Presentation: Immunotherapy (IT) Training in Canada: Current Experience of Fellows-in-Training (World Allergy Congress)

Tuesday, 6 December 2011

Poster Hall (Cancún Center)

Teresa Pun, HBSc, MD, FRCPC , Adult Allergy and Clinical Immunology, Health Sciences Center, University of Manitoba, Winnipeg, MB, Canada

Monika Kastner, PhD , Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

Harold Leeyonge Kim, MD, FRCPC , Department of Medicine, University of Western Ontario, McMaster University, Kitchener, ON, Canada

D. William Moote, MD, FRCPC , Department of Medicine, University of Western Ontario, London, ON, Canada

Susan Waserman, MD, FRCPC , Department of Medicine, McMaster University, Hamilton, ON, Canada

Background:

Allergen immunotherapy (IT) is a key component of allergy practice of allergy. Canadian fellows-in-training have expressed concern that they receive inadequate exposure to IT in their training programs.

Methods:

Canadian fellows-in-training in Allergy and Clinical Immunology, identified through the Canadian Society of Allergy and Clinical Immunology (CSACI), were contacted via email to complete a pilot survey (using survey monkey) to assess their exposure to, experience with, and comfort level in using IT.

Results:

Sixty-nine Canadian fellows-in-training were invited to complete the survey and 16 (23%) completed at least part of the survey. Fifty-four percent of 13 respondents were in their first year of fellowship. Fifty percent of 12 respondents were internal medicine trained. Eighty-three percent of 12 respondents acknowledged exposure to IT during their training. Eighty percent of 10 respondents had previously written a prescription for IT; 71% and 43% of 7 respondents had written 1 to 5 prescriptions for aeroallergen and stinging venom IT, respectively. Only 50% of 12 respondents felt comfortable prescribing IT. The most common reason cited was lack of experience; however, one respondent wrote that he/she would feel uncomfortable prescribing IT without using the standardized hospital IT form. Sixty-seven percent of 12 respondents had previously administered IT to a patient. Sixteen percent of 12 respondents felt uncomfortable administering IT due to lack of experience. Fifty percent of 12 respondents had treated a patient having an allergic reaction to IT and 100% of these same respondents felt "somewhat comfortable" to "very comfortable" in responding to an allergic reaction to IT. Seventy-five percent of 12 respondents agreed that a formal clinical rotation in IT would be helpful.

Conclusions:

The results of this pilot survey demonstrate that Canadian fellows-in-training in Allergy and Clinical Immunology are not receiving adequate exposure and training in IT. Future studies will help to explore this subject in more detail.

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