Pediatric Pulmonology fellowship

Our Accreditation Council for Graduate Medical Education (ACGME)-approved pediatric pulmonology fellowship-training program attracts promising pediatric candidates for subspecialty clinical and research training. Our goal is to develop the next generation of academic pulmonologists.

Clinical training is emphasized during the first year of the fellowship, with research training intermingled so that the scholarly approach is incorporated into the fellow’s education early in the process. Overall, clinical training accounts for a total of twelve months of the fellowship, with six to seven months of clinical service or elective time the first year of training, and the remaining five to six months total during the final two years. There are non-service rotations that are required parts of clinical training, including Pediatric Pulmonary Function Laboratory and Pediatric Sleep Laboratory, during the first year.

Our fellows care for children with wide-ranging lung diseases and breathing disorders, such as asthma, sleep-disordered breathing, apnea, central hypoventilation, cystic fibrosis, ciliopathies, bronchiectasis, interstitial lung diseases, bronchopulmonary dysplasia, bronchiolitis, pneumonia, chronic respiratory insufficiency, thoracic tumors and congenital lung anomalies during their clinical rotations. Because Washington University has an active pediatric lung transplantation service, fellows are exposed to the pre-operative evaluation and post-operative care of these patients. Fellows have regular, half-day outpatient clinics that are held in the Pediatric Pulmonary Center at St Louis Children’s Hospital, supervised by divisional faculty. Fellows also acquire the procedural skills and techniques needed for a pulmonary subspecialist, including flexible fiberoptic bronchoscopy, bronchoalveolar lavage and transbronchial biopsies. They receive training in the interpretation of pulmonary function studies, allergy tests and overnight polysomnograms.

On average, the pulmonary fellows are on call every three to five weekends and handle overnight calls from home, including when covering the inpatient service. In addition, the fellow will be on call for parents and other caregivers of children and adolescents with chronic lung disease who receive care from the Division of Allergy and Pulmonary Medicine approximately one night every two weeks. Pediatric-trained allergy fellows, as well as faculty share these outpatient call responsibilities with pediatric pulmonology fellows.

Training in research and its methodology is an essential component of our fellowship program, and the fellows are provided with significant protected time during which they develop and hone skills necessary to be successful as a physician and investigator who can succeed in academia. Research activity and scholarly pursuits are scheduled in long, uninterrupted blocks. As evidenced by their recent grant and publication record, our pulmonology fellows have participated in basic, translational and clinical research programs, which include:

  • National Institutes of Health (NIH)-funded childhood asthma research programs, including the Children’s Asthma Management Program (CAMP), Children’s Asthma Research and Education Program (CARE), Network Clinical Center (AsthmaNet), and Inner City Asthma Consortium (ICAC) that are helping us understand the benefits and long-term effects of asthma treatment in children,
  • Minority programs designed to impact asthma morbidity, such as the Asthma Van
  • NIH-sponsored, multidisciplinary center examining pulmonary complications leading to morbidities and mortality of sickle cell disease,
  • Interdisciplinary NIH-funded project examining the role of respiratory viruses and associated immune response on graft dysfunction, supported by the pediatric lung transplantation program
  • Therapeutic Development Network, a Cystic Fibrosis Foundation (CFF)-supported program designed to rapidly bring new therapies to cystic fibrosis patients,
  • Center for the Genetic Determinants of Mucociliary Clearance Consortium, part of the NIH Rare Diseases Clinical Research Network, which was created to better define pathogenesis, natural history, and treatment of primary ciliary dyskinesia and atypical forms of cystic fibrosis,
  • Clinical research program studying the prevention of sudden infant death syndrome, funded by the Gates Foundation,
  • NIH-supported research program examining early determinants of chronic lung disease of infancy, and the mechanistic underpinnings of Cystic Fibrosis and Asthma,
  • A Pediatric Pulmonary Diseases & Asthma Center of Excellence in the Children’s Discovery Institute of the St. Louis Children’s Hospital.

Research opportunities are not limited to the division, and numerous collaborations exist throughout the medical center. Fellows have joined renowned, well-established basic research programs that are examining the genetics, molecular mechanisms, cellular pathophysiology and disease processes of asthma, cystic fibrosis, surfactant deficiencies, ciliopathies, emphysema, immunodeficiencies and respiratory infections. It is expected that as the fellow progresses through their project, he or she will prepare and submit grant applications, scientific abstracts and first-authored papers that pertain to their work. With time, the trainee will become increasingly independent, and the mentor, scholarship oversight committee and program director will assure that satisfactory progress toward independence has been made.

Several didactic conferences are required parts of the training, providing the fellows with a comprehensive understanding of pulmonary physiology, pathophysiology and clinical care. In addition to the clinical and research lecture series scheduled by the Department of Pediatrics, the Division of Pediatric Allergy and Pulmonary Medicine has clinical conferences essential to our educational mission: the Pediatric Pulmonary Physiology Conference, Pediatric Pulmonary Pathology Conference, Pediatric Pulmonary Clinical Conference, Respiratory Physiology Review and Journal Club.

The Division of Pediatric Allergy and Pulmonary Medicine offers challenging medical goals and unparalleled research potential. If you are interested in pursuing a career in pediatric pulmonary medicine at Washington University in St. Louis, please contact us at:

Cadence Kuklinski, MD
Assistant Professor of Pediatrics
Director, Pediatric Pulmonology Fellowship Program
One Children’s Place
MSC 8116-43-14
St. Louis, Missouri 63110
Telephone: 314-454-2216
E-mail address:

Pediatric Allergy/Immunology fellowship

The Washington University School of Medicine Allergy & Immunology fellowship is a two-year ACGME accredited program. There is an optional third year for those who wish to explore research more deeply. Trainees learn from faculty in both the department of internal medicine, division of allergy and immunology, and the department of pediatrics, division of allergy and pulmonary medicine and division of rheumatology and immunology. Our goal is to develop future Allergy and Immunology leaders who are outstanding clinicians and pioneering researchers working to advance our understanding of the field. Clinical experience is provided in a wide range of diseases, including allergic rhinitis, anaphylaxis, asthma, contact dermatitis, drug allergy, eosinophilic esophagitis, food allergy, hereditary angioedema, immunodeficiency, mast cell disease, venom allergy, and urticaria. 

Two tracks are available with one for those trained in internal medicine and the other in pediatrics. Those that have trained in medicine-pediatrics residency are able to apply to either track.

First-year fellows spend most of their time in our outpatient clinics, including specialty clinics devoted to patients with asthma, drug allergy, eosinophilic esophagitis, immunodeficiency, and urticaria. During the second year, fellows have time dedicated to research, as well as elective time that can be used to customize their allergy training. Fellows can rotate with ENT, rheumatology, hematology, pulmonary, and also with community allergists. There is ample opportunity for research projects in the fellowship program. Fellows can choose basic or clinical research and can work with a faculty mentor in our division or other divisions.

Our Allergy and Immunology faculty perform clinical and basic research in areas including food allergy, asthma, drug allergy, hereditary angioedema, and immunodeficiency. In particular, Washington University has an outstanding basic Immunology research program, with faculty spanning many departments and divisions who are available to mentor our Fellows.

Additional information on the allergy and immunology fellowship can be found on the John T. Milliken Department of Medicine Division of Allergy and Immunology website