Nephrology Fellowship

Our clinical curriculum is based on attending-supervised patient experiences in the management of acute kidney injury, end-stage renal disease, glomerular pathology, transplantation and critical care nephrology with state of the art lectures and case reviews by key faculty. Our program uniquely offers a diverse population and its pathology, and an emphasis on critical care. This year we will begin our plasmapheresis program offering trainees an added skill. Educational objectives and expectations for each rotation are reinforced with attendings and fellows each month.

Service Descriptions and Rotations

Consult Service

The goal of the Nephrology Consultation rotation is to provide the instruction, clinical experience, and opportunities to acquire expertise in the prevention, evaluation, and management of the following disorders:

• Disorders of fluid, electrolyte, and acid-base regulation
• Acute renal failure
• Bedside use of ultrasonography as a diagnostic tool
• Hypertensive disorders and accelerated hypertension
• Renal disorders of pregnancy
• Urinary tract infections
• Tubulointerstitial renal diseases, including inherited diseases of transport, cystic diseases, and other congenital disorders
• Glomerular and vascular diseases, including the glomerulonephritis, diabetic nephropathy, and Atheroembolic renal disease
• Disorders of drug metabolism and renal drug toxicity
• Geriatric aspects of nephrology, including disorders of the aging kidney and urinary tract
• urinalysis
• percutaneous renal biopsy
• placement of temporary vascular access for hemodialysis and related procedures
• Plasmapheresis
• Intermittent renal replacement therapy (i.e. Hemodialysis, Peritoneal Dialysis)
• Continuous renal replacement therapy
• Sustained Low Efficiency Daily Dialysis (SLEDD)

Our program will ensure that each fellow has the necessary knowledge and are familiar with the following procedures, including their indications, contraindications, complications, and interpretations of results, as well as their cost-effectiveness and application to patient care:

• Renal ultrasound
• Renal Biopsy
• Catheter Placement

CLINICS

Transplant/Glomerular Diseases Clinic/General renal clinic

• Continuity of care of outpatient renal disorders
• Chronic renal failure and its management by conservative methods, including nutritional management of uremia
• Hypertensive disorders
• Genetic and inherited renal disorders
• Glomerular and vascular diseases, including the glomerulonephritis, diabetic nephropathy
• Disorders of mineral metabolism, including nephrolithiasis and renal osteodystrophy

ESRD Service

The goal of the Elmhurst End Stage Renal Disease Service is to ensure that each Fellow is provided with ample clinical experience and supervised involvement in decision making for patients undergoing renal replacement therapies. Specific areas in which Fellows are to receive training and become proficient include:

• evaluation and selection of patients for acute hemodialysis or continuous renal replacement therapies
• evaluation of end-stage renal disease patients for various forms of therapy and their instruction regarding treatment options
• drug dosage modification during dialysis and other extracorporeal therapies
• evaluation and management of medical complications in patients during and between dialyses and other extracorporeal therapies, including dialysis access, and an understanding of the pathogenesis and prevention of such complications
• long-term follow-up of patients undergoing long-term dialysis, including their dialysis prescription and modification and assessment of adequacy of dialysis
• an understanding of the principles and practice of peritoneal dialysis, including the establishment of peritoneal access, the principles of dialysis catheters, and how to choose appropriate catheters
• an understanding of the technology of peritoneal dialysis, including the use of automated cyclers
• assessment of peritoneal dialysis efficiency, using peritoneal equilibration testing and the principles of peritoneal biopsy
• an understanding of how to write a peritoneal dialysis prescription and how to assess peritoneal dialysis adequacy
• the pharmacology of commonly used medications and their kinetic and dosage alteration with peritoneal dialysis
• an understanding of the complications of peritoneal dialysis, including peritonitis and its treatment, exit site and tunnel infections and their management, hernias, plural effusions, and other less common complications and their management
• an understanding of the special nutritional requirements of patients undergoing hemodialysis and peritoneal dialysis
• placement of temporary vascular access for hemodialysis and related procedures
• peritoneal dialysis
• acute and long-term hemodialysis
• continuous renal replacement therapy (continuous veno-venous hemofiltration, and sustained low-efficiency dialysis)

We will also ensure that Fellows have the necessary knowledge and are familiar with the following procedures, including their indications, contraindications, complications, and interpretations of results, as well as their cost-effectiveness and application to patient care:

• Radiology of vascular access
• Balloon angioplasty of vascular access

Transplant Service

The educational goal of the Transplant Clinic at Elmhurst is for each fellow to receive adequate experience and education to ensure that they will become proficient in the chronic care of outpatient transplant recipients.

