Albert Einstein College of Medicine
of Yeshiva University
Children’s Hospital at Montefiore
Division of Nephrology
Pediatric Nephrology Fellowship Training
Program
Educational Goals and Objectives of the Program
General
The Divisional goals and objectives for graduate medical education are to provide the clinical
and scientific experience required to train graduates of Pediatric Residency Programs for a career
in Academic Pediatric Nephrology. In accord with the ACGME General Competencies, the
education program of the Division will assure that its Trainees obtain competencies in the
following six areas: patient care, medical knowledge, practice-based learning and improvement,
interpersonal and communication skills, professionalism, and system-based practice. Trainees are
required to be Board-eligible in Pediatrics and have met the qualifications for Trainee eligibility
in the Essentials of Accredited Residencies in Graduate Medical Education in the AMA
Graduate Medical Education Directory. In accordance with the requirements established by the
Sub-Board of Pediatric Nephrology, the Pediatric Nephrology Training Program consists of one
year of intensive clinical experience followed by two years of basic, translational, or clinical
research training. It is anticipated that upon successful completion of the Training Program, the
Pediatric Nephrology Trainee will have acquired the capability and experience with which to
diagnose and manage pediatric renal diseases and to understand the physiology of fluid and
electrolyte regulation, and acquire scientific skills necessary for a career as a physicianinvestigator. Collaboration with the Division of Nephrology in the Department of Medicine
provides opportunities for research and education that has fostered the career development of
numerous Trainees. Combined courses in renal physiology journal club conferences in clinical
and basic research areas as well as renal grand rounds facilitate the Trainee’s acquisition of
knowledge and appreciation of the importance of critical scientific analysis. All Trainees are
required to complete the Fellows Course, which is offered by the Department of Pediatrics
during the academic year. This 27 session course provides skills that lead to an in-depth
understanding of biostatistics, clinical and laboratory research methodology, study design,
preparation of applications for funding and/or approval of clinical or research protocols, critical
literature review, principles of evidence-based medicine, ethical principles involving clinical
research, and the achievement of proficiency in teaching. The curriculum leads to an
understanding of the principles of adult learning and provide skills to participate effectively in
curriculum development, delivery of information, provision of feedback to learners, and
assessment of educational outcomes. Graduates will be effective in teaching both individuals and
groups of learners in clinical settings, classrooms, lectures, and seminars, and also by electronic
and print modalities. The Trainee will develop an understanding of ethical, socioeconomic,
medical/legal, and cost-containment issues as they apply to the provision of patient care and
graduate medical education. In addition, the Trainee will participate in the educational activities
of the Training Program and assume responsibility for teaching their peers, Pediatric Residents
and medical students. Finally, each Trainee has the opportunity to participate in the various
institutional committees such as the Committee on Graduate Medical Education and other
Departmental responsibilities. In the past 40 years over 100 graduates of the program have
remained in academic medicine and continue their research contributions.
First Year
All infants and children hospitalized with renal disorders or fluid and electrolyte abnormalities
are evaluated by the Pediatric Nephrology Service at the Children’s Hospital at Montefiore
(CHAM). During the first year of training, the Trainee will assume major patient care
responsibilities in the ambulatory, in-patient service, and in the Pediatric Dialysis Unit under the
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direct supervision of Pediatric Nephrology Faculty and commensurate with their level of clinical
competence and advancement.
The Trainee will acquire experience in the management of pediatric patients ranging in age from
premature newborn to young adulthood, who have various renal disorders including fluid and
electrolyte imbalance, hypertension, acute and chronic renal failure, congenital and acquired
abnormalities of the renal-genitourinary tract, glomerulonephritis, nephrotic syndrome, systemic
diseases with renal involvement, as well as renal transplant recipients. The importance of an
appreciation for the pathophysiology and management of these respective disorders will be
emphasized. Implementation of therapeutic regimens will utilize the newest available modalities
and be critically evaluated for their efficacy and safety. The Trainee is responsible for presenting
the patients with the appropriate laboratory and radiologic information, at the Pediatric
Nephrology Rounds on Monday and Friday mornings. Emphasis is placed on the teaching of
renal histology based on the biopsies performed by the Trainee, and the interpretation of renal
ultrasounds, nuclear scans, voiding cystograms, and other imaging techniques applied to the
kidney and genitourinary tract under the guidance of the Radiology and Nephrology Faculty.
Procedure skills to be acquired will include placement and interpretation of ambulatory blood
pressure monitors, renal biopsy, prescription and trouble shooting of renal replacement therapy
with hemo- or peritoneal dialysis, hemofiltration, and management of patients pre- and posttransplantation. The supervising Attendings are responsible for signing the Trainees
credentialing forms, as required by the New York State Department of Health, certifying that all
Trainees have successfully performed a minimum number of specific procedures. All these will
serve as the clinical framework for the acquisition of skills specific for competency in Pediatric
Nephrology.
