Pediatric Allergy &
Immunology Fellowship

Children’s Hospital of Michigan

Excellence in Allergy & Immunology Fellowship Training

The Children’s Hospital of Michigan Allergy/Immunology Fellowship Program has a long history of excellence in care for asthma, allergic and immune deficiency patients. The Children’s Hospital of Michigan is the first children’s hospital in the state of Michigan and the only free-standing children’s hospital in the Metro Detroit region. The main clinical hospital is located in Midtown Detroit. Fellows will see in-patient consultations in the main Children’s Hospital and the other hospitals part of the Detroit Medical Center. Fellows will gain additional ambulatory experiences from various outpatient locations across Metro Detroit.

Our two-year training program is fully accredited by the ACGME and provides balanced training in adult and pediatric. Candidates can be trained in Pediatrics, Internal Medicine, or Med/Peds.

Highlights of our program include:

Major pediatric tertiary referral center in southeast Michigan. The division is the coordinating center for the severe combined immune deficiency newborn screening program for the state of Michigan.

Provide comprehensive clinical training in Allergy/Immunology in adults and pediatric patients, with emphasis on evaluation and management of both Inborn Error of Immunity (IEI) and atopic disorders including food allergy, allergic rhinitis/conjunctivitis, drug allergy, insect sting allergy, urticaria, angioedema, anaphylaxis, eczema, other allergic skin conditions and asthma, and inborn error of immunity.

Electives

Fellows have the opportunity to do electives with a wide variety of other adult and pediatric divisions, including ENT, dermatology, rheumatology, pulmonology and infectious disease.

Research

Fellows have the opportunity to work on high-quality projects in QI, translational, and clinical research. Trainees are expected to present their research projects at national meetings and publish their research.

Time

Dedicated time for direct patient care activities and research/scholarly activities.

Multiple satellite outpatient centers across Metro Detroit to enhance ambulatory training experiences with diverse patient populations and pathology.

Dedicated clinic for immunodeficiency disorders with specialized nursing staff and social worker. Dedicated bone marrow transplant team for severe combined immunodeficiency.

Dedicated high-risk asthma clinic with asthma nurse educators and social worker. The high-risk asthma clinic is supported by a grant from Children’s Hospital Foundation offering medical and psychosocial support to children with severe and/or high-risk asthma. Research studies with emphasis on inner-city asthma are available for trainees.

Children’s Hospital of Michigan Emergency Department Overview

Annual ED Visits

Treatment Spaces

Level-

Pediatric Trauma Center, Pediatric Burn Center

Scholarly Activities

At the Children’s Hospital of Michigan, the Allergy/Immunology scholarly activities are designed to encourage educational experiences and prepare our fellows for the American Board of Allergy and Immunology.

Fellows attend and present at weekly didactic sessions including:

Educational didactic sessions covering the foundations in Allergy and Immunology (joint education session with Children’s Hospital of Michigan and the Henry Ford Health System)
Monthly journal clubs
Monthly Fellows-led evidence based-case discussions
Board review lectures
Procedural competency workshops

Incoming new fellows from Children’s Hospital of Michigan and Henry Ford Health System are provided with a joint boot-camp orientation during their first month of fellowship.

Fellows attend AAAAI/ACAAI Joint Board Certification Review Course (now virtual).

Conferences: Our trainees attend and are encouraged to present at 2 national specialty meetings yearly.

2-day in person patch testing training through the Contact Dermatitis Institute (optional)
Clinical Immunology Society Annual Meeting (optional)

The program is designed to develop a strong foundation in the basic and clinical immunology important to understanding and managing Allergic/Immunologic disorders.

First year fellows are offered a graduate level basic immunology course though Wayne State University.
Our trainees will be proficient in using and interpreting clinical immunologic laboratory testing during the weekly Immunodeficiency continuity clinic and elective rotation in Immunology laboratory at the Detroit Medical Center.

Committee work within the hospital and/or other health organizations is also encouraged.

Sample Fellows Schedule

	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY
AM	IP Consult	R/S	PIDD	R/S	Didactics
PM	OP CC	OP CC	IP Consult	OP CC	R/S

CC: Continuity Clinic
IP: Inpatient
R/S: Research/Scholarly Work
PIDD: Primary Immunodeficiency Clinic
OP: Outpatient

educational curriculum

Clinical Training

Fellows are provided with direct patient care of new and established asthma and Allergy/Immunology patients in the inpatient and outpatient settings.

Pediatric Allergy/Immunology training is provided at the Children’s Hospital of Michigan.
Adult Allergy/Immunology training is provided at the Detroit Medical Center and the Henry Ford Health System.

Inpatient training:

Inpatient clinical training is conducted at the Children’s Hospital of Michigan, Detroit Receiving Hospital, Harper Hospital and Karmanos Cancer Institute.

