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Accelerated Research Pathway Allergy-Immunology

GENERAL INFORMATION

The Accelerated Research Pathway Allergy-Immunology (ARP-A-I) is designed to accommodate and encourage candidates who are committed to an academic career as physician scientists with a strong research emphasis in allergy-immunology. This pathway is not intended to be the only route to accomplish such a goal but provides flexibility and additional time for research training during the subspecialty fellowship without lengthening training beyond six years. Candidates entering the ARP may begin subspecialty training after completion of two years of general comprehensive pediatric training. A structured curriculum and close observation of the progress of the trainee during the core general pediatrics training is essential.  The length of subspecialty fellowship will be a minimum of four years. The availability of this pathway in any particular program will be at the discretion of the general pediatrics program director/allergy-immunology fellowship program director. Although it may be advantageous for both general pediatrics and allergy-immunology training to occur in the same institution, this is not a requirement of the pathway. If training does occur in the same institution, it is advisable for the general pediatrics program director and the allergy-immunology program director to work in concert in monitoring the progress of the trainee.

  1. There will be no specific eligibility criteria with the exception that candidates must be committed to an academic career with a strong research emphasis in allergy-immunology.
  2. Candidates for this pathway should be identified early, preferably prior to the start of the PL-1 year but no later than nine months into the PL-1 year. This is necessary so that the second year of training can be adapted in such a way that specified curricular requirements in general pediatrics will be met.
  3. The program directors and candidate will be required to seek prospective approval by the ABP and the American Board of Allergy-Immunology (ABAI). A plan for the training must be submitted to both Boards by May of the PL-1 year. The Boards will approve individuals and not training programs.
  4. Whether a trainee may remain in the pathway will depend on the assessment of the general pediatrics program director who will be required to verify competence at the end of two years of core training. The program director must be able to attest that trainee performance has been satisfactory and the curricular requirements have been met. The ABP suggests that the program director utilize the In-training Examination results at the beginning of the PL-2 year as a measure of medical knowledge competence.  A score at or above the mean of general pediatrics trainees nationwide would provide objective evidence of acquisition of knowledge commensurate with length of training.
  5. Planning and oversight of the Accelerated Research Pathway will require that the training be based in an institution that has a department of pediatrics that trains other pediatric subspecialists and has the infrastructure and faculty to support scholarly activity.   

 

GENERAL PEDIATRICS RESIDENCY TRAINING REQUIREMENTS

The training should be the same as described in the ACGME Program Requirements for Graduate Medical Education for Pediatrics as outlined in this document with the exceptions that follow.

The curriculum must include 2 years of clinical experiences.  Vacation leave, or other absences from training cannot exceed two months during these 2 years.

The clinical experiences should be organized in educational units.  An educational unit should be a block (four weeks or one month) or a longitudinal experience.  An outpatient educational unit should be a minimum of 32 half-day sessions and an inpatient educational unit should be a minimum of 200 hours.  

The specific curricular elements are detailed in the following chart: 

Requirements in General Pediatrics for 

Training in Pediatrics for those in the Accelerated Research Pathway

(effective July 2013)

Component

Educational Unit*

Emergency Medicine & Acute Illness

3 (with at least 2 in ED)

Developmental-Behavioral Pediatrics

1

Adolescent Medicine

1

Term Newborn

1

Inpatient Pediatrics (non-ICU)

5 (no maximum)

Ambulatory Experiences to include community pediatrics and child advocacy

2

NICU

2

PICU

2

**Additional Subspecialty

4 (minimum)

*(Educational Unit = 4 weeks or 1 month OR outpatient longitudinal experience of 32 half day sessions OR inpatient longitudinal experience of 200 hours)

**Additional Subspecialty includes 3 units from 3 different subspecialties from the following list:

  • child abuse
  • medical genetics
  • pediatric allergy and immunology
  • pediatric cardiology
  • pediatric dermatology
  • pediatric endocrinology    
  • pediatric gastroenterology
  • pediatric hematology-oncology
  • pediatric infectious diseases
  • pediatric nephrology
  • pediatric neurology
  • pediatric pulmonology
  • pediatric rheumatology

Additional 1 unit of single or combined subspecialties from the list above or below:

  • child and adolescent psychiatry
  • hospice and palliative medicine
  • neurodevelopmental disabilities
  • pediatric anesthesiology
  • pediatric dentistry
  • pediatric ophthalmology
  • pediatric orthopaedic surgery  
  • pediatric otolaryngology
  • pediatric rehabilitation medicine
  • pediatric radiology
  • pediatric surgery
  • sleep medicine
  • sports medicine

Subspecialty Experience
Educational experiences in the subspecialties must emphasize the competencies and skills needed to practice general pediatrics of high quality in the community.  They should be a blend of inpatient and outpatient experiences and prepare residents to participate as team members in the care of patients with chronic and complex disorders.

Supervisory Responsibility
At least 3 educational units of supervisory responsibility must be completed during the 2 years of training.  

Continuity Clinic
There must be a minimum of 36 half-day sessions per year of a longitudinal outpatient experience in a continuity clinic at a pediatric primary care site throughout the 2 years of general pediatrics training.  The sessions must not be scheduled in fewer than 26 weeks per year.   The patients should include those previously cared for in the hospital, well children of various ages, and children of various ages with special health care needs and chronic conditions. Residents must have a longitudinal general pediatrics outpatient experience in a setting that provides a medical home for the spectrum of pediatric patients and must care for a panel of patients that identify the resident as their primary care provider.    

The medical home model of care must focus on wellness and prevention, coordination of care, longitudinal management of children with special health care needs and provide a patient- and family-centered approach to care.   

Individualized Curriculum
There is no expectation of an individualized curriculum, but it is acceptable for a resident to complete electives appropriate for their career pathway.  

                                       

ALLERGY-IMMUNOLOGY FELLOWSHIP TRAINING REQUIREMENTS
    
Subspecialty training must be at least four years in duration and incorporate Scholarly Activity as required of the pediatric subspecialties overseen by the ABP.  A minimum of one year of clinical training is required with at least 6 months spent directly caring for children.  All trainees will be expected to participate in a core curriculum in scholarly activity skills (eg, study design, statistics, principles of evidence-based medicine, manuscript preparation, biomedical ethics, educational techniques).  The establishment of a Scholarship Oversight Committee and a written work product will be required.  The written work product must be provided to the ABAI as a prerequisite for certification.  Trainees will be required to meet the same standards for scholarly achievement as defined for those in the standard three-year subspecialty fellowship training programs leading to certification by the ABP. (See the General Eligibility Criteria for Eligibility in the Pediatric Subspecialties.) 
    
    
ELIGIBILITY FOR CERTIFICATION
    
To meet the eligibility requirements for certification in general pediatrics, the trainee must satisfactorily complete two years of core general pediatrics training and an additional year (1 year of clinical experience) in the allergy-immunology fellowship.  The year of clinical training must incorporate 6 months of direct care of children. Verification of clinical competence and training will be required from both the general pediatrics program director and the allergy-immunology training program director.  
    
Eligibility to take the allergy-immunology certifying examination will require completion of six years of total training (two years of general pediatrics and four years of allergy-immunology training).  The allergy-immunology program director will be required to verify training dates, as well as clinical and research competence to the ABAI.  
    
Approved by ABP 2016
Approved by ABAI 2016