The ACGME-approved infectious diseases (ID) fellowship program at Memorial Sloan Kettering provides a broad-based educational experience that includes the evaluation and management of a wide variety of infectious diseases that occur in medical and surgical patients, both adult and pediatric, and in the inpatient and outpatient settings.
The ID fellowship at MSK is unique because it is the only ID training program in the United States based at a cancer treatment center. Trainees become experts in the management of infections associated with cancer treatment, including allogeneic hematopoietic stem cell transplantation, checkpoint blockade treatment to enhance T cell-mediated clearance of tumors, and T cells expressing tumor-specific chimeric antigen receptors.
The MSK ID fellowship program has trained many distinguished ID specialists who have entered public health or academia and become leaders in the field. The academic programs and resources of MSK, its tradition of clinical and scientific excellence, and the high quality of other subspecialty programs throughout the hospital have provided MSK ID fellows with a supportive environment for clinical learning and scholarship. A number of former ID fellowship trainees hold career development awards from the National Institutes of Health (NIH) and oversee NIH-funded laboratory research programs.
Anna Kaltsas, MD – Fellowship Program Director
Dr. Kaltsas is the Director of the Infectious Diseases Fellowship Program, assistant attending physician at Memorial Hospital, and assistant professor of clinical medicine at Weill Cornell Medical College. Her areas of clinical expertise include the management of infections and infectious complications in people with cancer. Her research interests include C. difficile and invasive pneumococcal infection rates in cancer patients, among others.
Dr. Kaltsas earned her medical degree from Albany Medical College with honors, followed by internal medicine residency at New York-Presbyterian–Weill Cornell. She completed a three-year infectious disease fellowship at Albert Einstein College of Medicine/Montefiore Medical Center, during which time she also pursued a master’s degree in clinical research.
Dr. Kaltsas has an interest in medical education and oversees the infectious disease fellowship at MSK, as well as rotations from interested medical students, interns, residents, and fellows from other institutions and other specialties on the infectious disease service.
Fellows are assigned to Tuesday afternoon or Friday morning clinic during their fellowship training. In their assigned clinics, fellows treat HIV patients, internal and external referrals, and patient follow-ups from in-house consultations. Fellows also attend the Employee Health and Wellness clinic approximately four to six times a year to become proficient at evaluation and management of employees with LTBI or exposure to blood-borne pathogens.
|Rotation in Clinical Micro/Infection Control/AMP||MSK Inpatient Consults||NYPH-Cornell Inpatient Consults||Research|
|First Year||1 month||6-7 months||1 month||2-3 months|
|Second Year||N/A||2-3 months||N/A||8-9 months|
|Optional Third Year||N/A||N/A||N/A||11 months|
MSK Inpatient Consults
Inpatient consults for fellows are divided between two teams: the regular consult service, Blue Team, and the immunocompromised host service, Red Team, which consists of leukemia and transplant patients. Fellows alternate between Blue Team and Red Team over the course of their fellowship. To unload the consult burden from fellows, there is also an attending only service comprised of consults deemed of low educational value for fellows.
NYPH-Cornell Inpatient Consults
Fellows rotate for one month on the inpatient service at New York Presbyterian/Weill Cornell Medical Center as first-year fellows. There they encounter infectious problems occurring in a general hospital where patient populations include immunologically normal hosts, the elderly, patients with alcohol and/or drug abuse histories, returning travelers, and recent immigrants.
To enhance the fellows’ ambulatory care experience, second-year fellows complete one month rotations at the STD clinic at SUNY Downstate Medical Center in Brooklyn and the ID Associates/Travel Medicine Clinic of NYP/Cornell.
Elective time is offered to second year fellows who wish to pursue clinical rotations at local New York hospitals if arranged beforehand with the program director and leadership at the hospital in question. Recent electives pursued by fellows include a solid organ transplantation elective at Mount Sinai and outpatient HIV clinic elective at NYP/Cornell.
During one research block in the second year of fellowship, fellows spend eight half-day sessions at SUNY Downstate’s STD clinic. During another research block in the second year of fellowship, they spend six half-day sessions at the ID Associates/Travel Medicine Clinic affiliated with NYPH-Cornell.
Approximately fifty percent of MSK ID fellows seek additional research training that is not required for ID Boards certification. This is completed in an optional third year. See the Research section for additional information or visit the ID faculty members’ web pages to see the groundbreaking cancer research ID fellows are currently participating in.
