OK, I channeled my general nervousness about the rank list being done into writing down my impressions of programs (because this is what I was always looking for in previous years' threads--hopefully others can add their 2 cents as well). This is from the perspective of a pediatrician looking for an academic career. Honestly, the programs were A LOT more different from each other that I was expecting!
Interview Impressions (in alphabetical order)
Boston Children’s: Peds >> Adults. Big children's hospital.
Lots of immunodeficiency, also lots of inpatient (and ED?) consults for allergy. They have separate Allergy and Immunology inpatient services. There are blocks of covering the Allergy pager + service and the Immunology pager + service. Fellows also cover pediatric Rheumatology, including the inpatient service and call, for 3 months a year. This includes a “Kawasaki Disease” pager. I think this could be interesting if you are someone interested in those immunodeficiency/rheum overlap “immune dysregulation” patients. If I remember correctly, fellows had a lot of involvement in peri- and post-BMT patients. This was one of the places where I wondered if you were being trained to be “an A/I at this particular institution” rather than a general Allergist/Immunologist. Research opportunities (basic, translational, clinical) plentiful with clear funding for 3rd year. Strengths seem to be immunodeficiency and food allergy. Some fellows were also doing research at other institutions in Boston.
CHOP: Peds >> Adults. Big children's hospital.
First year heavy clinically, third year is a “pretending” along with research. Similar to Boston, lots of immunodeficiency in addition to allergy. They have inpatient services—seemed like mostly immunodeficiency but also could admit asthma patients/anaphylaxis obs patients known to the department. Seriously beautiful outpatient facilities. Fellows seemed happy and attendings were friendly. Third year funding seemed guaranteed. Many different research opportunities in immunodeficiency and food allergy (+related conditions), or in collaboration with departments outside A/I. Multiple young faculty who either have K’s or are close to K’s from who graduated from the fellowship.
Children’s Colorado: Peds >> Adults. Big children's hospital.
Due to large catchment area, see pretty good amount of immunodeficiency in addition to doing tons of allergy/food challenges. I don’t think they have an inpatient service. It was unclear from their website whether a third year was even an option but once there at the interview it was clear that this would be an option for folks interested in academic careers. They seem to still be building their research program but it seems like a matter of combining the many resources and patient populations already available. Active/growing programs in food allergy, EoE (with peds GI), immunodeficiency, clinical laboratory A/I. They referenced their “divorce” from NJH a lot, and I think this was not necessary – a lot of folks interviewing probably aren’t super aware of it and I think they could just play to their strengths. Faculty generally friendly and welcoming, program coordinator is awesome, fellows seemed happy.
Cincinnati Children’s: Peds >> Adults. Big children's hospital.
Good at basically everything, but areas of particular expertise/exposure include eosinophilic disease, food allergy, asthma, HLH, immunodeficiencies. I don’t think they have an inpatient team. Consult service seemed active but manageable. Excited about building careers of future fellows. Spend time in a very established, academic-minded private practice. Moving towards having the fellowship be structured as either A) a 2-year experience for people looking for private practice/clinician educator careers B) a 3-4+ year experience for people looking for research-driven careers. Have research programs in areas listed above in addition to an Immunobiology department fellows can work/collaborate with. Fellows seemed happy, faculty were friendly and approachable. Dinner was fun. Paid for hotel.
MGH: Peds = or slightly < Adults? Smaller children's hospital.
One fellow estimated their inpatient consults were probably 20% pediatrics, 80% medicine (with like ½ of the medicine consults being drug allergy). Do >600 drug desensitizations a year but have hired APPs to help with this. Also described having “e-consults” that are handled by 2nd years, 3rd years, and faculty. Said they had implemented these things partly to optimize/improve learning for actual in-person consults. No inpatient service, get NICU/abnormal TRECs consults but no transplants. Tons of opportunities for research, additional degrees that are well-supported by the department. Third year funding essentially guaranteed. Strengths include drug allergy, HAE, food allergy, mechanistic/translational allergy. Working on building the immunodeficiency program. Many (most?) junior faculty members come from the fellowship and it they were well-supported by the department while bridging from fellowship to first grants. Everyone was friendly and fun to meet with – this is a place that does 2 “panel” interviews with you + 3 faculty members in addition to a 1-on-1 interview. Lunch with fellows had 4 out of the 6 in the program in attendance and was a blast.
