Educational Curriculum

At the Children’s Hospital of Michigan, our fellowship training program prepares fellows to be qualified for the American Board of Allergy and Immunology. Graduates will be prepared to pursue future careers in academic medicine or subspecialty clinical practice.

Fifty percent of the 2-year program is devoted to direct patient care activities, with 65-70% pediatrics and 30-35% adult cross-training. At least 25% of the program is devoted to scholarly activities and research.

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 a 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 primary immunodeficiency.

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.

Examples of current fellow abstracts/publications:

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

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.

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.

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

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 II.

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.

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