The educational goal of the Transplant Nephrology Rotation at Mount Sinai is for each fellow to receive adequate experience and education to ensure that they will become proficient in the following core areas:

• evaluation and selection of transplant candidates
• preoperative evaluation and preparation of transplant recipients and donors
• immediate postoperative management of transplant recipients, including administration of immunosuppressant
• clinical diagnosis of all forms of rejection including laboratory, histopathologic, and imaging techniques
• medical management of rejection, including use of immunosuppressant drugs and other agents
• recognition and medical management of the surgical and nonsurgical complications of transplantations
• long-term follow-up of transplant recipients in the ambulatory setting
• knowledge of indications for biopsy of renal allograft biopsy, technical expertise in performing biopsy of renal allograft and interpretation of biopsy pathology specimens
• recognition and the management of kidney disease in non-renal organ transplant recipients

Renal ICU Service

During this rotation the fellow will round in the surgical/trauma ICU with one of the 2 renal-critical care attendings from the renal division. The educational goal of the Renal ICU Rotation is for each Fellow to receive adequate experience and education to ensure that they will become proficient in the following core areas:

• demonstrate knowledge of the indications for and provision of extracorporeal renal replacement therapy in the critical care setting, including intermittent hemodialysis, peritoneal dialysis, continuous Venovenous hemofiltration, and sustained low efficiency dialysis
• demonstrate knowledge of the pharmacology of medications administered to critically ill patients with renal disease Accurate diagnosis and effective management of acute kidney injury
• demonstrate competence in the management of electrolyte and acid-base disturbances in critically ill patients
• demonstrate competence in the management of nutrition in critically ill patients with renal disorders
• demonstrate competence in the management of disordered blood pressure regulation, including hypertension and hypotension in the critical care setting
• be able to accurately diagnosis and effectively manage patients with acute kidney injury

Training Schedule

Second year fellows have three months of research/elective of which one includes the ICU. Other possible electives include Urology, Pathology, transplant and Interventional Radiology. All fellows also attend courses in Renal Ultrasonography (Emory) and Glomerular Pathology (Columbia).

Conferences

The mission of our fellowship training program is to provide each trainee with a broad range of experiences in Nephrology including the preparation necessary for a successful career as an academic leader or a clinical practitioner. This is accomplished by a program that integrates an initial clinical year with a subsequent year or years of formal training in basic or clinical research. The clinical year provides extensive experiences in consultative Nephrology, acute and chronic hemodialysis, peritoneal dialysis, and renal transplantation, management of hypertension and evaluation and treatment of nephrolithiasis. Fellows rotate at Queens Hospital Center and Icahn School of Medicine at Mount Sinai. These venues provide a diverse and comprehensive exposure to clinical inpatient Nephrology. Fellows also participate in outpatient clinics including a formal outpatient end state renal disease (ESRD) program carried out in Broadway Dialysis Center. Fellows also receive extensive training in renal transplantation and work both in the outpatient and inpatient settings and experience in the management of a diverse population with a wide variety of conditions in an urban setting.

ACGME Competencies

The fellowship program requires the fellows to obtain competencies in the six areas according to ACGME regulations:

• Patient Care and Procedural Skills: Fellows should be able to provide compassionate, appropriate, and effective treatment of health problems and the promotion of health; and perform all medical, diagnostic and surgical procedures considered essential for the field of Nephrology.
• Fellows should have Medical Knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
• Practice-Based Learning and Improvement that involves evaluation of their own patients’ care, appraisal and assimilation of scientific evidence, and improvements.
• Interpersonal and Communication Skills that result in effective information exchange and teaming with patients, their families, and other health professionals
• Professionalism through a commitment to carrying out professional responsibilities, adherence to ethical principles.
• Systems-Based Practice: The fellows should demonstrate an awareness of and responsiveness to the larger context and system of health care

For more information, click here.

External Rotations

Transplantation-Icahn School of Medicine at Mount Sinai, New York. For information, please click here.

Consultation-Queens Hospital Center
For more information, please click here.

Didactic Curriculum

The clinical experiences in the ambulatory, inpatient, and acute care settings are complemented by daily didactic sessions. There are more than 500 hours each academic year of morning and afternoon conferences consisting of lectures and activities for the enhancement of knowledge. Each conference is attended by the program director or other faculty attending.

Mentoring Program

All fellows are matched with a faculty physician, who is intended to help the new fellows to adjust to their new roles. The faculty physician meets with them regularly throughout the fellowship to provide formal suggestions and advices regarding annual evaluations, development of a career plan to meet short term professional goals, research projects, and any other personal/professional matter.

