GOALS Employee Resource Group Explores Environmental Racism and How It May Appear In a Work Atmosphere

Updated on Jan 18, 2024 | Community, Diversity and Inclusion, Featured

The Growth in Operations, Administration, and Leadership Society (GOALS) employee resource group hosted its quarterly meeting, bringing together about 20 Black men from across the Mount Sinai community to discuss environmental and systematic racism and how it affects the work atmosphere.

The session was held Wednesday, December 6, at the Annenberg Building on the campus of The Mount Sinai Hospital. Anthony Smalls, MBA, Financial Analyst and Program Manager at the Icahn School of Medicine at Mount Sinai, organized the event.

The GOALS employee resource group aims to address issues that can affect change and meets quarterly to discuss various topics and provide networking opportunities for its members. Members have the opportunity to meet with those with experience and longevity at Mount Sinai Health System, which is vital to fostering mentorship.

Christopher W. Bland, MPH, AE-C, was the keynote speaker and led the discussion. He presented at Mount Sinai Health System’s Diversity, Equity, and Inclusion Summit in October 2023 on climate change and environmental racism.

Christopher W. Bland, MPH, AE-C, talks at a meeting of the Growth in Operations, Administration, and Leadership Society (GOALS) employee resource group.

“The word ‘system’ derives from the idea of placing together in an organized and arranged form,” he said.  “Thus, a system isn’t something that occurs but is a well-thought process to achieve a specific outcome. Unfortunately, the communities that house the Black and Latino populations are affected worst by some systems that are in place.”

Mr. Bland discussed the effects of health insurance and health care, food deserts, pollution, and trash pickups in Black and Brown communities.  He said that Mount Sinai has continued to serve the community with the highest form of medical care and fosters community relationships with organizations like One Hundred Black Men Inc.

Still, more work needs to occur to end these systematic cycles, he said, adding a quote from Martin Luther King, Jr.: “Injustice anywhere is a threat to justice everywhere.”

Added Mr. Smalls: “From redlining to income gaps to predatory lending to home loan discrimination to the racial wealth gap, our communities have had so many obstructions in our paths that if they were ever to be removed permanently from our course, we might hit levels that most could not fathom.”

Retention of staff of color is essential to diversity. With GOALS, members get an opportunity see others from our communities at different levels within Mount Sinai. A motto of One Hundred Black Men is “They will be what they see.”

To learn more about the GOALS ERG, email GOALS@mssm.edu or visit the website GOALS (Growth in Operations, Administrations and Leadership Society).

Mount Sinai-Harlem Health Center: Elevating Health Care Through Comprehensive Services

Jan 9, 2024 | Community, Featured

The Mount Sinai-Harlem Health Center has officially opened its 12-story, 85,000-square-foot facility, symbolizing a transformative moment in the delivery of health care to the Harlem community.

The $80 million investment reaffirms Mount Sinai’s commitment to providing inclusive, equitable, and high-quality health care. Key figures, including Evan L. Flatow, MD, President of Mount Sinai Morningside and Mount Sinai West, Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and Kelly Cassano, DO, Chief Executive Officer, Mount Sinai Doctors Faculty Practice, emphasized the significance of the state-of-the-art outpatient facility during a ribbon-cutting ceremony on Tuesday, December 12.

“In an era where accessibility and comprehensive care are paramount, Mount Sinai-Harlem Health Center will play a pivotal role in ensuring that community members, our neighbors, receive the care they deserve,” said Dr. Flatow. “The Center stands as a beacon of hope, embodying the spirit of inclusivity, innovation, and a commitment to the health and wellness of Central Harlem.”

Input from patients, families, care team members, local leaders, and community organizations was integral to the development of the Center, providing input to the design and care teams. The goal was to ensure the Center met the needs of the stakeholders. A video, with reflections from current patients, helps prospective patients learn more about the Mount Sinai-Harlem Health Center.

“In an era where accessibility and comprehensive care are paramount, Mount Sinai-Harlem Health Center will play a pivotal role in ensuring that community members, our neighbors, receive the care they deserve. The Center stands as a beacon of hope, embodying the spirit of inclusivity, innovation, and a commitment to the health and wellness of Central Harlem.” — Evan L. Flatow, MD, President of Mount Sinai Morningside and Mount Sinai West

The Center provides primary care, surgical specialties, mental health care, dentistry, imaging, and pharmacy services, and also houses the Institute for Advanced Medicine (IAM), known at this site as the Jack Martin Fund Center. This specialized center offers health care in a safe and welcoming environment, catering to individuals regardless of background, sexual orientation, or age.

The Jack Martin Fund Center within the Mount Sinai-Harlem Health Center goes beyond conventional health care, providing social and support services to ensure comprehensive well-being. IAM patients, from infants to older adults, have access to primary care, mental health care, in-house specialty services, radiology, laboratory, and pharmacy services—all seamlessly integrated to offer holistic care.