Specific responsibilities are distributed throughout the two to three years of the fellowship. In general, the first-year (junior) fellows provide the majority of inpatient care. Second-year (senior) fellows provide leadership and serve as role models for the junior fellows and other rotators to the ID service. The senior fellows are also responsible for organization and preparation of Intercity Rounds, hosted by MSK biannually; organization of monthly TransYork rounds; end-of-the-year presentation of research work at the “Advanced Topics in Infectious Disease” lecture series; supervision of the Blood Culture Quality Improvement (QI) Project and other QI projects; representation to the ID fellowship’s Program Evaluation Committee; and representation to the hospital’s Graduate Medical Education (GME) committee.
At the end of attending rounds, the ID consult team will round in the microbiology laboratory to review all new positive blood cultures, significant cultures from nonsterile sites, and other significant microbiologic results relevant to patient care. Director Yi-Wei Tang and Assistant Director Esther Babady supervise the microbiology laboratory.
The Antibiotic Management Program (AMP) handles antibiotic approvals six to seven days a week from 9:00 am to 5:00 pm. After hours (and also on some holidays and weekends), the approval pager is rolled over to the ID fellow on call. The bulk of night approvals generally occur before 11:00 pm.
Blood Culture Quality Improvement (QI) Project
As part of an ongoing QI project, the charts of all patients with one or more positive blood cultures (with the exception of coagulase-negative staphylococci recovered from a single blood culture) are reviewed by the on-service ID fellows to ensure adequacy of empiric antimicrobial therapy. The on-service attending serves as backup for the fellows. Formal consultation may be necessary to assist in the management of complicated bloodstream infections.
Needlesticks, Splashes, and Other Occupational Exposures
After hours and on weekends and holidays, the ID fellow may be contacted regarding an employee who has or was exposed to an infectious agent or who had an accidental needlestick or splash exposure (varicella, measles, mumps, rubella, pertussis, and various respiratory viruses including influenza). There is always an Employee Health attending on call that can guide and maximize ID fellow learning through these situations.
Conference designed to bring together specialists throughout NYC to discuss interesting and unusual cases in an “unknown diagnosis” format; it has served as a means by which citywide practitioners have alerted each other to new or unusual emerging pathogens since 1968. AIDS was first discussed in 1979-1980 at this meeting, and more recently, discussions have been held regarding bioterrorism.
Microbiology Plate Rounds
Research in Progress:
Faculty and fellows present their latest projects and research findings; faculty presentations serve as introductions to their work so fellows can familiarize themselves with possible research areas of interest and mentors.
Infection Control Meeting
ID Clinical Conference:
On-service fellows each present a case followed by a discussion that encompasses a focused, but thorough, literature review and summation of the critical points of the case. Pertinent radiographs and important smears or biopsies should be shown.
Department of Medicine Grand Rounds
Advanced Topics in Infectious Diseases (Grand Rounds):
joint conference organized by the Infectious Diseases Divisions of MSKCC and Weill Cornell Medical College. Guest speakers from local and distant academic institutions present on topics of their expertise.
Memorial Sloan Kettering has a long history of conducting research on the management of infectious diseases in immunocompromised patients. In the 1970s, our Infectious Diseases Service performed pioneering studies on the diagnosis of and therapy for infections in patients undergoing intensive chemotherapy for cancer, and in the 1980s we became a center for the study and treatment of AIDS. In recent years, the research focus of the Infectious Diseases Service has been extended to clinical and laboratory investigation of immune responses to bacterial, fungal, and viral infection.
Our laboratory and clinical investigators are studying adaptive and innate immune responses to infection in patients undergoing cancer chemotherapy and stem cell transplantation.
Broadly speaking, clinical investigation within the Infectious Diseases Service focuses on diagnosis and therapy of infections in the compromised host and hospital infection control. Collaborative clinical research projects between the Infectious Diseases Service and other services within Memorial Sloan Kettering focus on monitoring and augmenting antiviral immunity in transplant patients and people receiving other forms of cancer therapy.
Quantitative methods are being used to identify and characterize T lymphocyte populations that combat viral and fungal infections in immunocompromised patients. On a more basic research level, laboratories of the Infectious Diseases Service are studying infectious diseases in animal models to develop a deeper understanding of immune defenses against invasive microbes.
The research laboratories of the Infectious Diseases Service at Memorial Sloan Kettering are focused on the immune response to infection by bacterial, fungal, and viral pathogens. The pathogenesis of mycobacterial infections is also actively investigated. Interested fellows are encouraged to work in the laboratory on research projects that characterize the interface between the mammalian immune system and pathogens in the setting of infectious disease.