The outpatient Pediatric Nephrology Diagnostic Service at CHAM is a major Pediatric
Nephrology referral center for the Bronx, lower Westchester County and parts of Long Island,
located in CHAM. More than 1,250 patients are seen yearly of which approximately 25% are
new referrals with renal disorders ranging from hematuria, proteinuria, hypertension, urinary
tract infections, congenital genitourinary tract abnormalities, acute glomerulonephritis, chronic
renal failure, and various other renal-specific conditions including transplantation. Seven weekly
continuity clinic sessions provide an extensive experience for the Trainee with the Renal Team
comprised of a Pediatric Nephrology Social Worker, Transplantation Nurse Practitioner, Renal
Nutritionist, and the Pediatric Nephrology Faculty. In addition there are monthly-specialized
clinic sessions for the care of patients with advanced chronic kidney disease, as well as monthly
clinics combining Pediatric Nephrology care with Pediatric Urology or Pediatric Rheumatology
to address the complex needs of children with CKD resulting from GU anomalies or systemic
lupus erythematosus, respectively.
The Trainee participates in the End-Stage Renal Disease (ESRD) Program of the Division in the
Dialysis and Transplantation services at CHAM. Our center is the only facility in the greater
New York Metropolitan area approved exclusively for the care of children with ESRD. A 6station Pediatric Dialysis Unit in the Foreman Pavilion at Montefiore provides hemodialysis for
~10-15 pediatric patients and serves as the center for the expanding home peritoneal dialysis
program for approximately 5 families. On average, 10 pediatric renal transplants are performed
yearly. The medical management of these children prior to surgery, in the recovery rooms, and
following transfer to the Pediatric Intensive Care Unit is the responsibility of the Trainee and
Pediatric Nephrology Faculty. The Trainee is intimately involved in each phase of the process. In
order to expose the Trainee to the psychosocial and educational needs of the patients and their
families, monthly Pediatric Nephrology Team conferences are held to discuss in depth individual
chronic kidney failure, dialysis and transplant patients. In addition to the Pediatric Nephrology
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Faculty and Trainees, these meetings are attended by the Pediatric Transplantation and Dialysis
nursing staff, Renal nutritionist, Pediatric Renal Social Worker, and other personnel such as
hospital-based school teacher and Child Life Therapist, and if necessary, the Pediatric
Psychiatrist involved in the case.
During the first year of training, the Trainee will become familiar with the various clinical
research projects within the Division, including multicenter clinical investigations of the Chronic
Kidney Disease in Children (CKiD) cohort, and other collaborative studies. A broad referral base
and a large group of patients with a variety of renal disorders provide opportunities for the
development and implementation of clinical and translational research projects. The Trainee is
encouraged to pursue either an existing study or an original investigation related to an existing
project with the support of the Pediatric Nephrology Faculty and Research Laboratory of the
Division. The research program of the Division incorporates a number of projects, which aims to
translate problems in clinical Pediatric Nephrology into bench research investigations. Current
research efforts are:
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The role of polarity proteins Par1a/b and LKB1 in podocytes and kidney development
The role of Par1a/b in acute kidney injury
The role of Par1a/b in intrahepatic bile duct development
The role of LKB1 in diabetic nephropathy
Outcomes of Prematurity and Neonatal Acute Kidney Injury and Einstein/Montefiore
Clinical Registry and Biorepository
ACTH for Frequently Relapsing and Steroid Dependent Nephrotic
Syndrome (ATLANTIS study)
NKMC AWAKEN study: Neonatal Kidney Multicenter Collaborative to investigate:
Assessment of Worldwide Acute Kidney Injury in Neonates
Assessing bleeding time before renal biopsy in children with SLE
Assessing the validity of urinary microRNA profiles in patients with lupus nephritis
Development of a point-of-care device to diagnose active lupus nephritis in children with
SLE
Profiling of microRNAs in urine, serum, and kidney tissue of a mouse model of immune
complex nephritis
Assessing long-term outcome of pediatric lupus nephritis in adults who do not progress to
end-stage renal disease
The role of extracellular RNA and RNA-binding proteins in the development of systemic
lupus erythematosus
The utility of urinary microRNAs as biomarkers of renal progression in children and
adults with chronic kidney disease
SCOPE Collaborative: a clinical, multicenter study of peritonitis and exit site infections,
and now adding hemodialysis access infections
Nephrotic syndrome and Primary Glomerular Diseases: role of biomarkers and genetics
Role of experimental maternal malnutrition on renal development and epigenetic profile
Risk of hypertension in African American Children with APOL1 polymorphism in G1
and G2 alleles
Adherence to treatment regimen in pediatric and adolescent kidney transplant recipients
of different racial backgrounds and their transition to adult care.