Other noteworthy services provided by the Institute include acupuncture and massage; dentistry; dermatology; gynecology; nutrition; nephrology; neurology; obstetrics/gynecology; pain management; and prevention of anogenital cancer, which includes cancers of the anus, penis, and vagina.

The Center also provides HIV/AIDS care, LGBTQ+ care, transgender care, social work guidance, and access to clinical trials.

“The Institute for Advanced Medicine has its roots in providing care for people with HIV/AIDS,” said Michael Mullen, MD, Director of the Institute. “We offer special programs specifically for this population, for example to help them adjust to their medications, to ensure HIV-negative patients take PrEP to keep them from becoming HIV positive, addressing uncontrolled viral load in patients, and coordinating care for patients who do not have enough, or any, insurance.”

“Mount Sinai Health System has made an enormous commitment to equity in health care,” said Dr. Charney. “Not only is this Center home to a wide range of health care services, it also houses the Diversity and Innovation Hub, a unique community-driven incubator that tackles disparities resulting from social determinants of health.”

The commitment to mental health is further supported through the behavioral health services provided at the Mount Sinai-Harlem Health Center. A dedicated team of psychiatrists, psychologists, and social workers offers a range of behavioral health programs, including the Child and Adolescent Psychiatry Outpatient Program, the Adult Outpatient Service, the Partial Hospital Program, and the Center for Intensive Treatment of Personality Disorders.

“We’re reaffirming our commitment to providing accessible and evidence-based mental health services to those in need,” said Prameet Singh, MD, Director of Behavioral Health Services at Mount Sinai Health System. “Our team is experienced in caring for New York City’s diverse population.”

In addition to these groundbreaking initiatives, the Center is set to open a specialty pharmacy, open to the Center’s patients and members of the community, and a multispecialty practice in 2024. This practice will offer a diverse range of services, including care for digestive and kidney issues, eye care, orthopedics, and podiatry, enhancing the accessibility of specialized care within the community.

Learn more about the Mount Sinai-Harlem Heath Center

Unsung Security Officers Participate in Resilience Educational Program: For Some, a First Introduction to Helpful Strategies

Updated on Jan 8, 2024 | Community, Diversity and Inclusion, Featured

Wayne Powell, Security Training Manager, and Reverend Zorina Costello, DMin, MDiv, MS, who helped create a resilience program specifically for security officers.

Hospital security officers are often our first human contact when we walk into a hospital. While they share the job description of “front-line worker,” along with doctors and nurses, they are both highly visible and yet “unsung” for all they do.

As the pandemic swept through New York City hospitals in 2020, their jobs transformed overnight as they became enforcers of new COVID-19 rules. One of the toughest rules: telling some visitors they could not come in. “Visitors to The Mount Sinai Hospital were not happy to hear about that. They wanted to see their loved ones, and we had to tell them ‘just one of you can go up,’” says Wayne Powell, Security Training Manager at The Mount Sinai Hospital.

One year into the pandemic, the faculty of Mount Sinai’s Center for Stress, Resilience, and Personal Growth took notice of the unique strain security officers were shouldering and created a resilience program, specifically tailored to officers like Mr. Powell. And more recently, they published a paper describing their approach and results.

“It was like a counseling session where you take a time out and reflect and think about the positive things and channel that to something great,” Wayne Powell, Security Training Manager, said of the program.

The Center opened in 2020 to serve as a resource for all Mount Sinai Health System staff and students. Staffed by social workers, psychologists, psychiatrists, and a healthcare chaplain, the Center provides educational workshops, confidential behavioral health care, and a resilience-building mobile app to faculty, staff, and trainees. Center faculty and staff also regularly publish peer-reviewed scientific articles about their findings, so that other health systems may benefit.

Reverend Zorina Costello, DMin, MDiv, MS, played a key role in creating the security officer program during the height of the COVID-19 pandemic in 2021. In addition to her Doctorate of Ministry in Pastoral Counseling. Rev. Costello has training in counseling, providing the skills to develop workshops tailored to security personnel that would have an impact.

“They often work alone and have few opportunities to socialize with their colleagues. In addition, they face myriad physical hazards and long working hours, making them susceptible to psychological stress, fatigue, and occupational burnout,” says the Rev. Dr. Costello.

During her 10 years at Mount Sinai, she has had the opportunity to meet the security team beyond just “hello” or “good morning.”  During her lengthy tenure in Mount Sinai’s chaplaincy, she had become the main point of contact for staff when colleagues passed away, giving her an intimate connection with hospital staff, including the security team.

While facilitating services for security personnel over the years, she started to understand their unique culture. “I was beginning to see how their isolation was affecting them and how the services presented unique opportunities for isolated workers to come together,” says Rev. Dr. Costello.

Rev. Dr. Costello served as co-author of a paper titled “A Resilience Program for Hospital Security Officers During the COVID-19 Pandemic Using a Community Engagement Model,” published in the Journal of Community Health in September 2023.

