Allergy and Immunology Fellowship

Clinical Program

This combined internal medicine-pediatrics training program in this specialty has been in existence at Virginia Commonwealth University (formerly Medical College of Virginia) for several decades.  It was ACGME accredited prior to March of 1983, and has remained since that time.  The program accepts up to 2 residents into the program per year.  Those trained from 1983 onward have each passed their ABIM certification exam.

Mission
Our mission is to prepare specialists who are well rounded in Allergy & Immunology. These specialists will not only provide expert medical care for patients with allergic and Immunologic disorders but also serve as consultants, educators and being critical in interpreting medical research in asthma, allergic and immunologic diseases.

Duration
The ACGME accredited Allergy/Immunology training period typically is two years in duration with the exception of the ABIM or Pediatric research tracks, which would extend their time in the program to fulfill the research requirements.  Also, some trainees have been granted, at the request, an additional year of research training beyond the two years of training that enabled them to sit for the certification exam.

Prerequisite
Prerequisite training consists of completion of a residency in Internal Medicine or Pediatrics that would qualify them to sit for the certification exam of the American Board of Internal Medicine or the American Board of Pediatrics.  Selection criteria consists of medical school performance, residency performance, USMLE scores, personal interview, ECFMG certification (if applicable), valid visa/green card/permanent residency card (if applicable) and other accomplishments (e.g., research publications) as considered appropriate.

Goals & Objectives
The goal of our Allergy/Immunology Program is to provide trainees with a comprehensive experience in allergy/immunology, both in the care of adult and pediatric patients with allegic and immunologic diseases and in scholarly activities related to this field that are tailored to the interests of each trainee.  Clinical training consists of practical clinical rotations, didactic instruction, conference preparation and presentation and both self-directed an assigned reading.  Clinical rotations are designed to provide our residents with the knowledge base and technical proficiency that they will need to become outstanding practitioners of allergy and immunology and in some cases to pursue academic careers as clinician-educators or research investigators.

Program Certifications
The VCU allergy/immunology program is fully accredited by the ACGME.

Training

Overall training is roughly divided into 50 percent direct patient care, 25 percent scholarly activity and research and 25 percent in educational activities. All fellows are adequately trained in system-based practices, professionalism, patient care, advancement of their medical knowledge, interpersonal and communication skills and practice-based learning.

Clinical Training
Clinical training in both pediatric and adult allergy emphasizes both inpatient and outpatient management of allergic and immunologic disease. The majority of clinical practice is in the outpatient setting, with approximately 300 adult and 600 pediatric allergy outpatients seen in the allergy clinics each month. Active in-hospital consultative practices are provided at VCU Medical Center, and with a tendency toward a greater volume of adult consults versus pediatric. Overall contact breaks down to about 60% pediatric and 40% adult patients.

In addition to the routine outpatient and inpatient consultative encounters, fellows are expected to participate in daily rounds on patients with primary immunodeficiency who are being treated with bone marrow transplantation. Elective rotations include bone marrow transplantation, community allergy practice, and rhinoscopy in the otolaryngology clinics. Some cross training in rheumatology is provided, but fellows may additionally elect to participate in adult or pediatric rheumatology clinics.

Research Training
Ample opportunities are available to pursue basic and clinical research. Each fellow is expected to develop has his or her own research project that they work on, in addition to any projects they may have teamed up with the faculty to pursue. Fellows can team up with faculty to work on many different projects.
Basic science research opportunities are available in the areas of mast cell biology and basic immunology. Trainees have participated in studies defining two types of human mast cells, cloning of the gene(s) for mast cell tryptase, and development of immunoassays for tryptase to serve as precise clinical indicators of mast cell involvement in human disease.
Clinical research focuses on training fellows in principles of clinical research including designing, collaborating, collecting data, interpreting and writing a paper. Clinical research opportunities in asthma, urticaria, immunodeficiency, anaphylaxis, eosinophilic esophagitis, mastocytosis, desensitization and allergic rhinitis are available to fellows.

Didactic Training
For two to three months beginning in July of each year, a series of basic lectures is given by the faculty to orient and educate the first-year fellows on the most common conditions seen in the clinics. This also serves as review of potential board material for upper level fellows. First-year fellows also required to attend and pass the graduate-level Immunobiology course offered by the VCU School of Medicine.
Additionally, educational conferences are held on a regularly scheduled basis with attendance required of all fellows and faculty.