Cystinosis as a lysosomal storage disease and the discovery of new therapeutic targets
involving the autophagy pathway.
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By the time the Trainee completes the clinical year of training, the research project of the trainee
is already formulated and mentors are identified. The Division Chief gives the direction of the
research training with the assistance of the Program Director, taking into consideration the
feasibility of the project and the interests of the Trainee.
Second and Third Year
The second and third year Trainees will still have ongoing clinical responsibilities for bi-monthly
Pediatric Nephrology outpatient session for continuity of patient care, in- and outpatient service
(if not completed entirely during the first year), and the occasional nights and weekend coverage
with the other Trainees. However, the main focus of this stage of training is on scholarly
activities.
All Trainees will be expected to engage in projects in which they develop hypotheses or in
projects of substantive scholarly exploration and analysis that require critical thinking. Areas in
which scholarly activity may be pursued include, but are not limited to: basic, clinical, or
translational biomedicine; health services; quality improvement; bioethics; education; and public
policy. Trainees must gather and analyze data, derive and defend conclusions, place conclusions
in the context of what is known or not known about a specific area of inquiry, and present their
work in oral and written form. The basic and translational research component of the program
will take advantage of the numerous research facilities available at this large medical center and
the Albert Einstein College of Medicine. The Trainee will be offered the opportunity to perform
basic scientific investigation using the newest techniques in cellular and molecular biology. The
laboratory experience will emphasize the scientific principles of research and provide a
foundation for the Trainee to develop into a physician-investigator. The supervision of the
Trainee by the appropriate Pediatric Nephrology Faculty member, who is skilled in a particular
area of investigation, provides a safe mechanism to assure the research success of the Trainee.
Emphasis is placed on the development of technical and critical evaluation skills, data
acquisition and analysis, review of manuscripts, and writing of abstracts and scientific papers.
Reading of research articles related to the work is strongly encouraged in order to develop
specific knowledge, as well as critical judgment of methods and experimental design. The
research resources of the Division including technical assistance, scientific instruments and
supplies, and funds for the investigations, provide an excellent opportunity for the Trainee to
learn in depth many state of the art research techniques. If needed, the resources of the
laboratories of the Division of Nephrology, Department of Medicine, and other basic research
laboratories, are available for the Trainee under the direction of Faculty members familiar with
the requirements for research training.
As the Trainee progresses with his/her research endeavors, they are encouraged to work more
independently and further develop the ability to formulate new questions and experimental
approaches. In this manner, the research projects performed during the third year of training are
more effectively designed and carried out with the Trainee assuming as much responsibility as
their skills permit. This will enable the Trainee to complete the last stage of the research
experience by preparing and submitting a manuscript to a scientific journal as the first author for
critical review. The Program Director and other involved Faculty will assist the Trainee in this
process in preparation for their academic career.
In summary, it is anticipated that upon successful completion of the Pediatric Nephrology
Training Program, the Trainee will have developed skills in clinical Pediatric Nephrology basic
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and translational investigative research, and teaching. The Trainee will also be familiar with the
evaluation of psychosocial aspects of life-threatening and chronic diseases as they effect the
patient and family, and in the need for counseling both acute and chronically ill patients and their
families. The Trainee will also be provided with instruction and experience in the operational
aspects of a Pediatric Nephrology Service, including the dialysis facility. Knowledge of the
economics of the practice of Pediatric Nephrology, staffing needs, care maps, appropriate
communication with referring physicians and planning for program development will be
acquired during the training. This training will prepare the graduate to assume the responsibilities
of a clinician-educator and physician-scientist and contribute to the field of Pediatric Nephrology.
Evaluation Process for Core Competencies and Scholarly Activities
The Pediatric Nephrology Faculty evaluates the Trainees at monthly intervals based on rotations.
Deficiencies are discussed with the Trainee by the Program Director, and plans for appropriate
correction are then outlined. In addition the overall performance of the Trainee is assessed at sixmonth intervals by the entire faculty and discussed with the Trainee by the Program Director. On
a yearly basis, Pediatric Nephrology peers, Pediatric Trainees, patients and Allied Health Care
Workers also evaluate the Trainees. The Trainee will have the opportunity to evaluate the
Training Program and Faculty on a six-month basis anonymously. The Division Faculty will
discuss the evaluations and suggestions, and plans to implement changes in the Training Program
will be formulated. This system of mutual feedback is aimed at improving the individual Trainee
by identifying any deficiencies early in the process to maximize the success of the Trainee. In
addition, the feedback for the Faculty is important to implement changes in the curriculum of the
Training Program.