The paper describes how she and colleagues at the Center first conducted a pilot program and then launched a second program based on feedback they received, the latter comprised of twelve short briefings in which faculty and staff at the Center provided education around psychological first aid (PFA). PFA is an evidence-based approach to providing emotional support and ensuring safety in the acute aftermath of a stressful event. The program was well attended, reaching 107 officers who identified mostly as male (86 percent) and people of color (95 percent).

Viewed as a success, and fully embraced by security personnel, the program will be replicated at Mount Sinai West and Mount Sinai Morningside, according to Rev. Dr. Costello.

Security officers participated in 20-minute briefings that included a visual presentation with discussion focused on acknowledging the officers’ contribution to workplace safety and their exposure to violence; educating officers about clinical services available to them through the Center; and, discussing basic psychological first aid and coping skills. In a follow-up survey, the team found that the majority of officers (71 percent) felt that the workshops gave them the tools to do their jobs well and that the skills they honed were relevant (72 percent) to their lives outside of work.

“An important aspect of the briefings was to share resources at Mount Sinai for additional support, due to the officers’ limited knowledge of how to access mental health supports. While little is known about these kinds of interventions for security personnel, we do know from studies of police officers that two key impediments to getting help include not knowing how to access help and concerns about the stigma,” said Rev. Dr. Costello.

This work was funded in part through the support of the Aronson Family Foundation and by grants from the Health Resources and Services Administration and the National Center for Advancing Translational Sciences.

Mr. Powell, who is looking forward to his 60th birthday in December, has served Mount Sinai for 27 years. Yet this was his first exposure to these beneficial mental health concepts.

“For me personally, it was very successful, especially coming off the COVID-19 pandemic. It was like a counseling session where you take a time out and reflect and think about the positive things and channel that to something great,” says Mr. Powell. As he onboards new security personnel, he has made it a priority to sign his employees up for this training program.

Reflections From an Ethics Fellowship at Auschwitz

Updated on Dec 19, 2023 | Community, Featured

Students attending the Fellowships at Auschwitz for the Study of Professional Ethics at a library in Charité–Universitätsmedizin Berlin, where several specimens, including casts of body parts of some famous scientists and skulls of people from Namibia during German colonization, were displayed.

For many pursuing a path in medicine, a fellowship is an opportunity to learn and hone specialized skills in their chosen subspecialty. But medical education encompasses so much more than just medical skills and knowledge—compassion and ethics are just as important for a physician during medical training.

A group of students and graduates from the Icahn School of Medicine at Mount Sinai got to explore those values more deeply at the Fellowships at Auschwitz for the Study of Professional Ethics (FASPE), a two-week program in Berlin, Germany, and Krakow, Poland, exploring ethical atrocities committed in medicine in the past and opportunities for improvement today.

“The immersive experience it offers, allows participants to learn about some of the professional responsibilities of physicians,” says Rosamond Rhodes, PhD, Professor of Medical Education and Director of Bioethics Education at Icahn Mount Sinai.

When guided by humanitarian commitment, medicine can achieve great things, but when doctors lose sight of the profession’s fiduciary responsibility, horrors can come from it, says Dr. Rhodes. Students benefit tremendously from learning about critically important pieces of history in medicine, she adds.

Over the years, seven people from Icahn Mount Sinai have participated in the fellowship. Browse the slideshow and read from three recent fellows on their accounts of the program, and how it has reshaped their perspectives.

Käthe Kollwitz’s statue Mother With Her Dead Son in the Neue Wache building in Berlin, Germany.

“I found myself able to make myself vulnerable in sharing my thoughts and being transparent when discussing the fellowship’s fundamental themes, namely: what is inside us that makes us prone to becoming perpetrators or complicit in flawed systems, despite our most noble intentions?”
Krishna Patel, student, Class of 2025

Humboldt University of Berlin, in which some 20,000 books were burned during the Nazi regime.

“It is no secret that both health care and education, especially in the United States, are flawed systems—to say the least—yet how can this be reconciled with the vast majority of individual agents, including teachers, nurses, doctors, and aides who devote themselves to a career of helping others during times of high need and vulnerability?”
Krishna Patel, student, Class of 2025

A memorial on Rosenstraße in Berlin, commemorating women who protested for their Jewish husbands to be released.

“In my work as a physician, this experience compelled me to consider the ethical challenges of addressing histories of collective harm and health-related trauma in underserved communities. In particular, this lesson from FASPE shaped my career interests in gender equity and preventive health.”
Esha Bansal, MD, MPH, Class of 2023

FASPE fellows at Charité–Universitätsmedizin Berlin.

“In discussing how to memorialize the remains of victims of the Holocaust and Germany’s colonial campaigns in West Africa, we confronted challenges around the use of human specimens in research without consent. Having previously worked with digital forms of clinical data and understanding its growing ubiquity in health care technologies, I was struck by similar implications that are increasingly posed by digital data.”
Anish Kumar, student, Class of 2025

A lecture hall at  Charité–Universitätsmedizin Berlin.

