implementation of a clinical or #asic

research proect

!resent research proect and updates at A < I Research Conference

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o 1styear resear'2 t.$'s $#e!t$-$e# a!# resear'2 .r.sa)

.rese!t at tea'2$!% '!-ere!'eso *!#year

C".)etes resear'2 .r5e't t sat$s-a't$! - resear'2"e!tr

Prese!ts -$!a) resear'2 .r5e't re.rt

Pre.ares "a!0s'r$.t $- a..r.r$ate

# 1nowledge and application of #asic sciences

Understand the pathophysiology of inflammation and its relation to asthma,

allergic rhinitis, chronic sinusitis, atopic dermatitis and other allergic disordersand its application in anti-inflammatory therapies

o 1styear + I!ter"e#$ate (!3)e#%e )e,e)

o *!#year 6!3)e#%e '""e!s0rate r a,e t2e a,era%e

.ra't$'$!% AI s.e'$a)$st

Understand the pathogenesis for primary immunodeficiencies and its

application for therapy using I=I', $( transplant, gene therapy and othertherapies

o 1styear I!ter"e#$ate (!3)e#%e )e,e)

o *!#year 6!3)e#%e '""e!s0rate r a,e t2e a,era%e

.ra't$'$!% AI s.e'$a)$st

2 !ractice-$ased 7earning and Improvementa Analy9e own practice for needed improvement

Use evaluations #y faculty and others to improve practice

# Use of evidence from scientific studies

Incorporate new or novel0 pharmacologic agents and treatment programs

into treatment of allergic/immunologic diseases

Incorporate diagnostic and management decisions #ased on the Allergy $ 8aunders,

!hiladelphia, )@G)&0 Immuno#iologyD The Immune 8ystem in *ealth < %isease , 6th"dition, "d Faneway, Avery

!u#lishing, "ast Rutherford, .)0 FACI, current articlesG0 Arthritis and Rheumatism , current articles@0 Annals of Internal (edicine , current articles)0?ew "ngland Fournal of (edicine , current articles

))0?ature , current articles).08cience , current articles)20Fournal of "xperimental (edicine , current articles)30Fournal of Immunology, current articles)60Cell, current articles)&0Immunity , current articles)0Fournal of Clinical Investigation , current articles

$y signing #elow, I indicate that I have received and read a copy of this curriculum and have had

the opportunity to have my uestions answered

HHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH HHHHHHHHHHHHH8ignature of the 4ellow %ate

Revised &/.)