NIH: Peds* = Adults. Work at some larger children's hospitals.
Exposure to bread-and-butter A/I outside the NIH, crazy weird stuff at the NIH. Clinical training is split between GW (adult), Children’s National (pediatrics—A/I and an NIH attending has an immunodeficiency clinic there), Johns Hopkins (pediatrics—lots of food allergy), and the NIH. At the NIH, you spend 6 weeks on their inpatient service first year and second year supervising a resident team taking care of patients with rare immunologic diagnoses. Spend time in clinic seeing patients on “protocols”. As a pediatrician, one *caveat is that they don’t admit kids under the age of 2-3 (due to the lack of a PICU or Peds ED I think?)—hence the pediatrics experience elsewhere. This was the other place where I wondered if you were being trained to be “an A/I at this particular institution” rather than a general Allergist/Immunologist. There’s been some faculty turnover recently and some of the personalities seem pretty big, but there are awesome opportunities in many areas of A/I including immunodeficiency (duh), eosinophilic disease, mast cell disease, food allergy. The resources for research and clinical work (because you don’t have to worry about insurance) are incredible. Over a three-year fellowship, $60,000 of loans (+taxes) are paid off by the NIH/government.
Northwestern (Lurie/Peds): Peds >>Adults. Big children's hospital.
Strong clinical allergy and immunodeficiency. Good support for fellows who would like research careers through a pretty structured T32. I’m not sure if it’s because it was awkward that several people had not read my application, or because the interviews were in a building far away from the hospital, but this one didn’t stand out as much as I expected it to. I don’t remember a ton of specific things that made it stand out. A fellow specifically mentioned it could be hard to get into translational projects and some are being mentored by faculty who were previously at Northwestern but have moved to other institutions. Most of the labs are on the adult side.
San Diego: Peds = Adults. Big children's hospital.
Strong clinical program, strengths are in HAE, clinical food allergy, eosinophilic esophagitis. Clinical experiences at the University Hospital, the VA, the Children’s Hospital (Rady), I think another adult hospital, an academically-affiliated practice, and Kaiser (sometimes with the editors of JACI: In Practice). I don’t think there’s an inpatient service. Because of the number of NICUs in San Diego and the size of Rady, see plenty of immunodeficiency. Have capability to get WES results in <7 days, don’t transplant yet (send to UCLA) but looking to start a program. Major HAE referral center. Recently have had a lapse in T32 funding – fellows mentioned that more of their clinic time has shifted to the VA due to funding changes. Did seem like with the right project/mentor third year funding was very available. Most active research seemed to be in the areas mentioned above in addition to basic/translational work with allergic effector cells. Faculty were friendly and approachable, fellows seemed happy.
UNC: Peds = Adults. Smaller children's hospital.
Really well-balanced clinical program in terms of adult and peds. Strengths include food allergy (including major clinical trials/translational work and alpha-gal), asthma, environmental effects on lung health. Just hired new faculty member to help immunology program continue to grow. Spend time both in Chapel Hill and in Raleigh (like 20-30 min away) for clinic. No inpatient service. Optional 3-year program with funding for third year. Supportive of fellows running with new ideas for research projects. In addition to the allergy/asthma/lung work above, there are also opportunities to work on A/I projects with GI (one of the fellows was in a GI lab). Collaborative environment. Everyone at UNC was friendly and approachable, fellows seemed happy.
Wisconsin: Peds = Adults. Smaller children's hospital.
Another really well-balanced program age-wise – was pretty neat that the adult and peds clinics are literally next to each other on different hallways in the same building. No inpatient service. Clinically, strong asthma and allergy, less immunodeficiency (one fellow commented that they might not see enough but I’m not sure if I agree after talking to faculty). Strong research in terms of birth cohorts, longitudinal biobanks, resources within the university to do translational work. Fellows attend/are involved in clinical trial meetings. Infrastructure/resources strong enough that fellows (including first year) have posters at AAAAI every year of fellowship. Again, strong research opportunities in large cohort studies of asthma, eosinophils, some mechanistic immunodeficiency and allergy, food allergy. Third year funded by T32. Faculty were great, fellows seemed happy. Paid for hotel.
