NIAID Allergy and Immunology Fellowship Program

Paneez Khoury, M.D., M.H.Sc., Program Director
Jenna R.E. Bergerson, M.D., M.P.H., Associate Program Director
Edwin Mayah, M.H.A., M.B.A., Program Coordinator

NIAID offers a three-year training program in allergy and immunology. This program, open to physicians who have completed internal medicine and/or pediatric residency training, is designed to provide trainees with high-quality clinical and research skills that will enable them to successfully pursue careers in academic medicine. 

The NIAID Allergy and Immunology Clinical Fellowship Program is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). Fellows are eligible to sit for the Board of Allergy and Immunology certification examination after successful completion of the first two years of the program.

Highlights of the Program

  • Three-year, ACGME-accredited training program in allergy and immunology, with an option for a fourth and fifth year of research training for highly motivated fellows committed to an academic career
  • Focus on individualized career development, including for academic medicine or translational research careers
  • Development of outstanding clinical skills and advanced clinical and basic research skills
  • First year devoted to clinical training (inpatient and outpatient) in the diagnosis and management of patients (children and adults) with common and complex allergic and immunologic diseases at the NIH Clinical Center and regional academic centers (Children’s National Medical Center, George Washington University, Johns Hopkins Hospital)
  • Intensive training in clinical laboratory assessment, clinical genomics, and inpatient management of patients with complex allergic and immunologic diseases at the NIH Clinical Center, including patients on hematopoietic stem cell transplantation and gene therapy protocols
  • Broad exposure to rare immunologic diseases in a clinical research setting, including disorders of the adaptive and innate immune systems, such as chronic granulomatous disease, Job’s syndrome, GATA-2 deficiency, hyper-IgM syndromes, CTLA4 haploinsufficiency, interferonopathies; hypereosinophilic syndromes; mastocytosis; and hereditary alpha tryptasemia
  • Second year adds research training and development of original research projects in an area of choice, including allergic diseases, immune deficiency and immune dysregulatory diseases, autoinflammatory diseases, HIV, vaccine immunology and clinical trials, and basic immunology
  • Intensive didactic sessions and/or journal clubs held weekly to cover basic immunology, allergic and immunologic diseases, clinical laboratory immunology, clinical genomics, pharmacology, vaccines, clinical trial development, patient safety and quality improvement
  • Regular case conferences covering primary immune deficiency, immune dysregulatory, and allergic diseases, attended by senior investigators
  • Opportunities for formal research training, including a certificate in clinical research through the NIH Clinical Center, a masters in health science in clinical research through the NIH-Duke University collaborative program, and a Ph.D. through the NIH-Oxford-Cambridge Ph.D. program
  • Four clinical fellows recruited each year:
    • Three positions for physicians trained in internal medicine and/or pediatrics
    • One position for physicians trained in pediatrics, as a collaborative NIAID/Children’s National Health System pediatric training track




First- and second-year fellows attend a Friday Conference.

First- and second-year fellows attend a Friday Conference.

Credit
NIAID

The majority (80%) of the first year of training is dedicated to clinical activities, with intensive exposure to the broad spectrum of allergic and immunologic diseases in children and adults. Clinical rotations covering outpatient and inpatient aspects of the specialty are completed at the NIH Clinical Center (outpatient clinics, inpatient ward, allergy and immunology consultation service, and pulmonary function lab), the Children's National Medical Center (pediatric allergy and immunology; pediatric consultations), the Johns Hopkins Pediatric Allergy Clinic (pediatric allergy, with a focus on food allergy), and the George Washington University (adult allergy; adult consultations; ENT).  In the second year of training, 20% of time is devoted to direct clinical activities, including a monthly primary immunodeficiency clinic at NIH, allergy continuity clinic, and coverage of the NIH Clinical Center Allergy and Immunology Consultation Service.  The training program complies with the requirements of the ACGME and the American Board of Allergy and Immunology (ABAI).  Fellows who successfully complete all training program requirements in the first two years are eligible to sit for the American Board of Allergy and Immunology Certification Examination.