The progress of the Trainees in their scholarly activities is assessed at the local level. Each
fellow must have a Scholarship Oversight Committee. The Scholarship Oversight Committee
should consist of three or more individuals, at least one of whom is based outside the
subspecialty discipline; the fellowship program director may serve as a Trainee’s mentor and
participate in the activities of the oversight committee, but should not be a standing (i.e., voting)
member. This committee will:
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Determine whether a specific activity is appropriate to meet the ABP guidelines for
scholarly activity
Determine a course of preparation beyond the core fellowship curriculum to ensure
successful completion of the project
Evaluate the Trainee's progress as related to scholarly activity
Meet with the Trainee early in the training period and regularly thereafter
Require the Trainee to present/defend the project related to his/her scholarly activity
Advise the program director on the Trainee's progress and assess whether the Trainee has
satisfactorily met the guidelines associated with the requirement for active participation
in scholarly activities
Involvement in scholarly activities must result in the generation of a specific written “work
product.” Examples include, but are not limited to:
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A peer-reviewed publication in which a fellow played a substantial role
An in-depth manuscript describing a completed project
A thesis or dissertation written in connection with the pursuit of an advanced degree
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An extramural grant application that has either been accepted or favorably reviewed
A progress report for projects of exceptional complexity, such as a multi-year clinical
trial
Teaching Opportunities
In addition to the clinical and research training of the Trainees, the program provides numerous
opportunities for them to develop their teaching abilities. In the clinical setting, the Pediatric
Nephrology Trainee guides the Pediatric Residents and medical students in the evaluation and
management of the patients and provides them current literature for review. The Trainees are
required to conduct seminars, clinical conferences and lectures that are given at the various
Division education meetings, as well as for medical students and Pediatric Residents. Topics that
have been presented by to Pediatric Residents include: HUS, HTN, Nephrotic Syndrome, Acid
Based Abnormalities, Glomerular Disorders, and Fluid & Electrolyte Metabolism. These
exercises are supervised by a Pediatric Nephrology Faculty member who is responsible for
assuring the high quality of the teaching as well as guiding the Trainee as to their performance.
In addition, Trainees in second and third year will run small group sessions with first year
medical students as part of the Renal Systems Course at the Albert Einstein College of Medicine.
Conferences and Extracurricular Opportunities
The Trainee is given the opportunity to attend the Miami Seminars in Pediatric Nephrology in
first year, the RRI Dialysis Conference in second year and the American Society of Nephrology
(ASN) in third year. Trainees are encouraged to submit abstracts to major scientific meetings
(ASN, Pediatric Academic Societies), if their supervising faculty deems appropriate, irrespective
of their level of training. Accepted abstracts allow the Trainee to attend these meetings in
addition to the above mentioned.
Each Trainee is given the opportunity to spend one week each summer in the second and third
years at the Hospital’s Satellite Children’s Dialysis Unit located in the Catskill mountains at the
Frost Valley YMCA. This unique program began in 1975 and was the first pediatric dialysis
summer camp facility to include mainstreaming of the campers with various kidney conditions
including chronic kidney failure and transplantation. The experience broadens the Trainees
appreciation of the obstacles encountered by pediatric nephrology patients as they attempt to
rehabilitate and continue with their development.
Meet Our Fellows
Janice Desir, MD
Medical School: Wright State University School of Medicine
Med/Peds Nephrology, PGY-8
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Lauren Becton, MD
Medical School: University of North Carolina Chapel Hill School of Medicine
PGY -7
Natalie Uy, MD
Medical School: UMDNJ-New Jersey Medical School
PGY-6
Abhijeet Pal, MD
Medical School: Maulana Azad Medical College, India
PGY-5
Saritha Ranabothu, MD
Medical School: Gandhi Medical School, India
PGY-4
Rebecca Hjorten, MD
Medical School: Stanford University School of Medicine
PGY-4
Meet Our Faculty
Frederick Kaskel, MD, PhD
Professor of Pediatrics, Vice Chair of Pediatrics
Division Chief
Research interests: glomerular diseases, hemolytic uremic syndrome,
hypertension, chronic kidney disease in children (CKiD)
Marcela Del Rio, MD
Assistant Professor of Pediatrics
Director, Pediatric Kidney Transplant Program
Research interests: medical adherence and transition of care in kidney
transplant recipients
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Beatrice Goilav, MD
Assistant Professor of Pediatrics
Director, Pediatric Nephrology Training Program
Research interests: lupus nephritis, urinary biomarkers, RNA biology in
autoimmune diseases
Kimberly Reidy, MD
Assistant Professor of Pediatrics
Research interests: kidney development, role of polarity proteins in kidney
development and disease
Amy Skversky, MD
Assistant Professor of Pediatrics
Director, Pediatric Dialysis Program
Research interests: quality improvement in pediatric dialysis
Caroline Straatmann, MD
Assistant Professor of Pediatrics
Research interests: Acute kidney injury in neonates, ACTH for frequently
relapsing, steroid-dependent focal segmental glomerulosclerosis
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