Outpatient training:

Outpatient clinical training is conducted at multiple Children’s Hospital of Michigan Clinics and the Huron Valley Sinai Hospital.
Some adult outpatient experiences are coordinated with the Henry Ford Health System.
Elective rotations in ENT, dermatology, rheumatology, pulmonology and infectious disease are available in both adult and pediatric specialties.
- Other elective rotations include clinical immunology laboratory and allergen extract preparation.
Fellows will participate in multidisciplinary clinics including an immunodeficiency clinic and a high-risk asthma clinic.
A weekly clinic for drug allergy testing and oral food challenges will provide fellows the opportunity for procedures.

Fellows will gain experience in the areas of asthma, food allergy, allergic rhinitis/conjunctivitis, drug allergy, angioedema, anaphylaxis, insect sting allergy, eczema, urticaria and other allergic skin conditions, and inborn error of immunity.

Fellows will also learn to be proficient in skills important for Allergy/Immunology practice and the American Board of Allergy and Immunology including epicutaneous and intradermal skin testing, pulmonary function testing, allergy immunotherapy preparation and administration, food and drug desensitization and immunoglobulin replacement.

Research Training

Fellows will learn to design and conduct Allergy and/or Immunology research under the supervision of research mentor(s). Research mentors are fellowship program faculty, faculty of Central Michigan University College of Medicine and/or Department of Immunology and Microbiology, Wayne State University. Research resources are available through the Children’s Research Center of Michigan and the Children’s Hospital Foundation.

Under the guidance of their research mentor, fellows will work to complete a research project. During this time, fellows will learn to:

Conceptualize an idea and develop a research protocol
Submit a research protocol to the Institutional Review Boards
Draft and apply for a grant proposal
Develop data collection methods and apply statistical analysis methods in collaboration with our biostatisticians

Fellows are expected to present their research at a national conference and work towards submitting a manuscript to peer-reviewed publications.

Throughout the 2 years, fellows will attend weekly conferences on research methodology and principles of study design. This lecture series on epidemiology, research principle, statistics and clinical trials is provided to all specialty pediatric fellows at the Children’s Hospital of Michigan. This allows A/I fellows to meet the other fellows and provides networking opportunities and encourages collaborative research efforts.

Fellows are also expected to present their progress in the division’s research meetings held on a quarterly basis.

Our Current Fellows

Examples of current fellow abstracts/publications

2024

Pillay, D., Navalpakam, A., Shaulis, R., Rhuehle, M., Hurden, I., Huang, J., Poowuttikul, P. Outcomes of T Cell Receptor Excision Circle (TREC) Based Severe Combined Immunodeficiency (SCID) Newborn Screening (NBS) in Michigan: 10 Year Data. Oral presentation, American Academy for Asthma, Allergy & Immunology Conference, 2024.

Mongkonsritragoon, W., Pillay, D., Huang, J., Poowuttikul, P. Cost Barriers as Factors Associated with Poor Asthma Control in the United States – Findings from Child Asthma Call Back Survey. Poster presentation, American Academy for Asthma, Allergy & Immunology Conference, 2024.

Yamak, O., Pansare, M., Revan R., Thomas R. Likelihood of Admission to Pediatric Intensive care unit (PICU) due to Anaphylaxis: What are Clinical Markers? Poster presentation, American Academy for Asthma, Allergy & Immunology Conference, 2024

2023

Yamak O, Kwiatkowski V, Navalpakam A., Poowuttikul P. “IL6ST Hyper IgE Syndrome: A Case Series of Three Related Family Members with Identical Mutations and Variable Presentations.” Poster presentation, American Academy for Asthma, Allergy & Immunology Conference, 2023.

Kwiatkowski V, Navalpakam A., Poowuttikul P. “Idiopathic Hypereosinophilic Syndrome Diagnosed in an Infant: A Case Report.” Poster presentation, American Academy for Asthma, Allergy & Immunology Conference, 2023.

2022

Yamak O, Poowuttikul P, Navalpakam A. “A Unique presentation of GATA2 deficiency, Emberger Syndrome” Poster Presentation, American College of Allergy Asthma and Immunology, 2022.

Navalpakam A, Poowuttikul P. “Immune profiles in Inner-city Asthmatic Children Receiving Frequent Systemic Steroids”. Poster Presentation, American Academy for Allergy, Asthma & Immunology, 2022.

Navalpakam A, Thanaputkaiporn N, Poowuttikul P. Management of anaphylaxis. Immunol Allergy Clin North Am. 2022 Feb;42(1):65–76.

2021

Navalpakam, A., Poowuttikul, P. B cell Deficiency. Massoud Mahmoudi, Absolute Allergy and Immunology Board Review Book (1st Edition) by Springer Publisher. Accepted for Publication June 2021.

Navalpakam A, Secord E, Pansare M. The impact of COVID -19 on Pediatric Asthma in the United States. Pediatric Clinics of North America. 2021.

