The fellows are assigned to one- or two-week rotation blocks to provide a full array of clinical nephrology experience, high quality training, and opportunities to explore electives and clinical research. Educational objectives and expectations for each rotation are reinforced with attendings and fellows in the beginning of the block and at regular intervals. We provide state-of-the-art training for our fellows while also prioritizing their wellness.
Our fellows rotate primarily at two sites: Albany Medical Center and Stratton VA Medical Center.
| Rotation | Duration | Site |
|---|---|---|
| Acute/Inpatient | 12-15 weeks per year | Albany Medical Center |
| Chronic/ESRD Inpatient | 10-12 weeks per year | Albany Medical Center |
| Transplant | 6-8 weeks per year | Albany Medical Center |
| VA Inpatient (with outpatient HD training) | 8-10 weeks per year | Stratton VA Medical Center |
| Albany Medical Center Ambulatory Care | 1 half-day per week | Albany Medical Center |
| Outpatient Dialysis (PD and HHD) | 2-4 weeks per year | Stratton VA Medical Center, Fresenius Outpatient Dialysis, DCI |
| Albany Medical Center Electives | 6-8 weeks per year | Pediatric Nephrology, Interventional Radiology, Plasmapheresis, Clinical Research |
| POCUS Training | 2 weeks (during course of training) | Albany Medical Center |
Fellows in the combined Nephrology/Critical Care track will continue their one-year training in Critical Care after completion of their two-year Nephrology training.
Rotations
The Acute or Team A rotation is a two-week rotation at Albany Medical Center with emphasis on acute kidney injury (AKI), ICU nephrology (100+ ICU beds), volume and electrolyte disturbances, hypertensive emergencies, and intoxications.
The Acute team consists of one faculty member (assigned to the team full-time), a nephrology fellow, and usually a resident and a medical student. The census is around 20-25 patients, and an average of four to five consults per day. The assigned faculty fully supports the trainee, more so when numbers exceed pre-established caps.
It is the most intense rotation but also the most educationally rewarding one, given the variety of cases seen throughout those weeks. Trainees are exposed to the “usual” AKI, but also rare disorders such as AKI due to different kinds of vasculitis or TMA, arising from the fact that Albany Medical Center, the only academic medical center in the region, is also a Level 1 Trauma Center and tertiary referral center, serving a vast population of about three million people. Our fellows are directly part of patients' diagnosis and acute care.
This team also provides extensive training in AKI requiring renal replacement therapy, including intermittent HD and CRRT (CVVH, CVVHD, regional anticoagulation), sometimes simultaneously with ECMO therapy, with a state-of-the-art dialysis unit and dialysis equipment.
The Chronic or Team B rotation is a two-week rotation at Albany Medical Center geared to train fellows in providing consultative care to and managing complications among patients with end-stage renal disease receiving long term dialysis. The team consists of one faculty member and one fellow, census is around 20-25 patients, and will provide broad exposure to patients on HD and PD, admitted with different clinical scenarios, including vascular access issues.
The educational goal for the fellows is to address common and uncommon dialysis-related complications (anemia, CKD-MBD, HTN), and assessment and management of volume status in this population. During this time, the fellow will also participate in outpatient home dialysis clinic as deemed by the program director.
This rotation consists of two-week blocks under the supervision of the transplant team at Albany Medical Center. The fellow will have inpatient and outpatient experiences in kidney transplantation, including inpatient rounds and transplant clinic for pre-transplant, post-transplant, and living-donor’s evaluations.
The renal transplant curriculum and rotation for nephrology fellows is created with one main objective: to furnish graduating nephrology fellows with the comprehensive knowledge and experience necessary to provide transplant care to patients that is expected of general nephrologists today, and in the future.
The fellows' continuity practice is an integral part of their training. Fellows have a half-day weekly continuity clinic for the duration of the fellowship at our office’s location at South Clinical Campus. The fellow will have broad experience with outpatient management of CKD, primary and secondary HTN, glomerulonephritis, and electrolyte disorders. Emphasis is given toward dialysis planning in advanced kidney disease, focusing on in-home dialysis options and kidney transplantations. Close collaboration with other specialties (cardiology, rheumatology, and endocrinology) within Albany Medical Center is achieved for comprehensive patient care. One faculty member supervises up to two fellows in each session, so ample time is dedicated for the educational benefit of the trainee.
The rotation at the Stratton VA Medical Center combines most of the individual experiences available at Albany Medical Center. Fellows perform consultations on the inpatient service including the intensive care unit, with exposure to acute dialysis therapies. They also acquire outpatient training in dialysis therapy in the outpatient dialysis unit located within the premises. Additionally, they will have outpatient exposure with a half-day clinic once or twice a week. There is significant dedicated time for one-on-one education from the VA faculty.
The elective rotation blocks allow the fellows a variety of learning opportunities tailored to each fellow’s interests. Main electives include interventional radiology for hemodialysis access interventions and renal biopsies, pediatric nephrology, apheresis for PLEX therapies, rheumatology, cardiology, outpatient dialysis, and clinical research.
Our fellows rotate at our Mount Hope dialysis clinic for two to four weeks yearly to gain maximum knowledge in outpatient in-center hemodialysis, peritoneal dialysis, and home hemodialysis. Second-year fellows attend the annual “Home dialysis university program” to gain more expertise in the field, and our fellows attend home dialysis clinic in another four-dialysis unit, with exposure to around 50 home dialysis patients.
Our fellows receive a two-week training in point of care ultrasound under the director of Critical Care Echocardiography at Albany Medical Center. This course is recognized by the Society of Critical Care Medicine. Equipment is available to apply this knowledge on a daily basis for our admitted patients.
Our fellows have the opportunity to engage in ongoing clinical research projects led by our faculty, tailored to their personal interests. Over the past few years, they have made substantial contributions to numerous publications, significantly enhancing the body of work in their field of interest.
Nephrology Conferences
The Nephrology Fellowship Program has a structured, year-round conference schedule aimed to cover core curriculum topics, as well as provide a forum for renal grand rounds and journal clubs to advance academic learning opportunities.
The Summer School Series occurs in the first two months of fellowship and covers an array of essential basics in nephrology for the incoming fellows.
| Day | Conference |
|---|---|
| Monday, noon-1:00 p.m. | One of the following: Grand Rounds, Case Presentation, Biopsy Conference, Multidisciplinary Nephrology and Rheumatology Conference, Journal Club, Board Review (KSAP, NephSap, BRCU), Interventional Radiology Conference, Wellness Conference |
| Thursday, noon-1:00 p.m. | Didactic Session: Review of Comprehensive Clinical Nephrology (by Feehally and Johnson) |
| Friday, noon-1:00 p.m. | One of the following: Grand Rounds, Case Presentation, Biopsy Conference, Multidisciplinary Nephrology and Rheumatology Conference, Journal Club, Board Review (KSAP, NephSap, BRCU), Interventional Radiology Conference, Wellness Conference |