The first month of the program is devoted to an overview of basic concepts in allergy and immunology, with lectures and skills development sessions provided at the NIH Clinical Center, the Children’s National Health System, the George Washington University, and the Walter Reed National Military Medical Center.  Examples of topics covered during this month include overview of basic immunology; laboratory assessment of the immune system; physical examination of the immune system; basic concepts in molecular biology, genetics, and genomics, with applications to immunologic diseases; overview of primary immunodeficiency and immune dysregulatory disorders; review of asthma guidelines and management in adults and children; laboratory assessment of pulmonary function; overview and management of food allergy, atopic dermatitis, allergic rhinitis, acute and chronic urticaria, drug allergy, and anaphylaxis; eosinophilia and hypereosinophilic syndromes; mast cell activation syndrome and mastocytosis; physical urticaria; HIV basics; principles of hematopoietic stem cell transplantation and gene therapy; newborn screening for severe combined immunodeficiency (SCID; anaphylaxis and airway management training through simulation; allergen immunotherapy and venom allergy workshops; training in allergen skin testing; patient safety; and quality improvement training.

NIH Clinical Center

The majority of clinical training (50%) takes place at the NIH Clinical Center, based on the NIH main campus in Bethesda, MD.  The NIH Clinical Center includes 200 inpatient beds and 93 day hospital stations, as well as 15 outpatient clinics. All patients admitted or seen at the NIH Clinical Center are enrolled on research protocols.

NIAID Inpatient Ward Rotation (1.5 months in first year)

During this 1.5-month rotation at the NIH Clinical Center, fellows work with senior investigators and supervise and teach a team of four internal medicine residents from George Washington University and Georgetown University in the evaluation and care of patients with complex immunologic and allergic diseases, as well as complications associated with these diseases. 

This rotation affords the unique opportunity to evaluate and manage opportunistic infections in adult and pediatric patients with a range of inherited and acquired immune defects. The NIAID inpatient ward admits 40 to 60 patients per month who are enrolled in various infectious diseases and immunology clinical research protocols.

Some of the conditions that fellows see during this rotation include but are not limited to HIV/AIDS, immune reconstitution syndrome; tuberculosis (drug-sensitive and -resistant); parasitic infections; chronic granulomatous disease and hyper-immunoglobulin E (Job’s) syndrome with invasive bacterial and fungal opportunistic infections; immune disorders that cause susceptibility to disseminated mycobacterial infections; bronchiectasis disorders that lead to increased susceptibility to pulmonary mycobacterial infections; chronic active Epstein-Barr virus infection; X-linked agammaglobulinemia; X-linked severe combined immunodeficiency; leukocyte adhesion deficiencies; hyper-immunoglobulin (Ig)M syndromes; and GATA-2 mutations resulting in increased susceptibility to both infectious and hematopoietic complications.

The inpatient ward team also manages patients who have undergone stem cell transplantation for these immunodeficiencies and evaluates patients admitted with opportunistic infections due to as-yet-undefined immune defects. Through exposure to this unique array of conditions, fellows acquire an in-depth understanding of immunology and how dysregulation of specific arms of the immune system confer particular infection susceptibilities.

NIAID Outpatient Rotation (3 months in first year)

This 3-month rotation (split into two 1.5-month blocks) provides fellows with exposure to patients with complex allergic and immunologic patients in the outpatient, clinical research environment. Through this experience, fellows gain expertise in diagnosing and managing immunologic diseases and associated complications by working with senior NIH investigators. Typical disorders seen in the NIAID outpatient clinic include autoimmune lymphoproliferative syndrome, PI3K deficiency, monogenic allergic disorders with atopic dermatitis, hypereosinophilic syndromes, eosinophilic gastrointestinal disorders, mastocytosis, hereditary alpha tryptasemia syndrome, physical urticaria, DOCK8 deficiency, hyper-IgE syndromes, common variable immunodeficiency with gastrointestinal complications, and chronic granulomatous disease. 

