Kelly D. Stone, M.D., Ph.D., Program Director
Dean D. Metcalfe, M.D., Associate Program Director
Overview
NIAID offers a three-year, ACGME-accredited training program in allergy and immunology. This program, open to physicians who are well-grounded in clinical internal medicine or pediatrics, is designed to provide trainees with the high-quality clinical and laboratory skills that will enable them to pursue careers in academic medicine.
Structure of the Clinical Training Program
The majority 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 National Institutes of Health (NIH) Clinical Center (outpatient clinics, inpatient ward, allergy and immunology consultation service, and pulmonary function lab), the Walter Reed Army Medical Center (WRAMC), the Children's National Medical Center, the Johns Hopkins Pediatric Allergy Clinic, and a local practice.
Patients seen at NIH under research protocols have a wide variety of disorders, including allergic diseases, asthma, inherited and acquired immunodeficiencies, mast cell disorders (including mastocytosis), idiopathic eosinophilias, autoimmune diseases, and HIV/AIDS. In addition, fellows in training are the allergy and immunology consultants for the NIH Clinical Center and rotate through the NIH diagnostic immunology laboratory, the pulmonary function laboratory in the National Heart, Lung and Blood Institute (NHLBI), and the NHLBI adult asthma clinic.
In the second year, fellows are engaged in both clinical care (limited continuity clinics and consultation service) and in research. The third year of training is devoted exclusively to research. Fellows have the option, with approval, for a fourth and occasionally a fifth year of research training.
Fellows also receive broad instruction in allergic and immunologic disorders and attend conferences designed to prepare trainees for the American Board of Allergy and Immunology (ABAI) examination. Conferences include a basic and clinical immunology lecture series, case conferences, journal clubs, and NIAID Grand Rounds. Fellows are generally fully qualified to take the ABAI certification examination after two years in the program.
Structure of the Research Training Program
The core of this clinical fellowship program is the effort devoted to research training and performance of original basic, translational, and/or clinical research. Fellows work under the direct supervision and mentorship of senior NIAID investigators. The research experience is characterized by close daily 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 work and/or perform clinical research in the laboratory 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 vary from clinical to the most basic aspects of cell and molecular biology. Trainees have pursued research projects in the following areas:
- The biology of the mast cell, basophil, and eosinophil
- 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 immunodeficiency disorders
- Biology and treatment of systemic mastocytosis
- The role of antibody and cellular immune systems in inflammation and autoimmunity
- The function of cellular receptors for immunoglobulin, cytokines, and matrix components
- The basis of mucosal immunity
- Humoral and cellular immunoregulation and immunoregulatory defects
- The biology of polymorphonuclear leukocytes, monocytes, and macrophages
- Aspects of the pathogenesis of HIV
- Vaccine immunology
Program Faculty and Research Interests
Representative NIH Clinical and Research Faculty
- Melody Carter, M.D., Staff Clinician, Laboratory of Allergic Diseases
- Anthony Fauci, M.D., Director, NIAID, and Chief, Laboratory of Immunoregulation
- Thomas Fleisher, M.D., Chief of Laboratory Medicine, NIH Clinical Center
- John Gallin, M.D., Director, NIH Clinical Center, and Chief, Clinical Pathophysiology Section, Laboratory of Host Defenses
- Steven Holland, M.D., Chief, Laboratory of Clinical Infectious Diseases
- Ashish Jain, M.D., Chief, Clinical Immunology Unit, Laboratory of Host Defenses
- Amy Klion, M.D., Chief, Eosinophil Pathology Section, Laboratory of Parasitic Diseases
- Hirsh Komarow, M.D., Staff Clinician, Laboratory of Allergic Diseases
- Clifford Lane, M.D., Clinical Director, NIAID, and Chief, Clinical and Molecular Retrovirology Section, Laboratory of Immunoregulation
- Stewart Levine, M.D., Chief, Lung Inflammation Section, NHLBI
- Harry Malech, M.D., Chief, Laboratory of Host Defenses
- Dean Metcalfe, M.D., Chief, Laboratory of Allergic Diseases
- Jo Ann Mican, M.D., Staff Clinician, Division of Clinical Research
- Joshua Milner, M.D., Chief, Allergic Inflammation Unit, Laboratory of Allergic Diseases
- Thomas Nutman, M.D., Deputy Chief, Laboratory of Parasitic Diseases
- William Paul, M.D., Chief, Laboratory of Immunology
- Calman Prussin, M.D., Chief, Lymphocyte Biology Unit, Laboratory of Allergic Diseases
- Koneti Rao, M.D., Chief, ALPS Unit, Laboratory of Clinical Infectious Diseases
- Helene Rosenberg, M.D., Ph.D., Chief, Inflammation Immunobiology Section, Laboratory of Allergic Diseases
- Ethan Shevach, M.D., Chief, Cellular Immunology Section, Laboratory of Immunology
- Kelly Stone, M.D., Ph.D., Director, Allergy and Immunology Clinical Training Program, Laboratory of Allergic Diseases
- Warren Strober, M.D., Chief, Mucosal Immunity Section, Laboratory of Host Defenses
- Helen Su, M.D., Ph.D., Chief, Human Immunological Diseases Section, Laboratory of Host Defenses
- Gulbu Uzel, M.D., Staff Clinician, Laboratory of Clinical Infectious Diseases
- Todd Wilson, D.O., Staff Clinician, Laboratory of Allergic Diseases
Faculty at Affiliated Training Sites
- Michael Nelson, M.D., Ph.D., Chief, Department of Allergy and Immunology, Director, Allergy and Immunology Training Program, WRAMC
- Cecilia Mikita, M.D., Associate Director, Allergy and Immunology Training Program, WRAMC
- Naynesh Kamani, M.D., Division of Blood and Marrow Transplantation and Immunology, Children’s National Medical Center
- Brett Loechelt, M.D., Division of Blood and Marrow Transplantation and Immunology, Children’s National Medical Center
- Hemant Sharma, M.D., M.H.S., Division of Immunology, Children’s National Medical Center
- Robert Wood, M.D., Chief, Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine
- Elizabeth Matsui, M.D., Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine
- Michael Kaliner, M.D., Institute for Asthma and Allergy
- Mark Scarupa, M.D., Institute for Asthma and Allergy
Examples of Papers Authored by Program Fellows and Faculty
- Zhang Q, Davis JC, Lamborn IT, Freeman AF, Jing H, Favreau AJ, Matthews HF, Davis J, Turner ML, Uzel G, Holland SM, Su HC. Combined immunodeficiency associated with DOCK8 mutations. N Engl J Med. 361(21):2046-55 (2009).
