Welcome

This is primarily a research fellowship for studying mechanisms of severe asthma with out-patient clinical training (1-2 half-day clinics a week) in the management of airway diseases such as severe asthma, COPD and chronic cough using inflammometry. This involves quantitative sputum cytometry, exhaled breath measurements and metabolomics and measurements of airway hyperresponsiveness. In addition, there is opportunity to participate in the evaluation of patients with eosinophilic disorders in two unique multidisciplinary clinics with haem-oncology (for patients with HES) and rheumatology (for patients with EGPA). The training will provide opportunities for training in research methodology, basic bench research and clinical trials in severe asthma and COPD, use of biologics, bronchial thermoplasty, advanced imaging techniques such as noble gas MRI and quantitative CT, and interaction with collaborators in molecular microbiology and virology, immunology, allergy, otolaryngology, radiology, haem-oncology and rheumatology. There would not be any in-patient or on-call responsibilities.

Entry Requirements

CV, 3 reference letters

Specialist training in Respirology or Allergy/Immunology (preferably 3 years post-training for overseas applicants), educational license with CPSO

Program Objectives

The objectives of the program are as follows:

• Training in out-patient evaluation and management of patients with a range of complex, airway diseases (including severe asthma, COPD, refractory cough, bronchiectasis) (one-two half-days a week).
• Training in the use and interpretation of measurements of airway responsiveness (to direct and indirect stimuli), airway inflammation (sputum, exhaled nitric oxide, exhaled breath condensate), and novel airway imaging (CT and functional MRI) in the management of airway diseases.
• Training in the use of biologics, and assessment for bronchial thermoplasty for severe asthma.
• Bench training in basic translational immunology as it applies to the management of complex airway diseases, particularly severe asthma and severe COPD.
• Training in health research methodology to develop and conduct clinical trials or observational studies in airway diseases. The trainee will be primarily responsible for one to two research projects.
• To provide a general understanding of molecular and cell biology, immunopathology and pharmacology of airway diseases by attending research and clinical respirology rounds, allergy & immunology rounds, journal clubs and symposia at the Firestone Institute of Respiratory Health and national and international conferences. The trainee is expected to contribute to these academic events by presenting data from his/her research. The training is expected to provide the ability to publish in high-quality scientific journals and attract peer-reviewed grants.
• The expectation is a minimum/year of fellowship of 1 first author and 2 co-author publications in journals with an impact factor of at least 3.0

Length of Training

One year (renewable for a second year)

Funding

At the level of a CIHR post-doctoral fellowship ($50,000+ benefits). Self-funded or funded from research grants

Supervision & Feedback

The following criteria are used for 3 monthly assessments

• 3 months: ability to develop research protocols, prepare Research Ethics Board Submissions, privacy regulations, Familiarity with Health Canada Submissions, Familiarity with publications from our lab related to asthma, COPD, inflammometry, able to assess patients with severe asthma, severe COPD, patients with recurrent exacerbations, and use inflammometry to manage them
• 6 months: participate in at least one manuscript as co-author, learn basic lab methods including sputum cytometry, and to perform independently basic tests such as skin prick, spirometry, methacholine provocation, and sputum induction, be familiar with all research administrative processes, maintain databases.
• 9 months: participate in at least two manuscripts as co-author, independently manage patients with complex airway diseases, be confident to choose the appropriate biologic, interpret results of advanced airway imaging., identify patients who may benefit from thermoplasty.
• 12 months: have initiated at least one project that candidate is primarily responsible for, recruited subjects for this study, be confident to independently manage exacerbations of severe asthma, copd, refractory cough, handle consultations from other specialists, and have participated in at least 3 clinics each of pulmonary vasculitis (EGPA) and hypereosinophlic syndromes.

Associated Programs