Information for Elective Trainees
- Dr. Samira Jeimy, Training Program Director, Samira.Jeimy@lhsc.on.ca
- Ashley Dolgos, Program Administrator, Ashley.Dolgos@sjhc.london.on.ca
- Interim coverage provided by Holly Vandermeulen until September 30, 2020: Holly.Vandermeulen@sjhc.london.on.ca
Scope of Clinics
Referral requests to our clinic commonly address the following areas. If you have any particular areas of interest in Allergy/Immunology or if you have specific objectives you would like to address during your rotation, please make us aware as early as possible so we may try to accommodate your learning objectives.
- Allergies: Food, Environmental, Venom, and Drug.
- Respiratory Conditions: Asthma and allergic respiratory disorders. Includes multidisciplinary asthma clinics.
- Dermatologic Disorders: Urticaria/Angioedema, Contact Dermatitis, Eczema, including patch testing
- Immunologic Disorders: Immunodeficiencies and Autoinflammatory disorders
- Allergic/Immunologic Therapies: Immunotherapy (aeroallergen, venom, and food), IVIG/SCIG, and Biologics
A typical day consists of clinics from 9 am to 5 pm. All the clinics are located at St. Joseph’s Healthcare London, 3rd floor, B-wing, in the Allergy clinic area. There are one to two staff in clinic each day, and you will be scheduled with one staff for the day.
You will be exposed to a broad range of both adult and pediatric patients with diseases relevant to the practice of Clinical Immunology and Allergy. It is expected that by the end of this rotation, you will have developed a multi-disciplinary team approach to patients affected by these disorders.
This will include:
- Eliciting a history, including relevant information that is concise, accurate and appropriate to the patient’s chief complaint (e.g. food, inhalant and venom allergy, immunodeficiency, acute and chronic urticaria, anaphylaxis, drug hypersensitivity, and contact hypersensitivity).
- Describing the pathophysiology, signs, and symptoms of allergic and immunologic diseases.
- Developing a differential, an appropriate plan for investigation, and management of specific allergic or immunologic problems.
- Applying knowledge and expertise to performance of technical/interpretation skills relevant to Clinical Immunology and Allergy. These will include skin prick testing, patch testing, pulmonary function tests, immunotherapy, immunoglobulin replacement, physical urticaria testing, oral challenges, and drug desensitization.
- Demonstrating the proper administration and use of medications, including epinephrine auto-injectors, asthma inhalers, and intranasal corticosteroids.
- Demonstrating a working knowledge of basic and clinical science topics at a level appropriate for stage of training.
- Demonstrating knowledge of at-risk patients within the discipline of Clinical Immunology and Allergy and advocating on their behalf.
- Resident Rounds: All off-service residents will prepare a presentation on an allergy or immunology topic of their choice. The topic should be something that interests you. You will be informed of the date on your schedule.
- Case Rounds: These are intended to be patient-centered roundtable discussions regarding a clinical problem. The trainee will present the case and relevant investigations (please bring your consult note and any additional data). These will occur 1-2 times per month. You will be notified of the date in advance.
- Journal Club: Our Journal Club is held on a Thursday evening (6:30 - 8 PM). Your attendance is optional, although we encourage you to attend.
- Clinical/Basic Sciences Rounds: On the last Friday of the rotation, rounds are held at 7:45 am in SJH B3-105.
- Academic Half Day: This is intended for core trainees only and occurs on Wednesday afternoons. You will attend your own scheduled academic half day.
Call and Days Away
As an elective trainee, you will not be required to participate in Clinical Immunology and Allergy call. However, you may be required to participate in call for your home program. Please let us know (well in advance of your start date) any post-call dates, approved absences and vacation dates as per PARO guidelines. In the case of illness or if you will not be attending a clinic on a given day, please email Jhasna Bermudez (email below), the Chief resident and the relevant attending staff.
- Canadian Society of Allergy and Clinical Immunology
- High yield review papers from AACI journal
- CSACI Immunotherapy Manual
- Commonly prescribed inhalers and nasal corticosteroids
- Food Allergies
- Approach to Immunodeficiency
- ACAAI /AAAAI Practice Parameters
Organized, clear, and succinct consult notes, dictated in a timely manner, are paramount to ensure optimal patient management. The letter is an important tool for communicating your findings and recommendations to the referring physician. Please refer to the consultation and dictation templates that are available in the clinic. There are some Allergy/Immunologic specific subheadings that you may not use typically. If you have any questions, please ask the Chief resident, or the attending with whom you are in clinic.
Interested in research? If you are interested in becoming involved in a research project, please discuss this with the faculty.
Assessment and Feedback
Because the attending physicians work in clinic on different days, unless otherwise specified, exit evaluations (ITERs) will be done in person by the last attending on with you during the last day of your rotation. Please remind us at least 4 days prior to the end of the rotation. All evaluations will be done based on feedback from all the attendings, who will observe selected patient encounters and review your case presentations and consult notes. It is your responsibility to ensure that any interim evaluations (e.g., mid-rotation evaluations) have been completed by that point in time.
Who to contact with questions
- Please email Ashley Dolgos if you have any concerns about scheduling or administrative details. Interim coverage provided by Holly Vandermeulen until September 30, 2020. Please carbon copy the Chief resident on your emails.
- Please contact the Chief resident if you require any additional information about the rotation.
We look forward to working with you.