Clinical Immunology Fellowship

Program Description: The Medical Laboratory Immunology Fellowship at UNC Hospitals is a 2-year training program accredited by the Committee on Post-Doctoral Educational Programs of the American Academy of Microbiology. The UNC program is one of only two accredited programs in the United States. The goal of this program is to provide training and experience in various aspects of medical laboratory immunology sufficient to allow the trainee take the certification examination given by the American Board of Medical Laboratory Immunology. Salary support for the fellow will be based upon the current departmental guidelines. Vacation and an annual fund for travel, books, etc. are provided and the amounts based upon the current departmental guidelines.

Several approaches are employed for the training of fellows:

  1. Hands on experience is a critical component for each of the rotations. Fellows get the opportunity to perform most of the assays in each of the rotations. This provides the opportunity for understanding the technology, quality control/assurance and troubleshooting. Laboratory technologists are a critical component of this training and provide useful insights into the intricacies of performing the assays. This also builds a rapport between the fellow and technologist that fosters more in depth interactions as the Fellow gains experience. After a time, the technologist utilize the fellows as sources of information and assistance in troubleshooting and interacting with clinicians.
  2. Didactic sessions with the faculty of the program. This is particularly important for those areas in which the fellows have little or no background or experience. Basic theory of the testing and appropriate use and interpretation of laboratory tests are covered in these sessions. Dr. Schmitz meets weekly with the trainees to review progress on rotations, provide didactic training and to discuss cases.
  3. Clinical exposure is obtained in a variety of ways by the fellows. Fellows participate daily in clinical rounds with infectious diseases. Arrangement have been made with transplant and allergy/immunology/rheumatology for fellows to attends clinics with program faculty at which they can experience first hand the application and interpretation of the testing the laboratories conduct. Fellows also interact with transfusion medicine faculty on relevant cases. A variety of conferences are open for the fellows to attend. Fellows present 2 cases per year at the Pathology residents report conference. Medicine, Surgery, Pathology and Rheumatology Grand Rounds are also open to trainees.
  4. Training Courses. Two formal courses sponsored by Pathology and Laboratory Medicine and the Hospital Laboratories are attended by the trainees. The diagnostic molecular pathology course is a several week course with didactic and practical laboratory experience. It covers all molecular testing performed in the Hospital labs (microbiology, inherited disease, chimerism, HLA). The second course is the laboratory management course in which Hospital laboratory staff conduct sessions covering many aspects of laboratory management.
  5. Self study. Fellows have access to library services via desk top computer and remotely. Attendance at continuing education activities and national conferences are an important component of training. Fellows receive funds to attend meetings and if presenting can receive further travel support from the Department of Pathology.


TRAINING OBJECTIVES

Infectious Disease Serology, 2 to 3 months:
The fellow will gain hands on experience in performing various serologic methods for the detection of antibodies to bacterial, viral and parasitic pathogens. The fellow will gain experience in the clinical application of these tests by participation in infectious disease rounds, providing consultation to physicians on the selection and interpretation of tests, providing continuing education to laboratory and clinical staff and via didactic sessions with Dr. Schmitz.

Methodologies available for hands on training include ELISA, IFA, Western blot, agglutination, flocculation and instrumentation for ELISA plate handling as well as IFA slide processing. The following tests are currently performed by the Immunology Laboratory:  HIV, HAV, HBV, HCV, EBV, Toxoplasma, CMV, HSV1/2, Syphilis, RMSF, Lyme. Additional tests that will be added in the next year include Ehrlichia.

Allergy/Autoimmune Disease Serology, 2 to 3 months:
The fellow will gain hands on experience in performing various serologic methods for the detection of antibodies to a variety of allergens and autoantigens utilized for the laboratory diagnosis of allergic and autoimmune diseases. The fellow will gain experience in the clinical application of these tests by participating in rounds and clinical conferences with rheumatology staff and to provide consultation to physicians on selection and interpretation of tests and provide continuing education to laboratory and clinical staff.

Flow Cytometry/Cellular Immunology, 3 to 6 months:
The fellow will gain hands on experience in performing flow cytometric immunophenotyping (lymphocyte subset enumeration, immunodeficiency diseases and leukemia/lymphoma phenotyping), and functional assays. Experience in evaluation of cellular immunologic function will also be obtained. The fellow will gain experience in the clinical application of these tests by participation in relevant rounds and clinical conferences and to provide consultation to physicians on selection and interpretation of tests and provide continuing education to laboratory and clinical staff.

Histocompatibility Testing, 2 to 3 months:
The fellow will gain hands on experience in performing cytotoxicity and DNA based HLA typing and antibody screening/crossmatching methods including PCR, cytotoxicity, ELISA and flow cytometric based methods as well as cytotoxicity based crossmatch testing. The fellow will gain experience in the clinical application of these methods by  participating in solid organ and bone marrow transplant rounds and clinical conferences and provide continuing education to laboratory and clinical staff. 