- Vinh DC, Patel SY, Uzel G, Anderson VL, Freeman AF, Olivier KN, Spalding C, Hughes S, Pittaluga S, Raffeld M, Sorbara LR, Elloumi HZ, Kuhns DB, Turner ML, Cowen EW, Fink D, Long-Priel D, Hsu AP, Ding L, Paulson ML, Whitney AR, Sampaio EP, Frucht DM, DeLeo FR, Holland SM. Autosomal dominant and sporadic monocytopenia with susceptibility to mycobacteria, fungi, papillomaviruses, and myelodysplasia. Blood. 115(8):1519-29 (2010).
- De Ravin SS, Cowen EW, Zarember KA, Whiting-Theobald NL, Kuhns DB, Sandler NG, Douek DC, Pittaluga S, Poliani PL, Lee YN, Notarangelo LD, Wang L, Alt FW, Kang EM, Milner JD, Niemela JE, Fontana-Penn M, Sinal SH, Malech HL. Hypomorphic Rag mutations can cause destructive midline granulomatous disease. Blood. 116(8):1263-71 (2010).
- Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, Leiferman KM, Nutman TB, Pfab F, Ring J, Rothenberg ME, Roufosse F, Sajous MH, Sheikh J, Simon D, Simon HU, Stein ML, Wardlaw A, Weller PF, Klion AD. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 124(6):1319-25 (2009).
- Prussin C, Lee J, Foster B. Eosinophilic gastrointestinal disease and peanut allergy are alternatively associated with IL-5+ and IL-5(-) T(H)2 responses. J Allergy Clin Immunol. 124(6):1326-32 (2009).
- Bansal G, Xie Z, Rao S, Nocka NH, Druey KM. Suppression of immunoglobulin E-mediated allergic responses by regulator of G-protein signalling 13. Nature Immunol. 9(1): 73-8 (2008).
- Arthos J, Cicala C, Martinelli E, Macleod K, Van Ryk D et al. HIV-1 envelope protein binds to and signals through integrin alpha4beta7, the gut mucosal homing receptor for peripheral T cells. Nature Immun. 9(3): 301-9 (2008).
- Milner JD, Brenchley JM, Laurence A, Freeman AF, Hill BJ et al. Impaired T(H)17 cell differentiation in subjects with autosomal dominant hyper-IgE syndrome. Nature. 452(7188): 773-6 (2008).
- Akin, C, Scott LM, Kocabas CM, Kushnir-Sukhov N, Brittain E, Noel P, Metcalfe DD. Demontration of an aberrant mast-cell population with clonal markers in a subset of patients with “idiopathic” anaphylaxis. Blood. 110(7): 2331-3 (2007).
- Holland SM, DeLeo FR, Elloumi HZ, Hsu AP, Uzel G et al. STAT3 mutations in the hyper-IgE syndrome. N Engl J Med. 357(16): 1608-19 (2007).
Representative Recent Program Graduates
- Cem Akin, M.D., Ph.D., Assistant Professor, Brigham and Women’s Hospital
- Princess Ogbogu, M.D., Assistant Professor, Ohio State University
- Julie Ledgerwood, D.O., Deputy Chief, Clinical Trials Core, Vaccine Research Center, NIAID
- Stefano Luccioli, M.D., Center for Food Safety and Applied Nutrition, Food and Drug Administration (FDA)
- Ashish Jain, M.D., Tenure Track Scientist, NIAID
- Helen Su, M.D., Ph.D., Tenure Track Scientist, NIAID
- Joshua Milner, M.D., Tenure Track Scientist, NIAID
- Todd Wilson, D.O., Staff Clinician, NIAID
- Brian Porter, M.D., Ph.D., Medical Officer, Division of Pulmonary, Allergy, and Rheumatology Products, FDA
- Jennifer Heimall, M.D., Assistant Professor, Children’s Hospital of Philadelphia
- Benjamin Soule, M.D., Assistant Professor, University of Pennsylvania
Application Information
The 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 two years.
Candidates are selected through the National Residency Matching Program. There are two to 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.
Applications must contain the following:
- 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)
Applicants must be on track to complete an ACGME-approved residency in internal medicine or pediatrics at the time they enter the program. Interviews are held between December and April.