“Here, we traced the steps of pioneers of medicine, where figures like Rudolf Virchow and Carl Wernicke elucidated concepts that have become integral to modern clinical practice. But it was in these same hallways where academics contributed to and benefited personally from the atrocities of the Nazi regime, gaining easy access to human subjects and cadavers for their research efforts.”
Anish Kumar, student, Class of 2025

Anish Kumar, Class of 2025
Krishna Patel, Class of 2025
Esha Bansal, MD, MPH, Class of 2023

Anish Kumar is currently on a Scholarly Year project—a yearlong research training—at RubiconMD, a New York-based digital health company that aims to improve access to specialty care. Professional interests include how clinical medicine and artificial intelligence intersect and resulting ethical questions, and using digital technologies and policy solutions to improve access to health care for LGBTQ+ and limited-English-proficiency patients.

As part of the FASPE program, our group had the opportunity to visit the Charité–Universitätsmedizin Berlin, a university hospital and medical school in the center of Berlin. Here, we traced the steps of pioneers of medicine, where figures like Rudolf Virchow and Carl Wernicke elucidated concepts that have become integral to modern clinical practice. But it was in these same hallways where academics contributed to and benefited personally from the atrocities of the Nazi regime, gaining easy access to human subjects and cadavers for their research efforts.

Our cohort visited a facility in Brandenburg, Germany, that was part of the Aktion T-4 campaign, in which medical professionals selected patients with serious illness or disability for systemic execution. Many of these clinicians were swayed by arguments that caring for such patients was excessively resource-intensive and that these patients represented “life unworthy of life.”

I was horrified to learn that doctors had signed up their own patients to be killed—a realization made even more chilling by witnessing the remnants of a gas chamber prototype that was used, which eventually became the notorious killing machines used to execute mass murder in concentration camps. I saw that rank-and-file physicians had been compelled to corrupt their core ethical values and murder their own patients, all in the name of public health.

In discussing how to memorialize the remains of victims of the Holocaust and Germany’s colonial campaigns in West Africa, we confronted challenges around the use of human specimens in research without consent. Having previously worked with digital forms of clinical data and understanding its growing ubiquity in health care technologies, I was struck by similar implications that are increasingly posed by digital data. Inspired by my experiences at Charité, I am currently writing an opinion piece arguing that certain forms of medical data should be considered “digital specimens” and that their use in research should be regulated in similar manners to physical samples.

I realize that part of my duty as a physician is to stay vigilant and speak out against claims that blindly dismiss the importance of an individual patient in alleged deference to the greater good. I am grateful for the opportunity to participate in FASPE and to walk away with a new vocabulary, refined perspective, and a deeper confidence in my ability to recognize and engage with the inevitable ethical dilemmas that will face me as a physician.

Krishna Patel is currently on a Scholarly Year project, and started a 501(c)(3) nonprofit called Health and Education Alliance, supported by Mount Sinai’s Diversity Innovation Hub Fellowship. The nonprofit builds partnerships between health care organizations and school districts to maximize access to health care and education opportunities through holistic community centers.

Before arriving in Berlin and Krakow for the two-week fellowship, I found myself grappling with a lot of excitement but also some element of concern. Having lacked any prior ethics background and knowing I would be in a cohort of folks with much more knowledge than me in this domain, I couldn’t help but worry about how I might be judged. However, I am so thankful to say that all of the other 41 fellows, who challenged me to break down and realize my own biases and weaknesses, were among the kindest, most insightful group of people I have had the pleasure of meeting.

In particular, it turns out that spending entire days in close proximity with everyone at historical sites, where some of the greatest horrors in history have been memorialized, is one of the best ways to bring people together, albeit in a way that I could not have comprehended prior to this experience.

I found myself able to make myself vulnerable in sharing my thoughts and being transparent when discussing the fellowship’s fundamental themes, namely: what is inside us that makes us prone to becoming perpetrators or complicit in flawed systems, despite our most noble intentions?

As a future physician who is currently in the midst of a Scholarly Year, where much of my work focuses on improving health care and education inequity for underserved neighborhoods and families with special needs, I have been unable to stop myself from ruminating on this question since the conclusion of the fellowship. It is no secret that both health care and education, especially in the United States, are flawed systems—to say the least—yet how can this be reconciled with the vast majority of individual agents, including teachers, nurses, doctors, and aides who devote themselves to a career of helping others during times of high need and vulnerability?

Truthfully, I still do not have the best answer to this question. However, without FASPE, I would never have been able to come away with the ethical framework to engage in self-introspection and evaluate my own biases and shortcomings as much as possible. Moreover, I do not believe I would have the courage or even the words to articulate some of my frustrations, which have encouraged communication with people I speak to for my Scholarly Year work in my hometown, Pittsburgh.

I could not be more grateful for my FASPE experience and I’m optimistic it will stay with me throughout the remainder of my professional career. It reinforces the notions that as physicians who have the great privilege of having roles and rights in patients’ lives not otherwise granted to most other professions, there is always more that we can advocate for as a collective profession to minimize harm and hold ourselves accountable.

