Date Issued: 06/23/2002
Prior Revision Date: 03/02/2009
Date Reviewed and Revised: 07/26/2010
Allergy and Immunology Curriculum
Department: Internal Medicine
Faculty Coordinator: Gary Gross, M.D.
Hospital: Texas Health Presbyterian Hospital Dallas
Periods offered: All
Length: 2 weeks
Max no. of residents: 1
First Day Contact: JoAnn Kroener (214) 691-1330
First Day Time: 9:00 a.m.
First Day Place: Dr. Gary Grosss office, 5499 Glen Lakes, Suite 100,
Requirements: Hours: 8:00 a.m. to 4:30 p.m. Monday - Friday
I. Course Description:
Residents will work with an allergist in outpatient
practice and will be exposed to a wide variety of immunological
diseases. They will participate in initial evaluations as well as follow
up evaluations in allergy clinic. They will also see inpatient consults when available.
II. Course Goals and Objectives: (based on ACGME competencies for resident
Residents are expected to provide care that is compassionate, appropriate and
effective for the promotion of health, prevention of illness, treatment of disease
and at the end of life.
- Gather accurate, essential information from all sources, including medical
interviews, physical examinations, medical records and diagnostic/therapeutic
procedures. Examples: Residents will obtain an accurate history, perform
an appropriate physical exam, form an assessment and therapeutic plan on the
patient with allergies or asthma.
- Make informed recommendations about preventive, diagnostic and therapeutic
options and interventions based on clinical judgment, scientific
evidence, and patient preference. Examples: Evaluation of urticaria,
interventions for seasonal allergies, prevention of asthmatic exacerbation.
- Develop, negotiate and implement effective patient management plans and
integration of patient care. Examples: Appropriate use of desensitization;
cost effective treatment of seasonal allergies; education regarding allergen avoidance.
- Understand the diagnostic and therapeutic procedures considered
essential to the practice of allergy and immunology. Examples: Role of skin
testing and RAST.
Residents are expected to demonstrate knowledge of established and evolving
biomedical, clinical and social sciences, and to apply their knowledge
to patient care and education.
- Apply an open-minded, analytical approach to acquiring new knowledge. Examples:
Understand relative importance of environmental controls.
- Access and critically evaluate current medical information and scientific
evidence. Examples: Recognize the importance of pharmacogenetics.
- Develop clinically applicable knowledge of the basic and clinical sciences
that underlie the practice of allergy and immunology. Examples: Understand
the biology of the immune system and how it influences clinical presentation
- Apply this knowledge to clinical problem-solving, clinical decision-making,
and critical thinking. Examples: Evaluate severe asthma with recommendations for management considering drug therapy, environmental controls and ongoing evaluation.
Practice-Based Learning and Improvement:
Residents are expected to be able to use scientific evidence and methods to
investigate, evaluate, and improve patient care practices:
- Identify areas for improvement and implement strategies to enhance knowledge,
skills, attitudes and processes of care. Examples: Improve understanding
of immunodeficiency by reviewing current literature in the area.
- Analyze and evaluate practice experiences and implement strategies to continually
improve the quality of patient practice. Examples: Develop a process
to ensure patient education regarding prevention of anaphylaxis.
- Develop and maintain a willingness to learn from errors and use errors to
improve the system or processes of care. Examples: Review management plans and support each recommendation.
- Use information technology or other available methodologies to access and
manage information, support patient care decisions and enhance both patient
and physician education. Example: Use of allergy/immunology websites
and text books.
Interpersonal and Communication Skills:
Residents are expected to demonstrate interpersonal and communication skills
that enable them to establish and maintain professional relationships with patients,
families and other members of health care teams.
- Provide effective and professional consultation to other physicians and
health care professionals and sustain therapeutic and ethically sound professional
relationships with patients, their families, and colleagues. Examples:
Verbally and in writing, communicate with consultants regarding the diagnostic
and therapeutic evaluation of the allergic patient.
- Use effective listening, nonverbal, questioning, and narrative skills to
communicate the patients. Examples: When interviewing a patient with
asthma or allergic rhinitis, use appropriate communication skills.
- Interact with consultants in a respectful, appropriate manner. Examples:
Discuss evaluation and recommendations of patients seen in consultation.
- Maintain comprehensive, timely, and legible medical records. Examples:
Thorough and complete progress notes reflecting the diagnostic and therapeutic
approach to the patient with allergies.
Residents are expected to demonstrate behaviors that reflect a commitment to
continuous professional development, ethical practice, an understanding and
sensitivity to diversity and a responsible attitude toward their patients, their
profession, and society.
- Demonstrate respect, compassion, integrity, and altruism in relationships
with patients, families, and colleagues. Example: Treat all patients and staff with respect.
- Demonstrate sensitivity and responsiveness to the gender, age, culture,
religion, sexual preference, socioeconomic status, beliefs, behaviors and
disabilities of patients and professional colleagues. Example: Avoid differential treatment of patients or staff.
- Adhere to principles of confidentiality, scientific/academic integrity,
and informed consent. Examples: Avoid discussing patient in their presence and acknowledge uncertainties in medical treatment to peers.
- Recognize and identify deficiencies in peer performance. Examples: Watch for incompetence in peers and discuss it with them or report it to supervisor.
Residents are expected to demonstrate both an understanding of the contexts
and systems in which health care is provided, and the ability to apply this
knowledge to improve and optimize health care.
- Understand, access and utilize the resources, providers and systems necessary
to provide optimal care. Examples: Be aware of source of patient benefits, pharmacy access and community setting.
- Understand the limitations and opportunities inherent in various practice
types and delivery systems, and develop strategies to optimize care for the
individual patient. Examples: Manage outpatient asthma with an understanding of when hospitalization would be required.
- Apply evidence-based, cost-conscious strategies to prevention, diagnosis,
and disease management. Examples: Treatment of allergies and asthma.
- Collaborate with other members of the health care team to assist patients
in dealing effectively with complex systems and to improve systematic processes
of care. Examples: Work with staff for performance of pulmonary function testing and other lab testing.
III. Methods of instruction:
- Didactic (schedule, topic, faculty)
Daily residents conference 12:00-1:00 p.m. - IM Training Room
Wednesday mornings 7:30-8:00 a.m. - Clinical Ground Rounds -
IM Training Room
Wednesday afternoons 12:15-1:00 p.m. - Internal Medicine Update - Haggar
Friday mornings 7:30 - 8:00 a.m. - Coffee with Cardiology - IM Training
Residents are assigned to an allergist. The resident is expected to work
with the allergist primarily seeing outpatients. Residents are expected
to attend every noon conference.