NHLBI Pulmonary/Pulmonary Function Laboratory Rotation (3 weeks in first year)

The NHLBI pulmonary consult and pulmonary function lab rotation provides training in the laboratory evaluation of airway function (including pulmonary function testing, methacholine challenge, and exercise challenge testing), asthma diagnosis and management, asthma management in special circumstances (e.g., pregnancy), occupational lung disease, allergic bronchopulmonary aspergillosis, and the evaluation of pulmonary disease in patients with immunologic diseases.

Allergy and Immunology Consultation Service (1.5 months in first year; 1.5 months in second year)

The allergy and immunology consultation service provides consultations for patients on protocols through the NIH Clinical Center, including the Undiagnosed Diseases Program. Fellows manage the consultation service for 1.5 months each year during the first and second years of training. Areas of particular focus are immunologic reactions to drugs and biologic agents, radiocontrast reactions, anaphylaxis, and immunodeficiency evaluations. Fellows provide consultations under the supervision of the faculty of the consultation service, with case-based teaching and literature reviews. Procedural competency developed during this rotation includes skin testing, graded challenges, and induction of drug tolerance.

NIAID Genomics Rotation (3 weeks in first year)

Fellows receive specific didactics on genetics in immune disorders. In the second half of the year during the genomics rotation, fellows develop competencies in approach to genetic disorders, gaining confidence in assessing research variants for patients receiving exome and whole genome testing on NIAID protocols. Fellows work closely with genetic counselors and molecular geneticists to develop competencies in variant interpretation. 

NIAID Primary Immune Deficiency Continuity Clinic (11 clinics in second year)

The NIAID Primary Immune Deficiency (PID) Clinic provides second-year allergy and immunology fellows with ongoing development of advanced clinical immunology laboratory and genomics interpretation skills in the diagnosis and management of patients with complex or undiagnosed primary immune deficiency and immune dysregulatory disorders. Second-year fellows evaluate patients with attending supervision and participate in case presentations and discussions of the patients with other fellows and faculty who have experience with these disorders. Development of independent assessments and treatment plans and the use of patient-based literature reviews is strongly encouraged. In addition, fellows are integrated into the patients’ research teams and are involved in the investigation of novel immune deficiency diseases, including publications that result from their contributions. Third-year fellows are required to attend and participate in the PID Clinic Case Conference twice a month, where cases are discussed with the broader NIH, Children’s National Health System, Johns Hopkins, and George Washington University PID community.

Rotations Outside NIH

John Hopkins University Hospital

First-year fellows have a 3-month pediatric allergy elective rotation at Johns Hopkins University designed to expose them to advanced training in the diagnosis and management of food allergy, eosinophilic esophagitis, and atopic dermatitis in children. Fellows participate in food challenges during this elective rotation to complement the training at Children’s National Medical Center.

George Washington Hospital

First-year fellows spend 3 months on an adult allergy and immunology rotation at George Washington University’s Allergy, Asthma and Sinus Center (George Washington Medical Faculty Associates). This rotation is designed to give first-year fellows exposure to the diagnosis and management of adults with allergic diseases and asthma in an academic practice setting. Procedural exposure to rhinolaryngoscopy, extract preparation, allergen immunotherapy prescription writing and administration, allergen skin testing, patch testing, and pulmonary function testing are key features of this experience. Fellows also participate in inpatient consultations with attending oversight at George Washington Hospital. Subspecialty exposure to otolaryngology and dermatology is provided during the rotation. Clinical training will be supplemented with allergy journal clubs. In addition to the Primary Immune Deficiency Continuity Clinic, fellows can elect this site for their basic allergy and immunology continuity clinic.

