Preparing Physicians to Treat the LGBTQI+ Community With Dignity as It Ages

Updated on Nov 14, 2025 | Engagement, Featured

Noelle Marie Javier, MD, left, with Roy Noy, MD, during Dr. Noy’s four-month observership at Mount Sinai to learn more about LGBTQI+ medicine and geriatrics.

The field of LGBTQ+ medicine has slowly been developing over the past decade, but a crucial intersection with a subspecialty has often been overlooked—geriatric medicine.

Throughout history, LGBTQI+ medicine has been underdeveloped and under-prioritized for several reasons, among them being that few people were historically willing to disclose and seek care as LGBTQI+ individuals, and that many members in the community lost their lives to the HIV/AIDS epidemic during the 1980s.

“There have been gaps in training at medical schools, residency, and fellowship training programs from the past until now,” says Noelle Marie Javier, MD, Associate Professor of Geriatrics and Palliative Medicine, and Medical Education, at the Icahn School of Medicine at Mount Sinai.

Across the majority of MD programs throughout the country, the average time devoted to training in LGBTQI+ medicine is about five hours in total across the four-year program, as cited in a 2011 JAMA paper. “That’s simply not enough,” says Dr. Javier.

These days, with increasing acceptance and awareness of diverse sexual orientations and gender identities in society, and modern advances in medicine, LGBTQI+ people are growing older and living longer—some with unique health concerns and disparities. These could include how older adults living with HIV are aging, or long-term effects of having received marginalized care or faced barriers to care. “Now, more than ever, we need to be prepared as physicians and allied health professionals to take care of them in a way that’s culturally humble, sensitive, and responsive,” Dr. Javier says.

The Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai is committed to providing inclusive and affirming care for older LGBTQI+ adults, which includes training and education for staff, students and trainees. Inspired by this work, the leadership at the Tel Aviv Sourasky Medical Center (Ichilov) reached out to the Mount Sinai LGBTQ+ Medicine Fellowship program to arrange a pilot program where a resident in geriatrics could gain knowledge and training through an observership for the care for older LGBTQI+ adults. During the fall of 2023, Roy Noy, MD, chief geriatrics resident at Ichilov, collaborated with Dr. Javier in expanding his geriatrics skills and developing a curriculum that he could use to train staff back in Tel Aviv.

Read more about Dr. Noy’s observership at Mount Sinai and the importance of focusing on geriatric LGBTQI+ medicine.

Dr. Noy is helping the Tel Aviv Sourasky Medical Center (Ichilov) set up an LGBTQI+ clinic for older adults. He spent four months at Mount Sinai observing various models of care in geriatrics and LGBTQI+ medicine.

How did this program come about?

Dr. Noy: We are trying to establish an LGBTQI+ service for older adults in our hospital at Tel Aviv. The head of the program, Roy Zucker, MD, was the inaugural fellow at the Mount Sinai LGBTQ+ Medicine Fellowship. He came up with the idea of trying to establish an observership for me to learn more from Mount Sinai about what is needed to start such a specialized service.

Dr. Javier: I was invited to be a plenary speaker at GLMA: Health Professionals Advancing LGBTQI+ Equality last year when Dr. Zucker and I first got acquainted. He wanted to set up a collaboration for one of his residents in the hopes of expanding his medical knowledge and clinical skills to take care of older LGBTQI+ adults.

What went into this observership?

Dr. Noy: The program had several parts to it.

  • On the broader geriatrics side, I did a lot of observing with different doctors and other team members working in the Brookdale Department Geriatrics and Palliative Medicine, and I joined them on their daily rounds. I also got to join the departmental educational programs.
  • For the LGBTQI+ medicine side, I observed Antonio Urbina, MD, Medical Director of Mount Sinai’s Institute for Advanced Medicine, in the HIV clinic. I got to train in Mount Sinai’s Center for Transgender Medicine and Surgery with Joshua Safer, MD, who is Executive Director of the Center. And I also got to shadow Angela Condo, MD, Assistant Professor of Geriatrics and Palliative Medicine, in the geriatrics clinic for people living with HIV.
  • In addition, I was connected with people and organizations who play an important role in LGBTQI+ health, such as SAGE, an advocacy and services group for LGBTQI+ elders, and MJHS Hospice and Palliative Care.
  • On the training side, I saw what they are doing for new and current employees, how they are implementing sexual orientation and gender identity data gathering, and how the Health System connects with the LGBTQI+ community.
  • There was also an academic side where I got to work with Dr. Javier on writing a chapter focused on affirming care, and we have an ongoing project concerning educational training programs.

