Allergy and Immunology

During this rotation, residents should develop an approach to the following :

1. Skin testing.

2. Patch testing: able to describe their use and carry out where appropriate.

3. Specific IgE.

4. Immunodeficiency work-up.

5. Spirometry: indication and interpretation.

6. Provocation tests (cold, urticaria, food challenges, occupational diseases, etc.)

7. Prick tests.

8. Ability to:

   1. • take an appropriate history.

      • perform an appropriate physical exam.

      • generate an appropriate diagnosis and differential diagnosis.

      • order appropriate investigations.

      • appropriately manage the patient.

      • Demonstrates ability to counsel patients re: allergen avoidance.

      • Learn to compose good consult and referral note.

      • Generate an appropriate differential diagnosis and follow-up.

      • Learn good verbal communication.

9. Appropriate referral patterns and plans for follow-up.

10. Anergy - able to perform and/or interpret results of anergy screen.

11. X-rays -- able to interpret sinus and chest x-rays.

12. Intravenous immunoglobulins -- describes immunological rationale for use; lists potential side effect and describes methodology for administration.

13. Immunotheraphy -- describes indication for use; desensitization protocols for ASA and protocols for penicillin.

14. Immunomodulators -- describes mechanisms of actions and lists indications for use.

15. Asthma medications -- able to organize a management plan using all therapeutic options -- describes side effects of each medicine and all delivery systems.

16. Nasal medications -- able to organize a management plan for management of nasal disease -- describes mechanism of action of each medication and the side effects of each medication.

By the end of this rotation, residents will be graded as “progressing as expected” in each of the following and in the Global Rating.  The expected level of performance in the PGY1 year is Interpreter level,  PGY2 is Manager Level, PGY3 is Educator Level (See Program Information - Overall Goals and Objectives).

1. Medical Expert

• Data Collection and Clinical Reasoning: The resident appropriately collects and synthesizes clinical information to formulate a primary diagnosis and appropriate differential.

• Clinical Decision Making: The resident is able to make appropriate and cost-effective investigation and management decisions based on the context of the case and best available evidence.

2. Communicator

• Patient and Family Communication: The resident communicates with and about patients and family in a patient-centered manner.

• Documentation and Verbal Presentation: The resident appropriately documents and presents cases for new consults, progress notes, and handover of care (succinctly organized, prioritized, summarized) including answering the question asked by the referring service.

3. Collaborator

• Interdisciplinary Team: The resident works well in a team, shares work, and interacts with referring physician and other healthcare providers effectively.

4. Leader

• Efficiency: The resident prioritizes tasks and manages time effectively.

5. Health Advocate

• Patient Advocacy: The resident addresses disease prevention, risk factor reduction, and health surveillance when indicated.

6. Scholar

• Personal and Team-based Learning:  The resident demonstrates an effective personal learning strategy (reading around cases, appropriate use of resources) and shares knowledge with other team members.

7. Professional

• Scope of Practice:  The resident is trustworthy and responsible, knows limitations (asks for help appropriately), and responds well to feedback.

Residents in clinical immunology and allergy are expected to achieve knowledge in the utilization and interpretation of common laboratory procedures relevant to clinical immunology. 

Assessment

We will use the following In-Training Evaluation Report (ITER):

• Allergy and Immunology

Entrustable Professional Activities (EPAs)

This rotation focuses on Core of the Discipline EPAs. However, due to scheduling, a resident may do this rotation during Foundations. Residents are allowed to start Core of Discipline EPAs during the Foundations stage. This rotation is an ideal learning environment for the following EPAs:

• CD2: Assessing, diagnosing, and managing patients with complex chronic diseases

• CD3: Providing internal medicine consultation to other clinical services

Rotation Supervisor

Dr. Harissios Vliagoftis

harissios.vliagoftis@ualberta.ca

There is no Medical Education Program Coordinator for this rotation you must contact the person above to set up. No rotation info will be sent out.