Allergy and Clinical Immunology
Education and Training Programs at Brigham and Women's Hospital
Our clinical training emphasizes evidence-based medicine, the achievements and limitations of current immune-modulating therapies, and the biological insights to be gained by applying cutting-edge science to clinical disease. Our approach to developing the next generation of academic leaders begins in the first year. Fellows are exposed to diverse clinical experiences across the ambulatory and inpatient settings, and guided to refine their clinical observations and develop a line of independent academic inquiry.
In the first year, fellows evaluate patients in a variety of ambulatory settings including the Brigham Hale Building for Transformative Medicine, the main Ambulatory Allergy practice at Chestnut Hill, Boston Children’s Hospital, Newton Wellesley Pediatrics, and the Brigham and DFCI Infusion Centers, giving them broad exposure to diverse pediatric and adult patient populations. In addition, trainees rotate through related subspecialties including Dermatology, ENT, Ophthalmology, Pulmonary, and Rheumatology. Fellows will have specific teaching in skin testing, immunotherapy, pulmonary function testing, and sinus and chest imaging. Through these rotations, our fellows get experience diagnosing and managing primary immunodeficiencies, autoimmune disorders, hereditary angioedema, anaphylaxis, food allergy, eosinophilic disease, drug allergy, and mastocytosis, as well as asthma, rhinitis, and nasal polyposis.
In the second year, fellows build a longitudinal clinic with a faculty member of their choice, fulfilling ACGME requirements. Most fellows choose to continue these clinics throughout their research years. Additional electives include rotations on the Immunodeficiency and Bone Marrow Transplantation Service at Children’s Hospital, and clinics in Pulmonary Medicine, Contact Dermatitis, Atopic Dermatitis, and beyond, as determined by fellow interest.
The inpatient Brigham Allergy/Immunology Consultation Service provides an additional opportunity to diagnose and manage patients in acute settings, to work closely with clinical faculty, and to teach the house staff. Our service sees several hundred consults a year. Call is shared among first and second year fellows. Common consultations include the diagnosis and management of: drug allergy, hypereosinophilic syndromes, angioedema, immunodeficiency, and anaphylaxis.
We have several clinical initiatives addressing the complex patients referred to our tertiary care center:
The Severe Asthma Program, part of the Mass General Brigham Asthma Center, brings together a team of allergists and pulmonologists who work in collaboration with specialists in Otolaryngology, Gastroenterology, and Psychiatry to help manage patients whose asthma has been difficult to control with conventional therapy.
The Aspirin Exacerbated Respiratory Disease Center, advances education, research, and treatment for patients with the hallmark triad of nasal polyposis, asthma, and sensitivity to aspirin and other non-steroidal anti-inflammatory drugs.
The Immunodeficiency Clinic is staffed by a team of experts who specialize in the diagnosis and treatment of patients with diverse immune defects and their autoimmune complications including common variable immunodeficiency, granulomatous lymphocytic lung disease, chronic granulomatous disease, CD4 lymphocytopenia, and other forms of primary and secondary immunodeficiencies.
The Drug Hypersensitivity and Desensitization Center is a comprehensive multidisciplinary team that evaluates and cares for 300-400 patients per year with adverse reactions to chemotherapy and monoclonal antibodies, as well as other biological agents. They perform nearly 1,000 desensitizations per year across inpatient and ambulatory settings.
The Mastocytosis Center, which includes physicians in Allergy/Immunology, Hematology/Oncology, Gastroenterology, and Pathology, provides genetic testing, histologic and flow cytometric diagnoses, and targeted treatments for children and adults with a range of mast cell disorders from urticaria pigmentosa to mastocytosis and mast cell leukemia.
The Food Allergy Center offers families with children at high-risk for the development of food allergy the opportunity to reduce this risk through early introduction in carefully characterized patients.
Didactic conferences are held on a regularly scheduled basis and include:
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