Living In New York City

All the knowledge and skills you will gain during your two-year fellowship, will be accompanied with an amazing experience in one of the world’s most vibrant and culturally rich cities. Theaters, concerts, arts, museums, opera, ballet, restaurants, festivals, street fairs, parks, shopping, hotels, and tourist sites give you an experience unlike any other city in the world. Most of our fellows live in Queens, one of the most ethnically and linguistically diverse communities in the United States. Queens is a New York City borough across the East River from Manhattan. Flushing Meadows Corona Park, with the Unisphere, a 12-story 1964 World’s Fair globe sculpture, hosts the annual U.S. Open tennis tournament. The park’s Queens Museum is known for the “Panorama,” a building-for-building model of New York City. Nearby Citi Field is the stadium of pro baseball team, the Mets.

Nephrology Fellowship Program Application Process

We accept applications only through ERAS. Our interviews are from September through October. For more information please contact our Program Coordinator:

Leopolda Silvera, MPA
Nephrology Fellowship Program Coordinator
718-334-3930
NYC Health + Hospitals/Elmhurst
79-01 Broadway, C7-10
Elmhurst, NY 11373
Email: silveral@nychhc.org

Requirements

• For IMG’s, must be ECFMG certified
• Passed USMLE Steps 1, 2 CK & CS
• Less than five years since graduation.

We strongly encourage all the fellows to participate in a research project as part of their fellowship training. When a fellow decides to participate in a research protocol, he/she is matched with a Research Assistant from our Research Department. The Research Assistant assists our faculty and fellows in preparation of proposal, approvals and assistance required to compile materials and information on research studies; reviewing and collecting data in the patient electronic record, among other duties. For more detailed information, please click here.

RESEARCH
ON-GOING

• Magnesium phosphate binder study (prospective study) – Drs. Coritsidis and Bansal (in CAPD patients,evaluating safety and bowel function outcomes)
• Renal trauma study (prospective study) – Drs. Coritsidis (long term renal function in renal trauma patients)
• Undocumented immigrants and outcomes on dialysis – Drs. Coritsidis, Linden and Bansal (assessing compliance to treatment in this population)
• Involuntary discharges from dialysis units – network data base – Dr Coritsidis
• Antibiotic usage in dialysis units – network data base – Drs. Coritsidis and Stern
• Use of ultrasonography in fistula evaluation (prospective study) – Dr Coritsidis
• evaluation of the effects of lower dialysate flow rates (prospective study) –

PAPERS

• Depa J, Coritsidis GN. Recurrence of Minimal Change Disease (MCD) Following a Motor Vehicle Trauma –An Atypical Cause and Review of Literature. J Trauma Inj 2019;32(2):111-114 https://doi.org/10.20408/jti.2018.048
• Coritsidis GN, Ram P, Miah F, Wyrick JM, Kalosza BA. Outcomes in Critically Ill Patients with Severe TBI: Ethnicity, Documentation and Insurance status. Accepted for publication to Critical Care Medicine, 2019
• Coritsidis GN, Machado ON, Farzin Levi-Haim F, Yaphe S, Patel RA, Jayaramakrishna D. Point-of-Care Ultrasound for Assessing Arteriovenous Fistula Maturity in Outpatient Hemodialysis. Accepted for publication to the Journal of Vascular Access 2019