Children’s National Hospital System

The pediatric allergy and immunology rotation at Children’s National Health System is designed to provide training in the breadth of allergic and immunologic disease seen in children. Initial workup, diagnostic testing, management, and follow-up care for these disorders will be emphasized. Over a 3-month block, first year fellows will receive education and training in outpatient clinics with multidisciplinary exposure in pulmonology, bone marrow transplant, gastroenterology, and/or rheumatology. Procedural experience with hypersensitivity skin testing, allergen immunotherapy, food and medication challenges, prescription of gamma globulin replacement and biologic treatments, and interpretation of pulmonary function testing will also be included. Fellows will gain experience with interpretation and management of newborns with abnormal TREC assays for T-lymphopenia/SCID. In-patient consultation will be provided for allergic/immunologic problems (including pediatric drug allergy, atopic dermatitis, asthma, and immunodeficiency diseases) and for select patients on hematopoietic stem cell transplantation service (with immunologic diseases). Clinical training will be supplemented with lectures and journal clubs. In addition to the Primary Immune Deficiency Continuity Clinic, fellows can elect this site for their basic allergy and immunology continuity clinic.

The core of this clinical fellowship program is the effort devoted to research training and performing original basic, translational, and clinical research. Fellows work under the direct supervision and mentorship of senior NIAID investigators. The research experience is characterized by close contact with the preceptor, individual instruction, and continuity during the training period. The goal of the research training is to provide a productive experience leading to the development of successful independent investigators.

Fellows perform clinical research and/or laboratory research for about 10 percent of the time during the first year, 60 percent in the second year, and exclusively in the third year. Allergy and immunology fellows may request to work in any of the laboratories within the intramural NIAID program. Research opportunities involve a wide range of investigations in various aspects of allergy and immunology. These range from basic cell and molecular biology or immunology to clinical research endeavors:

  • Biology of mast cells, basophils, or eosinophils and clinical programs or clinical trials targeting these cells in diseases
  • Pathophysiology and treatment of anaphylaxis and other allergic disorders
  • Effect of cytokines on cellular responses
  • Diagnosis of and host responses to infectious agents
  • Diagnosis, molecular characterization, and treatment of primary immune deficiency disorders
  • Biology and mechanisms of food allergy
  • Role of antibody and cellular immune systems in inflammation and autoimmunity
  • Function of cellular receptors for immunoglobulin, cytokines, and matrix components
  • Basis of mucosal immunity
  • Humoral and cellular immunoregulation and immunoregulatory defects
  • Bology of polymorphonuclear leukocytes, monocytes, and macrophages
  • Pathogenesis of HIV
  • Vaccine immunology and vaccine clinical trials

Didactic sessions in the training program include

  • Primary Immunodeficiency Case Conference (second and fourth Wednesdays, 4 p.m. - 5 p.m.):

This twice monthly case conference is attended by fellows, NIH investigators, and investigators at affiliate sites interested in immune deficiency and immune dysregulatory disorders. Fellows present interesting patient cases from the NIAID clinics and inpatient service, as well as cases from Children’s National or George Washington University, for discussion with the broader clinical immunology community.

  • Allergy and Immunology Consultation Service Case Conference (1 Friday per month)
  • NIAID Grand Rounds (Fridays, 8 a.m. - 9 a.m.)
  • Core Clinical Immunology Didactic Conference and Journal Club (Friday afternoons)

NIH-Duke Master’s Program in Clinical Research

Grant Writing Workshops

Grant writing seminars and workshops/courses are designed for research fellows, clinical fellows, postdoctoral intramural research training award (IRTA) fellows, and visiting fellows (VFs), as well as tenured and tenure-track investigators. Grant writing seminars consist of didactic sessions presented over a ½- to 2-day time period, and the intent of these seminars is to provide a broad overview on the grant writing process. The topics usually covered in such seminars include fundamentals of good grant writing, general preparation of the grant application (i.e., specific aims, research design, budgets, analysis of reviews, and strategies for rebuttal and re-application), roles and responsibilities of the extramural program officer and of the scientific review administrator, and an overview of various available funding mechanisms (e.g., career development awards [K and RO1] and the National Science Foundation Grant Awards).