Esha Bansal, MD, MPH, is currently a resident physician in internal medicine at Hospital of the University of Pennsylvania. Professional interests include reducing preventable morbidity and mortality through population health research and public policy, particularly in cardiovascular disease, and advancing gender equity by designing equitable, sustainable health interventions that reduce sexual and gender-based violence for women and girls worldwide.

While visiting important historical sites through FASPE, I was struck by the complexities of memorializing large-scale events of human suffering. Early in the fellowship, we visited the Grunewald train station, a major deportation site for the Jewish community of Berlin during World War II. Over time, several commemorations of the violence enacted at the Grunewald train station had been installed by diverse groups, simultaneously reinforcing and contrasting with one another to bring a piece of this history into the present and future.

In my work as a physician, this experience compelled me to consider the ethical challenges of addressing histories of collective harm and health-related trauma in underserved communities. In particular, this lesson from FASPE shaped my career interests in gender equity and preventive health. Inspired by “A Woman in Berlin,” an important post-World War II literary work by a German journalist, I wrote an essay arguing that past and present incidents of mass sexual violence should be proactively acknowledged as medical and public health crises with genocidal attributes.

At the conclusion of the fellowship, our cohort visited the Auschwitz-Birkenau Memorial and Museum in Oświęcim, Poland. Standing in the physical space where millions of people were exterminated was a powerful, humbling experience. This moment moved me to make my own contribution to the ongoing work of addressing medical and public health professionals’ complicity in mass crimes—including the genocides of World War II, in which Nazi physicians participated freely and voluntarily. I later wrote a commentary article calling attention to the unmet obligations of the medical and public health professions to address femicide, a severe and highly prevalent form of gender-based violence, as a global health problem.

Participating in FASPE reinforced my belief that as physicians and public health professionals, we must seek accountability for our profession’s role in perpetuating harm. I am grateful that FASPE offered me the intellectual framework, personal experiences, and practical skill set to begin my own professional ethics journey.

Anish Kumar, Class of 2025
Krishna Patel, Class of 2025
Esha Bansal, MD, MPH, Class of 2023

Anish Kumar is currently on a Scholarly Year project—a yearlong research training—at RubiconMD, a New York-based digital health company that aims to improve access to specialty care. Professional interests include how clinical medicine and artificial intelligence intersect and resulting ethical questions, and using digital technologies and policy solutions to improve access to health care for LGBTQ+ and limited-English-proficiency patients.

As part of the FASPE program, our group had the opportunity to visit the Charité–Universitätsmedizin Berlin, a university hospital and medical school in the center of Berlin. Here, we traced the steps of pioneers of medicine, where figures like Rudolf Virchow and Carl Wernicke elucidated concepts that have become integral to modern clinical practice. But it was in these same hallways where academics contributed to and benefited personally from the atrocities of the Nazi regime, gaining easy access to human subjects and cadavers for their research efforts.

Our cohort visited a facility in Brandenburg, Germany, that was part of the Aktion T-4 campaign, in which medical professionals selected patients with serious illness or disability for systemic execution. Many of these clinicians were swayed by arguments that caring for such patients was excessively resource-intensive and that these patients represented “life unworthy of life.”

I was horrified to learn that doctors had signed up their own patients to be killed—a realization made even more chilling by witnessing the remnants of a gas chamber prototype that was used, which eventually became the notorious killing machines used to execute mass murder in concentration camps. I saw that rank-and-file physicians had been compelled to corrupt their core ethical values and murder their own patients, all in the name of public health.

In discussing how to memorialize the remains of victims of the Holocaust and Germany’s colonial campaigns in West Africa, we confronted challenges around the use of human specimens in research without consent. Having previously worked with digital forms of clinical data and understanding its growing ubiquity in health care technologies, I was struck by similar implications that are increasingly posed by digital data. Inspired by my experiences at Charité, I am currently writing an opinion piece arguing that certain forms of medical data should be considered “digital specimens” and that their use in research should be regulated in similar manners to physical samples.

I realize that part of my duty as a physician is to stay vigilant and speak out against claims that blindly dismiss the importance of an individual patient in alleged deference to the greater good. I am grateful for the opportunity to participate in FASPE and to walk away with a new vocabulary, refined perspective, and a deeper confidence in my ability to recognize and engage with the inevitable ethical dilemmas that will face me as a physician.

Krishna Patel is currently on a Scholarly Year project, and started a 501(c)(3) nonprofit called Health and Education Alliance, supported by Mount Sinai’s Diversity Innovation Hub Fellowship. The nonprofit builds partnerships between health care organizations and school districts to maximize access to health care and education opportunities through holistic community centers.