Clinical allergy/immunology journal club – Friday afternoons
Basic allergy/rheumatology journal club – Friday afternoons
Allergy/rheumatology Grand Rounds – Friday afternoons
Medical Grand Rounds – Thursday mornings                    
Pediatric Grand Rounds – Tuesday mornings

Opportunities

A number of additional educational and professional opportunities are available to fellows in the training program at VCU.

National Conferences
During the two years of training, each fellow will attend both the national conferences (AAAAI and ACAAI) and is encouraged to attend other meetings on the national level (e.g., Clinical Immunology Society) and regional level (e.g., Swineford Allergy Conference). Some funds for travel are provided by a Personal Expense Account, but fellows are strongly encouraged to submit case reports and/or research data in order to apply for travel grants.

Simulation Lab
As part of fellowship training, regularly scheduled sessions are held for fellows in the VCU simulation lab to enhance patient safety and quality care. Examples include treating status asthmaticus and acute anaphylaxis.

Teaching
Opportunities are available throughout the fellowship training years to teach and educate residents and medical students. Fellows are encouraged to participate in and contribute to both pediatrics and medicine morning reports. Fellows are actively involved in teaching the house staff during the inpatient consultations and as the house staff rotate through our clinics. Exceptional fellows may be asked to participate in Pediatric and Internal Medicine residency core lectures.

Additional Training
Though the standard training program is two years, fellows with a strong interest in basic science or clinical research are encouraged to apply for funding for third year of training, with time protected for research pursuits.

Alumni

Lachara Livingston, MD
Medical School: University of Florida College of Medicine
Residency: Internal Medicine - University of South Florida Morsani College of Medicine
Email: lachara.livingston@vcuhealth.org


Elias Akl, MD
Medical School: University of Balamand Faculty of Medicine and Medical Sciences - Deir El-Balamand, North Lebanon
Residency: Internal Medicine - Mount Sinai School of Medicine (EHMC) – Englewood, NJ


Faculty

Wei Zhao, MD, PhD, FAAAAI, FACAAI
Wei Zhao, MD, PhD
Program Director
Assoc. Professor of Pediatrics
Chief, Division of Allergy & Immunology
Pediatric Ambulatory Medical Director
Areas of Interest: Atopic dermatitis, Chronic urticaria and angioedema, Food and drug mediated allergy, Immunodeficiency diseases
Email:  Wei.Zhao@vcuhealth.org

 

Lawrence B. Schwartz, M.D., Ph.D.
Lawrence Schwartz, MD, PhD
Charles and Evelyn Thomas Professor of Medicine
Chief, Division of Rheumatology, Allergy, and Immunology
Areas of Interest: Cellular and molecular biology of mast cells and basophils, Tryptase biochemistry, Immunoassay development, Desensitization of mast cells and basophils
Email: lawrence.schwartz@vcuhealth.org

 

Anne-Marie Irani, MD
Anne-Marie Irani, MD
Professor of Pediatrics
Division of Allergy & Immunology
Areas of Interest: Atopic dermatitis, Food allergy, Eosinophilic esophagitis
Email:  airani@vcu.edu

 

Santhosh Kumar, MD
Santhosh Kumar, MD
Asst. Professor of Pediatrics
Division of Allergy & Immunology
Areas of Interest: Drug allergy, Occupational allergy, Food allergy, Vaccine related allergy, Immune deficiency and autoimmune conditions
Email:  skumar@vcu.edu

 

ward

Brant Ward, MD, PhD
Asst. Professor of Medicine
Division of Rheumatology, Allergy, and Immunology
Areas of Interest: Immunodeficiency and autoinflammatory diseases, Screening and treatment of SCID, Mast cell roles in non-Th2 immunity, MDSCs in mastocytosis
Email: brant.ward@vcuhealth.org

 

Donna Mitchell, RN, MS, CPNP

Donna Mitchell, RN, MS, CPNP
Division of Allergy & Immunology
Areas of Interest: Asthma, Allergic rhinitis, Atopic dermatitis, Asthma education
Email: donna.mitchell@vcuhealth.org

Application

All applicants use ERAS to apply to the program.

Contacts