The grant writing seminars at NIH are offered through the Office of Extramural Research (OER) and the Office of Intramural Training and Education (OITE), as well as by individual Institutes.

OITE maintains a website with a full menu of career development resources for current trainees, including grant writing seminars. 

Separately, a Clinical Trials Development Series with NIAID’s Division of Allergy, Immunology, and Transplantation helps fellows prepare for writing protocols and independent clinical research programs.

Research Retreat

In addition to individual research mentors, fellows in their second year and beyond participate in a program-wide research mentoring program retreat. At mid-year, fellows submit formal summaries of their research projects, and at year-end they present their progress before the assembled allergy and immunology fellows and NIAID faculty, including the individual research mentors. This program is designed to obtain feedback on research and assist fellows in progressing along their career trajectory.

Attendance at National Meetings

Fellows have the opportunity to attend one national meeting a year during their first year of training, and additional conferences under their research mentor in the second and third years of fellowship.

NIH Clinical Center

  • Jenna Bergerson, M.D., Assistant Research Physician, Primary Immune Deficiency Clinic, Laboratory of Clinical Immunology and Microbiology, NIAID. Associate Program Director and Consult Director, A&I Training Program.
  • Melody Carter, M.D., Senior Research Physician, Laboratory of Allergic Diseases, NIAID
  • Jeffrey Cohen, M.D., Chief, Laboratory of Infectious Diseases, NIAID
  • Gregory Constantine, M.D., Assistant Research Physician, Human Eosinophil Section, NIAID
  • Ottavia Delmonte, M.D., Assistant Research Physician, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Dimana Dimitrova, M.D., Chief Research Medical Officer and Adjunct Investigator, Experimental Transplantation and Immunology Branch, National Cancer Institute (NCI)
  • Kirk Druey, M.D., Chief, Lung and Vascular Inflammation Section, Laboratory of Allergic Diseases, NIAID
  • Jessica Durkee-Shock, M.D., Assistant Research Physician, Laboratory of Infectious Diseases, NIAID
  • Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases
  • Tom Fleisher, M.D., Scientist Emeritus, Department of Laboratory Medicine, NIH Clinical Center
  • Ivan Fuss, M.D., Senior Research Physician, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Alexandra Freeman, M.D., Director, NIAID Primary Immune Deficiency Clinic and Senior Clinician, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Martin Gaudinski, M.D., Medical Director, Clinical Trials Program, Vaccine Research Center, NIAID
  • Pamela Guerrerio, M.D., Ph.D., Chief, Laboratory of Allergic Diseases, NIAID
  • Steve Holland, M.D., Scientific Director, Division of Intramural Research, NIAID
  • Paneez Khoury, M.D., M.H.Sc., Senior Clinician, Human Eosinophil Section, Laboratory of Parasitic Diseases, and Director, Allergy and Immunology Fellowship Training Program, Laboratory of Allergic Diseases, NIAID
  • Amy Klion, M.D., Chief, Human Eosinophil Section, Laboratory of Parasitic Diseases, NIAID
  • Hirsh Komarow, M.D., Staff Clinician, Laboratory of Allergic Diseases, NIAID
  • H. Clifford Lane, M.D., Clinical Director, Division of Clinical Research, NIAID
  • Julie Ledgerwood, D.O., Senior Clinician and Chief Medical Officer, Vaccine Research Center, NIAID
  • Michael Lenardo, M.D., Chief, Molecular Development of the Immune System, Laboratory of Immune System Biology, NIAID
  • Stewart Levine, M.D., Senior Investigator, Laboratory of Asthma and Lung Inflammation, NHLBI
  • Michail Lionakis, M.D., Sc.D., Chief, Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Jonathan Lyons, M.D., Chief, Translational Allergic Immunopathology Unit and Lasker Scholar, Laboratory of Allergic Diseases, NIAID
  • Harry Malech, M.D., Chief, Genetic Immunotherapy Section, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Maura Manion, M.D., Staff Clinician, Division of Clinical Research, NIAID
  • Dean Metcalfe, M.D., Chief, Mast Cell Biology Section, Laboratory of Allergic Diseases, NIAID
  • Ian Myles, M.D., M.P.H., Lasker Scholar, Laboratory of Clinical Immunology and Microbiology
  • Luigi Notarangelo, M.D., Chief, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Ken Olivier, M.D., M.P.H., Senior Clinician and Chief, Pulmonary Clinical Medicine Section, NHLBI
  • V. Koneti Rao, M.D., Staff Clinician, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Sergio Rosenzweig, M.D., Ph.D., Chief, Immunology Service, Department of Laboratory Medicine, NIH Clinical Center
  • Rachel Sparks, M.D., M.P.H., Assistant Clinical Investigator, Laboratory of Immune System Biology, NIAID
  • Helen Su, M.D., Ph.D., Chief, Human Immunological Diseases Section, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Gulbu Uzel, M.D., Staff Clinician, Laboratory of Clinical Immunology and Microbiology, NIAID
  • Christa Zerbe, M.D., Director, NIAID Infectious Diseases Clinical Fellowship Program and Staff Clinician, Laboratory of Clinical Immunology and Microbiology, NIAID

