What We Do
Our program consists of 8 attending physicians and 4 fellows. Our patient base includes "primary care" allergy (20%), referrals from PCPs (50%) and referrals from outside Allergists, ENT Physicians, Pulmonary Doctors and Dermatologists from the mid-Atlantic area (30%). It is anticipated that that the fellow will see 60:40 or 50:50 mix of adult and pediatric patients during their training. All faculty physicians participate in general allergy and immunology care; however, our areas of expertise includes Asthma, Hereditary Angioedema, Alpha-1-Deficiency, Food Allergy, Drug Allergy, Eosinophilic Gastrointestinal Disorders and Immunodeficiency.
During their training fellows will develop expertise in caring for patients with the following conditions:
- Asthma, allergic and non-allergic rhinitis/rhinosinusitis, allergic conjunctivitis, atopic dermatitis, contact dermatitis, food allergy and/or intolerance, hymenoptera venom sting allergy, drug allergy, anaphylaxis, urticaria and angioedema.
- Various immunodeficiencies, Hereditary Angioedema, Alpha-1-deficiency, eosinophilic and mast cell disorders
Structure of the Training
- The majority of the time during the first year will involve providing care to patients in the outpatient clinic with a team consisting of attending physicians, fellows, residents and students rotating on the service. The nurses in clinic perform skin testing, patch testing, spirometry, drug allergy testing, insect venom testing and desensitization to drugs, insects and aeroallergens. We also preform rhinoscopy and skin biopsy. We have a very active immunotherapy program and treat approximately 500 patients a month. We abide by the 25% academic time, 25% research and 50% patient care ratio suggested by the ACGME and the RRC.
- During the second year there is a greater ratio of time dedicated to research and less to clinical activities. It is expected that all fellows actively participate in research and submit manuscripts for publication to contribute to the field of allergy and immunology. All fellows must also participate in a safety and quality improvement project. Second year fellows can pursue electives in Immunology, Infectious Diseases ENT, Pulmonary, Sleep and Dermatology if desired.
- Mondays (7:30 -8:30 a.m.) is a fellow-directed board review.
- Tuesdays from 7:30 to 08:30 a.m. fellows are expected to attend either Pediatric or Medicine grand rounds
- Wednesday morning from 7:30-8:30am fellows review questions as part of board review. Every Wednesday from 8-11, there is allergy-immunology conference when all members of the training program including adult and pediatric allergists, fellows, residents and students attend (BMR C5860). We start the morning with a business meeting and updates from around the table. We proceed to inpatient cases seen during the proceeding week and finally have either core lectures, journal clubs, research or QA/QI presentations.
- Fridays are fellow's continuity clinic. The faculty rotates supervising these clinics.
Your Role and Activities During the Training
In the outpatient clinic, fellows will work directly with the attending, residents and students, seeing new and return patients. Fellows will be rotated to work with all the faculty members to ensure a well-rounded training experience. Responsibilities in clinic include teaching the residents and students as our clinic is respected for its excellence in teaching.
Fellows will also be responsible for inpatient consultations which range from drug desensitizations, penicillin skin testing, anaphylaxis, angioedema, and immunodeficiency evaluations. Fellows will be supervised specifically by either pediatric or adult faculty according to the age of the patient. Every patient encounter is supervised to obtain maximal educational benefits for the fellows. We do not have an inpatient allergy and immunology service and serve primarily as consultants.
Each year during training it is anticipated that each fellow will present at least 3 abstracts. Fellows usually attend the ACAAI, AAAAI and PAAA each year and are required to submit abstracts to present at these 3 meetings. We also have a CME event each year when each fellow presents a 10 minute presentation on a topic in A/I to improve teaching and oral presentation skills. In addition, fellows present journal clubs; however, the majority of core lectures are the responsibility of the faculty.
All fellows, as noted above, are required to perform research. In addition they are expected to present their research each year at the Wednesday Allergy conference. Presentation of fellows research is expected at a national meetings and faculty will aid in mentorship in research pursuits. At least one submitted manuscript is also required, but most fellows graduate with 3 or more publications.
A QA/QI/safety project is also required of every fellow. Annual updates during the Weds AM meeting are expected. The primary goal of this requirement is improvement in patient care and safety.
Fellows will also enroll and take a graduate level basic immunology course in innate and adaptive immunity during their first year. The class is usually 1-2 hrs 3 days a week from Jan-through March and provides the needed foundation in immunology.
Goals and Objectives for the Fellowship
It is expected that during your training you will:
- Gain an understanding of the breadth of patients cared for by allergists in different settings and with a variety of issues;
- Develop an appreciation of the care of patients with chronic illnesses (e.g. asthma, chronic urticaria) and those with acute illness (e.g. acute sinusitis), and the complexities of managing both;
- Reinforce and develop your history gathering and physical diagnostic skills;
- Develop skills necessary to communicate with PCP and subspecialists;
- Be able to deliver superior oral presentations;
- Be able to perform percutaneous skin tests, patch test, drug challenge, bee sting testing, skin biopsy, rhinolaryngoscopy, immune assessments, immunotherapy, drug challenges and desensitizations and spirometry;
- To be able to read scientific literature in the field and successfully publish in an A/I journal.
- Develop and complete a safety and or quality improvement project.
- Develop and present abstracts and posters;
- Have effective teaching ability
The success of fellows in the program will be based upon attendance, effort, professionalism, patient care and enthusiasm. I truly think learning is fun and we have strived to recruit people that are successful working in a group while sharing and caring for others.
We have been successful in passing the boards for many years with a100% ABAI pass rate. We have fellows who have succeeded in academics as well as many who are very successful in private practice. The feedback from employees and our trainees is that they are very well trained, competent and confident in practicing Allergy Asthma and Immunology.
I hope we have the opportunity to work with you. I am confident you will enjoy working with us and you will be a success.
Allergy Section Chief and Program Director
Timothy Craig, DO
Penn State Milton S. Hershey Medical Center
Division of Pulmonary, Allergy and Critical Care Medicine
Section of Allergy, Division of Pulmonary, Allergy and Critical Care
500 University Drive, MC: H041, C5860 (BMR building)
Hershey, PA 17033