Before arriving in Berlin and Krakow for the two-week fellowship, I found myself grappling with a lot of excitement but also some element of concern. Having lacked any prior ethics background and knowing I would be in a cohort of folks with much more knowledge than me in this domain, I couldn’t help but worry about how I might be judged. However, I am so thankful to say that all of the other 41 fellows, who challenged me to break down and realize my own biases and weaknesses, were among the kindest, most insightful group of people I have had the pleasure of meeting.

In particular, it turns out that spending entire days in close proximity with everyone at historical sites, where some of the greatest horrors in history have been memorialized, is one of the best ways to bring people together, albeit in a way that I could not have comprehended prior to this experience.

I found myself able to make myself vulnerable in sharing my thoughts and being transparent when discussing the fellowship’s fundamental themes, namely: what is inside us that makes us prone to becoming perpetrators or complicit in flawed systems, despite our most noble intentions?

As a future physician who is currently in the midst of a Scholarly Year, where much of my work focuses on improving health care and education inequity for underserved neighborhoods and families with special needs, I have been unable to stop myself from ruminating on this question since the conclusion of the fellowship. It is no secret that both health care and education, especially in the United States, are flawed systems—to say the least—yet how can this be reconciled with the vast majority of individual agents, including teachers, nurses, doctors, and aides who devote themselves to a career of helping others during times of high need and vulnerability?

Truthfully, I still do not have the best answer to this question. However, without FASPE, I would never have been able to come away with the ethical framework to engage in self-introspection and evaluate my own biases and shortcomings as much as possible. Moreover, I do not believe I would have the courage or even the words to articulate some of my frustrations, which have encouraged communication with people I speak to for my Scholarly Year work in my hometown, Pittsburgh.

I could not be more grateful for my FASPE experience and I’m optimistic it will stay with me throughout the remainder of my professional career. It reinforces the notions that as physicians who have the great privilege of having roles and rights in patients’ lives not otherwise granted to most other professions, there is always more that we can advocate for as a collective profession to minimize harm and hold ourselves accountable.

Esha Bansal, MD, MPH, is currently a resident physician in internal medicine at Hospital of the University of Pennsylvania. Professional interests include reducing preventable morbidity and mortality through population health research and public policy, particularly in cardiovascular disease, and advancing gender equity by designing equitable, sustainable health interventions that reduce sexual and gender-based violence for women and girls worldwide.

While visiting important historical sites through FASPE, I was struck by the complexities of memorializing large-scale events of human suffering. Early in the fellowship, we visited the Grunewald train station, a major deportation site for the Jewish community of Berlin during World War II. Over time, several commemorations of the violence enacted at the Grunewald train station had been installed by diverse groups, simultaneously reinforcing and contrasting with one another to bring a piece of this history into the present and future.

In my work as a physician, this experience compelled me to consider the ethical challenges of addressing histories of collective harm and health-related trauma in underserved communities. In particular, this lesson from FASPE shaped my career interests in gender equity and preventive health. Inspired by “A Woman in Berlin,” an important post-World War II literary work by a German journalist, I wrote an essay arguing that past and present incidents of mass sexual violence should be proactively acknowledged as medical and public health crises with genocidal attributes.

At the conclusion of the fellowship, our cohort visited the Auschwitz-Birkenau Memorial and Museum in Oświęcim, Poland. Standing in the physical space where millions of people were exterminated was a powerful, humbling experience. This moment moved me to make my own contribution to the ongoing work of addressing medical and public health professionals’ complicity in mass crimes—including the genocides of World War II, in which Nazi physicians participated freely and voluntarily. I later wrote a commentary article calling attention to the unmet obligations of the medical and public health professions to address femicide, a severe and highly prevalent form of gender-based violence, as a global health problem.

Participating in FASPE reinforced my belief that as physicians and public health professionals, we must seek accountability for our profession’s role in perpetuating harm. I am grateful that FASPE offered me the intellectual framework, personal experiences, and practical skill set to begin my own professional ethics journey.

Mount Sinai Hosts Landmark Symposium on Urologic Oncology

Updated on Dec 14, 2023 | Community, Featured, Research

James Tisch, left, Co-Chairman of the Boards of Trustees of the Mount Sinai Health System, and Ash Tewari, MBBS, MCh, Chair of the Milton and Carroll Petrie Department of Urology.

The Department of Urology at the Icahn School of Medicine at Mount Sinai recently took center stage in the global medical community by hosting the Fifth International Prostate Cancer Symposium and World Congress of Urologic Oncology.

The event, held Friday, December 8, to Sunday, December 10, is considered a cornerstone in prostate, kidney, and bladder cancer. The event drew more than 500 registrants, including 90 of the world’s most renowned experts from more than 20 countries, and showcased groundbreaking research and clinical practices poised to redefine cancer care and impact patient outcomes worldwide.