Immunoglobulin Analysis/Molecular Biology, 1 to 2 months:
The fellow will gain hands on experience in the performance of assays for quantitation of immunologlobulins, serum protein electrophoresis and immunofixation. In addition, this rotation will include training in DNA analysis for mutations associated with various inherited diseases and gene rearrangements. 

Laboratory Management:
Experience in laboratory management will be acquired in an ongoing fashion during the 2-year fellowship by interaction with laboratory technical and supervisory and administrative staff. In addition, didactic lectures and discussions pertaining to laboratory safety, accreditation, personnel management, quality control/assurance will be attended by the fellow.

On Call Responsibility:
After sufficient training and documentation of competency, the fellow will participate in the on-call rotation for the serology and cellular immunology laboratories. This will include performance of STAT tests after hours, organ donor infectious disease serologic testing, leukemia/lymphoma phenotyping and consultation for clinical and laboratory staff.

Research:
The fellow will be expected to design, conduct and submit for publication, studies relevant to medical laboratory immunology. These may include but are not limited to commercial test evaluation, new method development, clinical outcome studies. Opportunities for collaboration with other investigators are possible. It is also expected that the fellow attends and presents data at national meetings related to medical laboratory immunology. 

Teaching:
The fellow will be expected to present continuing education lectures to immunology and other hospital laboratory staff. In addition, 2 cases per year will be presented the Pathology Residents Report. Throughout the 2 years of training, cases will also be presented at the weekly laboratory rounds and other conferences as needed. The fellow will also participate in teaching the first-year medical student immunology laboratory section.

Environment:
The Histocompatibility, Flow Cytometry and Clinical Microbiology–Immunology Laboratories of the University of North Carolina Hospitals where the fellows will do the bulk of their training occupy approximately 10,200 square feet of floor space. These laboratories contain state-of-the-art equipment for provision of diagnostic testing services for a large tertiary care hospital and clinics. The laboratories are accredited by the College of American Pathologists. In addition, the Histcompatibility laboratory is also accredited by the American Society for Histocompatibility and Immunogenetics.

The UNC Hospitals have a total of 706 beds and are the primary teaching hospitals for the University Of North Carolina School Of Medicine. There are three hospitals, the Memorial Hospital, Neurosciences Hospital (opened in 1996) and the Women’s and Children’s Hospital (opened in 2002). In Spring 2000, the UNC Health Care System purchased Rex Health Care System which includes a 350-bed hospital in Raleigh, NC, 25 miles from UNC Hospitals. The UNC Hospitals are located on the campus of the University of North Carolina at Chapel Hill. The laboratory supports training programs in Clinical Laboratory Science, Molecular Diagnostics, Clinical Pathology, and Clinical Laboratory Immunology. The Adult Infectious Disease Consult team begins their rounds each day in our laboratories which allows for significant and purposeful interaction with this service. In addition, the CMIL has an open door policy which encourages medical students, residents, fellows, and attending physicians to freely use the laboratory facilities and personnel to assist them, in evaluating their patients. The laboratory directors of the CMIL hold academic appointments in the Departments of Microbiology-Immunology and Pathology-Laboratory Medicine and actively participate in the basic science training of medical students. In addition, other faculty in the School of Medicine actively participate in the training of the fellows in clinical microbiology.

The fellows may freely use the Health Affairs Library which is located adjacent to the hospital. There also are numerous computer workstations available in the library with internet access available to the Fellow. The fellows have free access to electronic journals and have their own computer work station in the fellows office. The internationally recognized UNC School of Public Health is located across the street from the UNC Hospitals. The fellows are encouraged to attend conferences and seminars of interest there.


Applying to the Program:  Applications from US citizens and permanent residents (green card holders) are given preference. Foreign applicants may be considered if they have support from their national government or a non-governmental organization. ONLY COMPLETED APPLICATIONS WILL BE CONSIDERED.

Applicants must submit the following documents to be considered for the fellowship:

  1. Proof of receiving a doctoral level degree. Acceptable degrees include Ph.D., M.D., M.B.B.S., D.D.S., Sc.D., D.V.M., and Dr.P.H. An official transcript from the school granting your degree is usually sufficient.
  2. Three letters of recommendation
  3. A personal statement addressing why you want to receive training in this program
  4. Curriculum vitae

Completed applications are reviewed by program faculty. Applications are judged in part by the strength of letters of recommendation, the quality of the personal statement and how well the careers goals align with the program goals and the applicant’s body of work as outlined in the curriculum vitae. The top candidate(s) will be invited to an onsite interview based upon the review of applications by the program faculty.

   

Program Director: John L. Schmitz, PhD


For additional information, please contact…

Janice Badstein
McLendon Clinical Laboratories
UNC Hospitals
101 Manning Drive
1106 East Wing
Chapel Hill, NC 27514

Telephone: 919-966-2318

Fax: 919-966-6407