Children’s National Medical Center

Johns Hopkins Children’s Center

  • Robert Wood, M.D., Chief, Division of Allergy and Immunology
  • Jennifer Dantzer, M.D.

George Washington University

Volunteer Teaching Faculty

  • Calman Prussin, M.D., Adjunct Teaching Faculty, Laboratory of Allergic Diseases, NIAID
  • Jerry Shier, M.D., Assistant Professor, Johns Hopkins University and George Washington University





portraits of fellows

First Row, First Years: Ozge Aktas, M.D; Ejiofor Ezekwe, M.D., Ph.D.; Ian Lamborn M.D., Ph.D.; Max Norris, M.D. Second Row, Second Years: Stella Hartono, M.D., Ph.D.; Alyssa James, M.D, M.A.; Muhammad Bilal Khalid, M.D.; Chioma Udemgba, M.D. Third Row, Third Years: Sebastian Ochoa, M.D.; Stephanie A. Kubala, M.D.; Fourth Year: Diana Nichols Vinueza, M.D.

Credit
NIAID

We’d love to hear from our former fellows and faculty. Please email us with your current affiliation, position, and research interests, as well as current personal and professional contacts.

AI Fellow Program Graduates

Contact

Edwin J. Mayah, M.H.A., M.B.A., Program Coordinator

There are four positions available each year. Candidates are required to apply through ERAS and are selected through the National Residency Matching Program. The length of the fellowship program is three years; however, fellows may continue their research activities for one or more additional years.

Eligibility Criteria

Qualified candidates must be on track to complete an ACGME-approved residency in internal medicine or pediatrics at the time they enter the program.

Applications are accepted only through ERAS. There are four positions available per year. Candidates should apply for the program in the fall approximately a year and a half prior to entry via the ERAS system. These are the requirements you’ll need to submit:

  • My ERAS application
  • Three letters of recommendation
  • Personal statement
  • Medical school transcript
  • Medical student performance evaluation/Dean’s letter
  • USMLE or COMPLEX transcript
  • ECFMG status report (for international medical graduates only)

Interviews are typically scheduled between August and November.

Contacts

Paneez Khoury, M.D, M.H.Sc.
Program Director, Allergy and Immunology Fellowship Program

Jenna R.E. Bergerson, M.D., M.P.H.
Associate Program Director, Allergy and Immunology Fellowship Program

Edwin J. Mayah, M.H.A., M.B.A.
Program Coordinator, Allergy and Immunology Fellowship Program





Paneez Khoury, M.D., M.H.Sc., Program Director and Edwin Mayah, M.H.A., M.B.A., Program Coordinator

Paneez Khoury, M.D., M.H.Sc., Program Director and Edwin Mayah, M.H.A., M.B.A., Program Coordinator

Credit
NIAID
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