Allergy/Immunology

• Allergy-Immunology Elective Director (IM-407): Dr. Mark Dykewicz (mark.dykewicz@health.slu.edu)

• Pediatric Allergy-Immunology Site Director: Dr. Brad Becker (bradley.becker@health.slu.edu)

• Pediatric Allergy-immunology faculty

  • Dr. Brad Becker

  • Dr. Alan Knutsen

  • Dr. Manoj Warrier

• Allergy-immunology fellows

  • Dr. Sathvik Balaram

  • Dr. Cheshil Dixit

  • Dr. Syed Rizvi

  • Bimal Pangli

  • Nurse Practitioner: Melissa Bommarito APRN-CNP

• Interim Program Coordinator (Internal Medicine-AI)

  • Aleshia McCoy (aleshia.mccoy@health.slu.edu) Contact for MS 4 AI Elective

• Administrative assistant (peds-AI): Theresa Forsythe (Contact for MS 3 clerkship elective and career exploration)

  • Schedule: Monday through Friday 7:30am-4pm. Generally in office on Wednesdays

  • Office Phone: 314-577-5644, Cell Phone: 618-980-0589 - use while working from home

  • Fax: 314-268-2712

  • Email: theresa.forsythe@health.slu.edu

• +/- Residents (pediatric, family medicine, internal medicine) and fourth year medical student on allergy-immunology (IM-407) elective (2-4w)

• +/- Third year clerkship or career exploration student (1-2w)

• • Elective students. Contact Dr. Dykewicz and Claire Gray prior to the start of your rotation to discuss your rotation goals, objectives, strategies, as well as any schedule requests. Activities and schedules are personalized based on interest and can include adult, +/- pediatric clinics and consult services.

  • Pediatric clerkship and CE students. Contact Dr. Becker or Theresa Forsythe with any questions you might have after reading the site overview.

  • Review EPIC for the “clinical landscape” during your time on pediatric AI

    • Clinics. CG ACC Allergy (Cardinal Glennon EPIC code), CG Soco Allergy (SoCo Allergy Clinic EPIC code), CG ACC Imm (Cardinal Glennon Immunology EPIC code), CG ACC Op Infusion (Cardinal Glennon Infusion clinic EPIC code)

    • Inpatient/consult service

      • EPIC Systems listsc > CG Resident Treatment Teams > CG Allergy/Immunology

  • Review the Learners on Pediatrics Spreadsheet/Allergy-Immunology tab

    • Consider touching base with any outgoing learners and/or those scheduled with you.

    • Use the "insert comment" feature to sign up for individual clinics. Considerations in choosing include interests/goals, presence of other learners, how busy a clinic is (Eg. if two clinics held during a given half day session, consider picking one with greater number of patients),variety of experience, and/or continuity with a specific attending. We request no more than 2 learners per clinic/attending.

      • The expectation for all mini electives is a full work week in clinic potentially with a caveat that on half days a clinic is not held, you may be assigned to other tasks: Ranken Jordan visit, inpatient consults, procedures, individual study, etc at the discretion of the site director.

• Individual Study

  • Allergy/immunology individual study resources especially

    • Asthma history cheat sheet

    • Asthma care quick reference

  • Review EPIC templates

    • AI New patient visit

    • AI Follow up patient visit

White coats: required

• Adverse reaction to vaccines

• Allergic bronchopulmonary aspergillosis

• Allergic rhinitis/conjunctivitis

• Allergy testing

• Anaphylaxis

• Asthma (severe or poorly controlled)

• Atopic dermatitis (eczema)

• Drug allergy

  • Environmental and allergic rhinoconjunctivitis (severe or poorly controlled)

• Adverse food reactions including eosinophilic GI disease

• Frequent infections

• Hypersensitivity pneumonitis

• Immunodeficiency

• Insect allergy

• Latex allergy

• Primary immunodeficiency

• Recurrent sinusitis

• Urticaria/angioedema

*Topics recommended for early review in bold

Cardinal Glennon

• • South Tower, 1st Floor, in between the Café and the Ambulatory Care Center (ACC). Look for the “Allergy and Infusion Clinic" overhead sign as well as pictures of fish over the walls and bubble-tubes.

EPIC: CG SOCO Allergy

• Allergy Clinics (CG)

  • • Dr. Becker. Mon AM/PM, Wed AM (fellow’s clinic-2nd/4th Wed AM), Wed PM (fellow telehealth-1st/3rd/5th Wed PM), Thursday AM (telehealth)

    • Dr. Knutsen: Wed AM (fellow’s clinic-1st/3rd Wed AM)

    • Dr. Warrier: 2nd and 4th Wed PM

    • Epic: CG ACC Allergy

• Immunology Clinic (CG)

  • • Dr. Knutsen. Tues AM (9am IVIG/OFC CG), Thursday AM/PM, Friday AM (8am ICIG/OFC CG)

    • EPIC: CG Immunology

• South County (SoCo) Allergy Clinic

  • • Dr. Becker, Tuesday PM

    • 13000 Butler Crest Drive

    • St. Louis, MO 63128

    • 22 minutes from Cardinal Glennon

• In the Immunology clinic third year students are asked to actively observe

• In the Allergy clinic, third year students will actively observe 1-2 patient visits. Then students will independently see at least one patient per half clinic identified as appropriate by the supervising physician. When seeing patients independently, limit time in the room to 20 min and complete any remaining history and physical elements with the attending. We ask that you do not see patients with eosinophilic esophagitis or chronic urticaria independently. We encourage students to observe allergy testing.

• Medical documentation

  • Immunology clinic: Documentation is expected for elective students.

  • Allergy clinic: All students expected to write consult notes for patients independently seen using the allergy new and follow up visit templates. Remember to assign the attending to cosign the note and then sign the note.

    • .aicgnew for new allergy patients

    • .aicgfu for allergy follow up visits

  • Immunology clinic: Documentation is expected for elective students.

• Seeing new consults is a great opportunity to take a history, perform a thorough physical exam, and to work on an assessment, differential, and recommendations. Let the fellow or attending scheduled for consult service (amion.com/cgch) know you will be interested in seeing new consults, share your contact information, and ask him or her to let you know about any consults that might come during your time on AI.

• Document a consult (initial or follow up) for each encounter

• Route note to the supervising physician (fellow or attending)

• End each note with: “Discussed with Dr. X (AI attending)” so the team knows that they can act on plan.

• Support your recommendations citing primary literature, review article, or a textbook.

Conferences either hybrid in-person/Zoom or Zoom only. Invites will be sent out by Aleshia McCoy the prior week

• • • Immunology Review (Zoom)

      1. every other Monday 10:30 AM

    • Adult AI Conference (Zoom)

      1. Every Monday 11:45am

    • Pediatric AI conference (Hybrid in-person/Zoom)

      1. Every Tuesday 8-9AM

      2. Presented in the Mund Room 1st Floor CG (carpeted hallway).