Kwiatkowski V, Thanaputkaiporn N, Poowuttikul P. NFKB2 Mutation in 2 Siblings with DAVID Syndrome and CVID with Variable Presentations. Journal of Allergy and Clinical Immunology. 2022;149(2):AB27. doi:10.1016/J.JACI.2021.12.123

Frey SM, Goldstein NPN, Kwiatkowski V, Reinish A. Clinical outcomes for young children diagnosed with asthma versus reactive airway disease. Academic Pediatrics. Published online June 18, 2021. doi:10.1016/J.ACAP.2021.06.009

Navalpakam, A., Saini, S., Seth, D., Huang, H., Poowuttikul, P. A Quality Improvement Initiative to Improve Resident- Physician Practices Regarding Flu Vaccine Administration in Individuals with Egg Allergy. Journal of Allergy and Clinical Immunology Mar 2021; Vol. 147; Supplement 2, Page AB99.

Saini, S., Navalpakam, A. ,Seth, D., Huang, H., Poowuttikul, P. A Quality Improvement Initiative to Improve Resident-Physician Practices Regarding Peanut Introduction in Infancy. Journal of Allergy and Clinical Immunology Mar 2021; Vol. 147; Supplement 2, Page AB101.

Secord, E., Poowuttikul, P., Pansare, M., Seth, D., Saini, S. Pediatric Emergency Visits for Asthma Drop Significantly with COVID19 School Closure. Journal of Allergy and Clinical Immunology Mar 2021; Vol. 147; Supplement 2, Page AB150

2020

Saini, S., Huang, J., Seth, D., Secord, E., Poowuttikul, P. Pulmonary Sclerosing Hemangioma in a Young Adult with Coexisting 22q11.2 deletion, Evans Syndrome and CVID with MALT1 variant. Journal of Allergy and Clinical Immunology Mar 2020. Case Report Posters IIopens in a new tab.

Huang, J., Kaur, B., Farooqi, A., Miah, T., McGrath, E., Seth, D., Secord, E., Poowuttikul, P. Elevated Glycated Hemoglobin Is Associated with Reduced Antibody Responses to Vaccinations in Children. Pediatr Allergy Immunol Pulmonol. Accepted for publication Nov 20.

2019

Huang J, Pansare M. New Treatments for Asthma. Pediatr Clin North Am. 2019;66(5):925‐939. doi:10.1016/j.pcl.2019.06.001

Kothari M, Huang, J, Hancock U, Beydoun S, Seth D, Secord E, Poowuttikul P. Visual Recognition of Asthma Medication in Inner City Asthma Children and Caregivers. Annals Of Allergy, Asthma and Immunology Nov 2019; Vol.123, Issue 5, Supplement 1, S7.

Huang J, Saini S, Poowuttikul P, Seth D, Secord E. Abnormal T-cell Excision Circles Newborn Screening Test In An Infant Following Exchange Transfusions. Annals of Allergy, Asthma and Immunology Nov 2019; Vol.123, Issue 5, Supplement 1, S122

Saini S,Pansare M. New Insights and Treatments in Atopic Dermatitis. Pediatr Clin North Am. 2019;66(5):1021‐1033. doi:10.1016/j.pcl.2019.06.008

Poowuttikul P, Saini S, Seth D. Inner-City Asthma in Children. Clin Rev Allergy Immunol. 2019;56(2):248‐268. doi:10.1007/s12016-019-08728-x

Huang J, Kaur B, Seth D, Pansare M, Kamat D, McGrath E, Secord E, Poowuttikul P. Can Obesity Alter the Immune Response to Childhood Vaccinations? Journal of Allergy and Clinical Immunology Feb 2019; Vol.143; Supplement 2, Page AB299

Applying to our program

Our Allergy/Immunology fellowship program accepts applications through the Electronic Residency Application Service (ERAS) only and participates in the National Resident Matching Program (NRMP). Applications are accepted from July through October.

Candidates should provide USMLE scores, COMLEX scores if applicable, personal statement, dean’s letter, medical school transcripts, ECFMG Certificate if applicable, and at least 3 letters of recommendation through ERAS.

We are committed to a policy of nondiscrimination and equal opportunity for all candidates. We accept osteopathic graduates and COMLEX scores, however having USMLE scores is encouraged. We accept International Medical Graduates and sponsor J1 VISAs. Applicants have to be trained in the U.S. or Canadian pediatric or internal medicine or Med/Peds Residency Program.

fellowship program Contacts

Pavadee Poowuttikul, MD, FAAAAI

Program Director

Children’s Hospital of Michigan
Pediatric Education
3901 Beaubien Blvd.
Detroit, MI 48201

P: (313) 745-5751
Fax: (313) 993-7118
Ppoowutt@dmc.org

Dionne Weathers, MHA

Program Coordinator

Children’s Hospital of Michigan
Pediatric Education Office, 3rd Floor Main Hospital, 3T72
3901 Beaubien
Detroit, MI 48201

(313) 745-5751
dweather@dmc.org

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Pediatric Allergy & Immunology Fellowship