These clinics allow rheumatology trainees to enhance their medical knowledge of the pathophysiology, clinical features, diagnosis and management of a wide breadth of rheumatologic conditions, from mechanical to basic and rare rheumatologic diseases. They enable trainees to become competent in the longitudinal care of rheumatologic patients and to recognize how to diagnose and manage disease flares, maintain disease remission, and actively monitor for common and serious side effects. A significant portion of clinic patients are those who were seen for inpatient consultations, many of whom were previously in the critical care unit. Albany Medical Center is a large tertiary care center with a large catchment area; referrals often come from providers as far as two hours away. Serious rheumatologic disease complications like corneal melt, pulmonary hypertension, interstitial lung disease, renal crisis or glomerulonephritis, cardiomyopathy, and cerebritis are among many that are co-managed with other specialists.
The rheumatology inpatient consultation services provide a vital educational experience in the evaluation, diagnosis, treatment, and care of patients who range from the moderately to critically sick. Rheumatology patients require comprehensive care provided by their physicians. These rounds, completed under the direct supervision of an attending rheumatologist, are intended to provide the basic exposure, clinical knowledge, set of exam skills, and professional attitude needed in the care of patients with rheumatologic diseases. Specifically, fellows will be expected to demonstrate competency in the evaluation and diagnosis of suspected autoimmune and soft tissue diseases. Emphasis is placed on sharpening physical exam acumen as well as building robust differential diagnoses. Fellows are encouraged to take an eventual leadership role in their interaction with other providers, with guidance from a rheumatology attending.
The Scleroderma Foundation, headed by Dr. Lee Shapiro, has the largest scleroderma database in upstate New York and offers exceptional grounds for both research and clinical experience.
Fellows are involved in basic science and translational research in collaboration with the Department of Immunology and Microbial Disease. An Introduction to Immunology course with PhD candidates is part of the first year of training. Research opportunities are available with rheumatology attendings, in collaboration with basic science immunology, and in collaboration with other specialties (historically nephrology, pulmonology and ophthalmology). Ample opportunities for case reports are available due to rare case presentation inpatients.
In keeping with contemporary training standards, we offer education in musculoskeletal ultrasonography by certified faculty at Albany Medical Center. Additionally, in the Patient Safety and Clinical Competency Center, we have multiple models (including a large, life-sized interactive simulator, smaller models for injection purposes and cadavers) for detailed review in anatomy and training for physical exam enhancement and practice for procedures.
Scholarly activities are offered year-round, following the ACGME-guided curriculum requirements. They are presented in different formats, including journal clubs, seminars, grand rounds, morbidity-mortality and multi-disciplinary conferences (e.g. Vasculitis conferences with Pulmonology/Nephrology/Pathology; Interstitial Lung Disease conferences with Pulmonary/Pathology/Radiology), one-on-one sessions with Pathology for inpatient cases and other services. Fellows have an opportunity to teach daily and present conferences to faculty, residents, students, pharmacy residents and physician assistants. Extramural academic activities are encouraged and promoted. Fellows are encouraged to actively participate in activities and present their work at the New York State Rheumatology Society and the American College of Rheumatology (ACR) meetings. National and international conference attendance is strongly encouraged. Our fellows have consistently participated in the ACR Knowledge Bowl and have won medals on numerous occasions.
Efficacy of anakinra for idiopathic and non-idiopathic pericarditis refractory or intolerant to conventional therapy. Shaukat MH, Singh S, Davis K, Torosoff M, Peredo-Wende R.Shaukat MH, et al. Eur Heart J Acute Cardiovasc Care. 2020 Mar 11:2048872619886309. doi: 10.1177/2048872619886309. Online ahead of print.Eur Heart J Acute Cardiovasc Care. 2020. PMID: 32159368.
Anakinra for colchicine-intolerant/colchicine-resistant acute gout flare precipitated by decompensated heart failure. Saad Shaukat MH, Shabbir MA, Singh S, Torosoff M, Peredo-Wende R.Saad Shaukat MH, et al. Ir J Med Sci. 2020 Jul 18. doi: 10.1007/s11845-020-02322-3. Online ahead of print.Ir J Med Sci. 2020. PMID: 32683605.
Correction to: Anakinra for colchicine-intolerant/colchicine-resistant acute gout flare precipitated by decompensated heart failure. Saad Shaukat MH, Shabbir MA, Singh S, Torosoff M, Peredo-Wende R.Saad Shaukat MH, et al. Ir J Med Sci. 2020 Jul 23. doi: 10.1007/s11845-020-02323-2. Online ahead of print.Ir J Med Sci. 2020. PMID: 32705605.
Ngo, K.H, Maheshwari, A, Lemanski, N, Peredo-Wende, R. Corneal Melt through a Different Lens. Submitted for ACR Conference. (2020)
Ngo, K.H. Arthritis: Shaped by Father Time, Transformed by Mother Nature. Oral presentation at Albany Guardian Society-2019 and 2020.
Ngo, K.H. Scleroderma Pulmonary Disease chapter: PAH and ILD. Submitted for international publication. (2020)