ABSTRACTS

• Depa J, Omran I, Miah F, Coritsidis G. Does Nephrologist Presence in Emergency Department (ED) Referrals from Dialysis Units Affect Hospital Admissions. American Journal of Kidney Diseases, Volume 71, 533; 2018 DOI: https://doi.org/10.1053/j.ajkd.2018.02.077
• Coritsidis GN, Yaphe S, Depa J, Lee S. The Pathophysiology of Augmented Renal Clearance Similarly Affects Hepatic Clearance in Critically Ill Trauma Patients. J Am Soc Nephrol 29, 2018: 895a.
• Munro C, Echefu C, Ram P, Zakhia K, Coritsidis G. Massive transfusion activation in nontrauma patients: assessing the need for a unique protocol. Crit care Med 47, 1489, 2018 a*
• Yaphe S, Munro C, Rakhman I, Lubowski T, Lee TK, Bhat JG, Bhat P, Stern A, Coritsidis G. Outpatient Antibiotic Prescribing Patterns for Dialysis Patients in New York State. American Journal of Kidney Diseases, Vol. 73, Issue 5, p720, May 2019. DOI: https://doi.org/10.1053/j.ajkd.2019.03.298
• Yaphe S, Munro C, Rakhman I, Lubowski T, Lee TK, Bhat JG, Bhat P, Stern A, Coritsidis G. Incidence of Antibiotic Prescriptions and Clostridium Difficile Infections in the Hemodialysis Population of New York State American Journal of Kidney Diseases, Vol. 73, Issue 5, p720, May 2019. DOI: https://doi.org/10.1053/j.ajkd.2019.03.297
• Yaphe S, Munro C, Rakhman I, Lubowski T, Lee TK, Bhat JG, Bhat P, Stern A, Coritsidis G. Analysis of Dual State Antibiotic Prescription Practices in the ESRD Population. Accepted for presentation at the 2020 ASN meetings.
• Coritsidis G, Weiss S, Yaphe S, Alnazari N. Bloodstream infections in relation to environmental cultures in 12 dialysis units in New York City. Accepted for presentation at the 2020 ASN meetings.
• Michael Fingerhood, Aleef Rahman, Paul Catella, Ayesha M. Imam, Yamini Patel, Grant Coronica, Farhan Husain, Payal Ram, George Alonso, Coritsidis G. Net Fluid Balance Predicts Length of Stay and Mortality in Patients with Ventilator Associated Events. Submitted for presentation at the 2020 SCCM meeting.
• Ram P, Paul Catella, Grant Coronica, Yamini Patel, Kenra Ford, Coritsidis G. Massive Transfusion Activation in Non Trauma Patients at Urban Level 1 Trauma Centers. Submitted for presentation at the 2020 SCCM meeting.

GEORGE CORITSIDIS, M.D. is the Chief of the Division of Nephrology, and an intensivist with the pulmonary/critical care division at NYC Health + Hospitals/Elmhurst. Academically he is a professor at the Icahn school of Medicine at Mount Sinai, and involved in research projects pertaining to critical care and/or nephrology. He is also the director of the Broadway dialysis unit responsible for over 200 peritoneal and hemodialysis patients. He received his medical degree from the State University of New York Health Science Center at Syracuse and did his fellowship at the Albert Einstein College of Medicine. Other responsibilities and involvements include board member at the ESRD network of NY and the NGO “Sights on Health” as well as research mentor of the St. George University Masters in biology.

SAAD A. BHATTI, M.D. is an Attending of the Mount Sinai Health System, board certified in Critical Care and Nephrology.

MARITZA BROWN, M.D. is the Director of In-Patient Hemodialysis and an Assistant Professor at the Icahn School of Medicine at Mount Sinai.

JOSEPH J. LIEBER, M.D. is the Director of Medicine, Chief of Medical Consult Service, and Site Director for Internal Medicine Residency and an Assistant Professor at the Icahn School of Medicine at Mount Sinai.

ELLENA LINDEN, M.D. is a Nephrology Attending Physician at NYC Health + Hospitals/Elmhurst and at Broadway Dialysis Unit. She is the head of Transplant Clinic at the hospital. She is also an Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai. Her research interests include access to transplantation for undocumented immigrants. She is also the Director of the Renal Fellowship Training Program.

AARON STERN, M.D. is an Assistant Professor at the Icahn School of Medicine at Mount Sinai. He is also the Associate Director of the Renal Fellowship Training Program.

The Nephrology Fellowship Program at the Icahn School of Medicine seeks applicants with the dual aspirations of clinical excellence and academic advancement of the field.

All applications are accepted only through The Electronic Residency Application Service (ERAS). Please access the ERAS website at to apply. Applicants can set up accounts in ERAS beginning in July (One year prior to start of fellowship).

Application Checklist

All applications are processed through the Electronic Residency Application Service (ERAS):

Transcripts
Letters of Recommendation (3)
Personal Statement
Photo
Curriculum Vitae
USMLE scores
The Match

All positions in the Mount Sinai-Elmhurst Nephrology Fellowship Program will be filled via the National Resident Matching Program (NRMP). Interviews will occur during the Fall. Please refer to the NRMP Specialties Matching Service website for details regarding the Match process.

Contact

Leopolda Silvera, MPA
Nephrology Fellowship Program Coordinator
718-334-3930
NYC Health + Hospitals/Elmhurst
79-01 Broadway, C7-10
Elmhurst, NY 11373
Email: silveral@nychhc.org

George N. Coritsidis, M.D
Chief of Nephrology
(718) 334-3930
coritsg@nychhc.org

Dr. Ellena Linden
Program Director
(718) 334-3930
lindene@nychhc.org