A significant highlight was the presentation of the first Golden Robot Surgical Award for Excellence in Surgical Innovations for Cancer Patients to Ash Tewari, MBBS, MCh, Chair of the Milton and Carroll Petrie Department of Urology at Icahn Mount Sinai. This award was presented by Merryl and James Tisch, Co-Chairman of the Boards of Trustees of the Mount Sinai Health System, during a gala at the Pierre Hotel. The award recognizes a significant leap in medical innovation and patient care. Also attending were Brendan Carr, MD, MA, MS, whose appointment as Chief Executive of the Mount Sinai Health System is effective early next year, who opened the gala event, and Margaret Pastuszko, President and Chief Operating Officer.  Click here to watch a video shown at the gala titled “A Decade of Excellence: Dr. Ash Tewari’s 10-Year Voyage at the Department of Urology.”

Participants included 90 of the world’s most renowned experts from more than 20 countries.

Three Mount Sinai leaders opened the symposium: Dr. Tewari, Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of Icahn Mount Sinai, and David Reich, MD, President,The Mount Sinai Hospital and Mount Sinai Queens. Their insightful opening remarks set the tone for what was to be an intensive three-day exploration of the latest advancements and challenges in urologic cancer care.

One of the symposium’s highlights was an engaging presentation by best-selling author Deepak Chopra, MD, a pioneer in integrative medicine and a prolific writer titled “Major Breakthroughs in the Science of Healing.” Dr. Chopra’s talk focused on integrating AI with the holistic interplay of mind, body, and spirit in medical science.

The event also highlighted technological innovation in medical communication and education, featuring state-of-the-art holographic presentations by Declan Murphy, MB, BCh, BaO, Consultant Urologist, Peter MacCallum Cancer Centre, Melbourne, Australia, and Alberto Breda, MD, PHD, Chief, Uro-Oncology Unit and Kidney Transplant Surgical Program at Fundació Puigvert in Barcelona.

Additionally, a stimulating debate between Mount Sinai radiation oncologist Richard Stock, MD, and robotic surgery pioneer Mani Menon, MD, Professor and Chief of Strategy and Innovation at the Department of Urology, offered contrasting perspectives on treating intermediate-risk prostate cancer.

Ketan Badani, MD, the Department’s Vice Chair and Director of Robotic Operations, and other renowned speakers enriched the symposium with their expertise on modern surgical techniques in kidney cancer, fostering a collaborative learning culture.

The symposium’s final day, led by Peter Wiklund, MD, PhD, Professor and Director of the Bladder Cancer Program, showcased advanced surgical procedures and a panel discussion with Reza Mehrazin, MD, Associate Professor, and John Sfakianos, MD, Assistant Professor, providing deeper insights into bladder cancer management.

Interactive sessions, including live surgical demonstrations, 3D video presentations, and hands-on experiences in simulation laboratories, underscored the event’s commitment to innovative and experiential learning.

Reflecting on the symposium’s impact, Dr. Tewari noted, “This gathering served as a dynamic platform for exploring the various facets of urology and robotic surgery. The exchange of ideas and insights among our peers underscores our collective capacity to shape the future of urologic oncology significantly.”

 

Watch a slideshow of photos from the event:

Learn more about Urology at Mount Sinai

Institute for Health Equity Research Holds Inaugural Symposium to Exchange Ideas and Propel Research

Updated on Dec 19, 2023 | Community, Diversity and Inclusion, Featured

Carol Horowitz, MD, MPH, left, and Lynne D. Richardson, MD, directors of the Institute for Health Equity Research, at its inaugural symposium.

As part of its mission to elevate the science of heath equity, the Institute for Health Equity Research (IHER) held its inaugural symposium, one of the first major milestones in a new partnership between IHER and Royalty Pharma, established in 2022, to build an infrastructure to exchange ideas and propel research collaboration.

“We founded IHER to elevate the science of health equity to the same level as other important areas of science that are studied here at the Icahn School of Medicine at Mount Sinai. We are very pleased to partner with Royalty Pharma as we engage other leaders in the field to bring this conversation to the forefront,” says IHER Co-Director Lynne D. Richardson, MD, Professor of Emergency Medicine, and Population Health Science and Policy, Icahn Mount Sinai.

“We designed the symposium to explore two main areas of priority: collecting strong data to transform clinical care and building partnerships for cross-sector engagement,” says IHER Director Carol Horowitz, MD, MPH, Professor, Population Health Science and Policy, and Medicine, and Dean for Gender Equity in Science and Medicine.

The symposium, titled “From Inquiry to Action,” was held Friday, December 1, at Icahn Mount Sinai. The Institute was founded in 2020.

“To help us craft solutions that will really make a difference, we need community-based organizations to help us understand the lived experiences within the community,” says Dr. Horowitz. “We can’t come into a community without understanding the social determinants of health at a local level: Do members of the community have access to nutritious food, do they live in safe housing, how clean is the air?  Our institute is looking at all these different influences and working hand-in-hand with people from local communities to develop programs that tangibly improve their health.”

Dr. Horowitz moderated a panel of experts from community-based organizations, academia, and the public sector. The panelists described the challenges and possibilities of community-engaged equity initiatives.

“The use of data, both from health care organizations and from other sectors, is key to addressing structural inequities and achieving health equity,” says Dr. Richardson.