Fellows are provided with on-site training in laboratory investigation and also have opportunities to participate in basic science course work. Fellows with interest in microbiology, cell biology, and other fields have a variety research options at MSK along with opportunities at The Rockefeller University and Weill Cornell Medical College.
Infectious Diseases fellows can become involved with, and may initiate, a broad range of clinical studies. Research projects may include clinical reports, case series, and epidemiologic investigations. Faculty members within MSK or from The Rockefeller University or Weill Cornell Medical College who are associated with the MSK Infectious Diseases Service will supervise all research projects.
Though most clinical studies typically occur within the Infectious Diseases Service, they often cross borders into other disciplines. Thus, collaborative studies with other clinical services (including lymphoma, leukemia, and transplant) are commonplace and encouraged. The close relationship between the Clinical Microbiology Service and the Infectious Diseases Service also provides many opportunities for fellow-initiated research projects.
Lucille Castori Center for Microbes, Inflammation & Cancer
In January 2010, Memorial Sloan Kettering created a multidisciplinary research center to shed light on the role that microbes and the body’s inflammatory and immunological responses to them play in the development of cancer. The Lucille Castori Center for Microbes, Inflammation, and Cancer unites researchers in the areas of molecular biology, immunology, computational biology, and microbiology and members of the Infectious Diseases and Clinical Microbiology Services in Memorial Hospital.
In addition to facilitating research among MSK’s investigators and clinicians, the Castori Center provides grants for clinical and laboratory-based fellows to extend their research and training.
The fellowship director, service chief, and other faculty speak with each fellow individually regarding potential projects in the first months of fellowship. By fall of the first year of fellowship, fellows generally have identified a few areas of potential interest and a specific mentor for each area.
Many of our Infectious Diseases fellows have gone on to illustrious careers in academia, research, and clinical medicine, both in the United States and abroad. Our program has also trained many of our own current faculty members.
Esther Arguello Perez
Esther Arguello Perez
Maria Del Castillo Garcia
Anabella Lucca Bianchi
Maria Antonieta Del Castillo
Cesar Figueroa Ortiz
Anabella Lucca Bianchi
Amar Safdar (Research)
DAP12 Inhibits Pulmonary Immune Responses to Cryptococcus neoformans.
Heung L, Hohl T.
2016. Infect Immun. PMCID: PMC4907135
The Spectrum of Serious Infections Among Patients Receiving Immune Checkpoint Blockade for the Treatment of Melanoma.
Del Castillo M, Romero FA, Argüello E, Kyi C, Postow MA, Redelman-Sidi G.
2016. Clin Infect Dis.
Toxoplasma Encephalitis in Atypical Hosts at an Academic Cancer Center.
Morjaria S, Epstein DJ, Romero FA, Taur Y, Seo SK, Papanicolaou GA, Hatzoglou V, Rosenblum M, Perales MA, Scordo M, Kaltsas A.
2016. Open Forum Infect Dis. PMCID: PMC4834739
Gut Microbiota Predict Pulmonary Infiltrates After Allogeneic Hematopoietic Cell Transplantation.
Harris B, Morjaria SM, Littmann ER, Geyer AI, Stover DE, Barker JN, Giralt SA, Taur Y, Pamer EG.
2016. Am J Respir Crit Care Med. PMCID: PMC5003327
Comparison of respiratory virus shedding by conventional and molecular testing methods in patients with hematological malignancy.
Richardson L, Brite J, del Castillo M, Childers T, Sheahan A, Huang YT, Dougherty E, Babady NE, Sepkowitz K, Kamboj M.
2016. Clin Microbiol Infect. PMCID: PMC4994888
Deploying FLAREs to Visualize Functional Outcomes of Host-Pathogen Encounters.
Heung LJ, Jhingran A, Hohl TM.
2015. PLoS Pathog. PMCID: PMC4497593
West Nile Virus Central Nervous System Infection in Patients Treated with Rituxumab: Implications for Diagnosis and Prognosis, With a Review of the Literature.
Morjaria S, Arguello E, Taur Y, Sepkowitz K, Hatzoglou V, Nemade A, Rosenblum M, Cavalcanti M, Palomba M, Kaltsas A.
2015. Open Forum Infectious Diseases. PMCID: PMC4643542
Ribosomal RNA gene sequencing for early diagnosis of Blastomyces dermatitidis infection.