Dr. Richardson moderated a diverse panel that included leaders from health care, payors, and industry who described how cross sector data on health status and health care utilization can be linked to individual data on social risks and needs and to neighborhood data on physical and social exposures that threaten health. The panelists presented examples of how data can be harnessed to inform organizational strategies to promote equity and discussed the considerable challenges of using data in ethical and unbiased ways that do not adversely impact minoritized populations.

Through many voices and viewpoints, a familiar pattern emerged: a sobering story of a broken system that continues to fail its most vulnerable patients.

The keynote speaker, former New York State Health Commissioner, Mary T. Bassett, MD, MPH, FXB Professor of the Practice of Health and Human Rights, Harvard T. H. Chan School of Public Health, described the unequal landscape of medicine over time and across the country.  At one point, she reminded the audience that it was only 15 years ago that the American Medical Association, the voice of organized medicine in the United States, acknowledged that it had wrongly allowed, even endorsed, policies that prohibited Black physicians from practicing in hospitals.

“That Black individuals disproportionately suffer from kidney failure is one of many manifestations of unequal care that has its seed in a very long list of inequities,” says Dinushika Mohottige, MD, MPH.

Two members of the IHER faculty presented their research, beginning with Dinushika Mohottige, MD, MPH, Assistant Professor, Population Science and Policy, and Medicine (Nephrology). Dr. Mohottige, who specializes in kidney health equity, led her presentation with a startling statistic: While 13 percent of the U.S. population is Black, Black Americans make up 35 percent of individuals receiving dialysis care.

“That Black individuals disproportionately suffer from kidney failure is one of many manifestations of unequal care that has its seed in a very long list of inequities from underinsurance, limited access to doctors, and a wide spectrum of unequal social determinants working against them. Kidney patients, specifically, also experience the lingering challenges resulting from a race-based algorithm that has been phased out but which previously limited the possibilities for transplantation for Black patients,” says Dr. Mohottige.

Dr. Mohottige has found partners to leverage equity data to reform transplant roadblocks. To address the eGFR algorithm, a race-based correction that had the effect of overestimating a Black patient’s kidney function, she has worked with colleagues to help implement restorative policies to require unbiased, race neutral estimates of kidney health that began in January 2023.

She discussed cascading barriers to transplantation that begin with challenges to transplant referral and evaluation.

“These challenges can include trauma, discrimination, financial or employment instability, mental health or substance abuse, underinsurance, food insecurity or transportation barriers. If you are an individual with any of these challenges, imagine how hard it is to take even the simplest of steps in this long journey,” says Dr. Mohottige. “A fundamental part of change is simply making sure providers know that any of these obstacles can be an impediment, and we know from the data that clinicians are not always aware of these roadblocks.  To address this, we are working with multiple partners to build training programs to fill some of the education gaps among providers who treat these vulnerable populations.”

“Faith-based organizations are a natural place to integrate mental health supports,” says Sidney Hankerson, MD, MBA.

Sidney Hankerson, MD, MBA, Associate Professor, Population Health Science Policy, and Psychiatry, and a Mount Sinai Biomedical Laureate, described several initiatives designed to address mental health inequities in New York City. African Americans and Mexican Americans, he told his listeners, have the lowest rates of depression treatment in the United States. Dr. Hankerson is working to address this problem through partnerships he has developed with faith-based organizations throughout the NYC area and Westchester County.

Through the First Corinthians Baptist Church in Central Harlem, he has collaborated with church leadership to develop free mental health care embedded in their HOPE (Healing on Purpose and Evolving) Center. With a new grant from the Mother Cabrini Health Foundation, he is expanding the program by training psychiatry residents at Mount Sinai in the principles of community engagement and supervising residents who provide direct clinical services at the HOPE Center.

Through the TRIUMPH (TRansformIng yoUr Mental health through Prayer and Healing (Triumph Together), he has developed an eight- week training program to teach motivational interviewing in churches in the five boroughs and Westchester. TRIUMPH aims to address racial and gender disparities that affect Blacks and other communities of color by promoting mental health equity, increasing mental health literacy, reducing stigma, and improving access to care for depression, anxiety, prolonged grief, and drug use.

“More people initially seek help for depression from clergy than from psychiatrists.  So, faith-based organizations are a natural place to integrate mental health supports,” says Dr. Hankerson.

Through grant funding from the Scarlett Feather Foundation, Dr. Hankerson is now launching “Brothers Connect,” a suicide prevention program aimed at black youth ages 13-19. The program will roll out in YMCA’s across the city to reach boys participating in basketball leagues.

“All of these programs have one thing in common: They are all created as community-based networks of care to reach vulnerable populations where they are,” says Dr. Hankerson. “Our churches and local Y’s are safe havens where we can have the greatest impact. These programs underline how important it is for an institution like Mount Sinai to find partners in the community to reach patients who aren’t likely to walk through our doors and ask for help.”

Learn more about the Institute for Health Equity Research

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