Morjaria S, Otto C, Moreira A, Chung R, Hatzoglou V, Pillai M, Banaei N, Tang YW, Figueroa CJ.
2015. Int J Infect Dis.
Bacteremia caused by Arcobacter butzleri in an immunocompromised host.
Arguello E, Otto CC, Mead P, Babady NE.
2015. J Clin Microbiol. PMCID: PMC4365236
The effects of intestinal tract bacterial diversity on mortality following allogeneic hematopoietic stem cell transplantation.
Taur Y, Jenq RR, Perales MA, Littmann ER, Morjaria S, Ling L, No D, Gobourne A, Viale A, Dahi PB, Ponce DM, Barker JN, Giralt S, van den Brink M, Pamer EG.
2014. Blood. PMCID: PMC4133489
Tolerability of chemotherapy in HIV-infected women with breast cancer: are there prognostic implications? AIDS Patient Care STDs.
Parameswaran L, Taur Y, Shah M, Traina T, Seo SK.
Impact of peri-transplant vancomycin and fluoroquinolone administration on rates of bacteremia in allogeneic stem cell transplant (HSCT)recipients: a 12 year singly institution study.
Seo SK, Xiao K, Huang YT, Jongwutiwes U, Chung D, Maloy M, Giralt S, Barker JN, Jakubowski AA, Papanicolaou GA.
2014. J Infect. PMCID: PMC4163089
A case of protothecosis in a patient with multiple myeloma.
Figueroa CJ, Camp BJ, Varghese GI, Miranda E, Querfeld C, Hassoun H, Kamboj M, Pulitzer MP.
Disseminated adenovirus infection in cancer patients presenting with focal pulmonary consolidation.
Lee JY, Palomino-Guilen P, Babady NE, Lamson DM, St George K, Tang YW, Papanicolaou GA.
2014. J Clin Microbiol. PMCID: PMC3911433
IFN-γ release assays in the diagnosis of latent tuberculosis infection among immunocompromised adults.
Redelman Sidi G, Sepkowitz K.
2013. Am J Respir Crit Care Med.
Adenovirus viremia and disease: comparison of T cell-depleted and conventional hematopoietic stem cell transplantation recipients from a single institution.
Lee JY, Chung D, Xiao K, Papadopoulos EB, Barker JN, Small TN, Giralt SA, Zheng J, Jakubowski AA, Papanicolaou GA.
2013. Biol Blood Marrow Transplant. PMCID: PMC4049479
Oncogenic activation of Pak1-dependent pathway of macropinocytosis determines BCG entry into bladder cancer cells.
Redelman Sidi G, Iyer G, Solit DB, Glickman MS.
2013. Cancer Res. PMCID: PMC3756537
International travel patterns and travel risks of patients diagnosed with cancer.
Mikati T, Taur Y, Seo SK, Shah MK.
2013. J Travel Med.
Intestinal domination and the risk of bacteremia in patients undergoing allogeneic hematopoietic stem cell transplantation.
Taur Y, Xavier JB, Lipuma L, Ubeda C, Goldberg J, Gobourne A, Lee YJ, Dubin KA, Socci ND, Viale A, Perales MA, Jenq RR, van den Brink MR, Pamer EG.
2012. Clin Infect Dis. PMCID: PMC3657523
Inhibition of mycobacterial infection by the tumor suppressor PTEN.
Huang G, Redelman-Sidi G, Rosen N, Glickman MS, Jiang X.
2012. J Biol Chem. PMCID: PMC3391101
Mycobacteria exploit three genetically distinct DNA double-strand break repair pathways.
Gupta R, Barkan D, Redelman-Sidi G, Shuman S, Glickman MS.
2011. Mol Microbiol. PMCID: PMC3812669
ABSTRACTS AND ORAL PRESENTATIONS
Infections presenting 30 days after Chimeric Antigen Receptor (CAR) Modified T-cells: A single-center experience.
Romero A, Seo S, Hohl T, Taur Y.
October 2016, ID Society of America (IDSA) conference, New Orleans, LA.
Pooling NYC resources to educate fellows about antimicrobial stewardship and infection prevention and control.
Ostrowsky B, Nori P, Munjal I, del Castillo M, Seo SK.
October 2015, IDWeek, San Diego, CA.
How to Apply
Thank you for your interest in our Infectious Diseases Fellowship program. We accept applications via ERAS. We review all applications regardless of visa status.