Dr. Javier: The idea was to expose Dr. Noy to different models of care within the geriatric and palliative medicine landscapes—not just inpatient geriatrics and palliative care, but also neurology and memory care, outpatient clinics, urgent care, and chronic illnesses. By the time we were done with the observership, we had developed several deliverables, including submitting a chapter titled “Affirming Care for LGBTQ+ Patients” to Clinics in Geriatric Medicine that is currently in process for publication, and a scoping review research project titled “A Scoping Review Protocol of Educational Training Programs in Medical and Health-Related Professions Caring for Older LGBTQI+ Adults, November 2023 to Present.”

What were your takeaways?

Dr. Noy: Now that we’re starting our own LGBTQI+ older-adults service here in Tel Aviv, having been at Mount Sinai has helped us figure out what we need to focus on, as well as what are topics unique to us.

One big thing I learned is about communication in the way we address the community. It is important for everyone in the medical field, but it’s especially important in geriatrics because we do need to see the full picture of the person sitting in front of us and understand where they’re coming from. That involves knowing what are things that had been problematic, the history of what had been in the way of them getting treatment, and you can’t do that without good communication.

I also learned that connection with the community is important if we are going to be successful. The way community organizations work with health care in New York, I want us to be able to work as closely knit with them like that too.

Dr. Javier: I like mentoring people who want to be trained in LGBTQI+ medicine and health care. But just as I had helped Dr. Noy with his training, he had helped me too. Prior to this observership, I had several ideas in mind about developing a curriculum, but when Dr. Noy arrived and we started talking about what the program should look like, it helped to create more concrete ideas. I learned a lot from him in terms of what the community is like in Israel and what health services are available to them.

The amazing thing that came from this was: I want this same enriching experience for my fellows here in the department. We have 30-plus fellows in the department and are the largest ACGME-accredited fellowship program in geriatrics and palliative medicine in the country, but creating a LGBTQI+-focused curriculum had been on the back burner for quite some time. There is no formalized curriculum as of yet. This observership catalyzed the need to start working on this curriculum and make it a priority. In some serendipitous way, I got the outcome—a formalized program—before I got the template, and now I’m tracing our steps back of what we did and achieved in this pilot trial.

Why is it important that we focus on training physicians to care for LGBTQI+ older adults now?

Dr. Noy: Similar to the United States, in Israel, older LGBTQ+ people were less likely to identify as such than younger people. And we know that the LGBTQ+ population tend to face more barriers to accessing health care than the general population—this could include avoiding seeking treatment because of previous bad experiences, or even just from stigma.

As they age, the problems could accumulate, and they might end up needing more comprehensive treatment, when they could have preventive treatments earlier. There are general things like cancer, hypertension, or diabetes surveillance that could be done earlier, but there are also conditions more likely within the LGBTQI+ community, such as depression and mental health, that could get ignored.

Then there’s the fact that thanks to advances in medicine, we now have people with HIV living to old ages—even into their 80s and beyond. There’s still so much we don’t know about how they age, such as cognitive decline, frailty, effects of polypharmacy, and more. It’s not just about managing their medication, but also understanding their wellness as a whole. It’s important that we start integrating that training from medical school onwards. And also that we work with the community to show that we do exist—we’re here for everyone in the community.

Dr. Javier: When I was training as a fellow, I was not trained in LGBTQI+ medicine. Even today, that’s still not the case in many institutions. We need to change that and fast. The fellows in my department are knowledgeable enough to be able to take care of the needs of patients and be culturally responsive, but competencies around optimal LGBTQI+ medical care is not a requirement for them to graduate. The integration of LGBTQI+ care should be reflexive in geriatrics and palliative care curriculums across the country.

There continues to be a lot of disparities and inequities in care, especially for older LGBTQI+ adults and people of color. According to the 2015 U.S. Transgender Survey, 40 percent of respondents have attempted suicide in their lifetime. There are many other unique health concerns in the community, and if you did not ask about the sexual orientation and gender identity of a person, you can miss out on the big picture of why they’re seeking care in the first place while being clouded by our own biases and prejudices in helping them.

Read more about how Mount Sinai is empowering health care for LGBTQI+ communities

The Importance of Affirming LGBTQI+ Health

How to Find an LGBTQI+ Experienced Medical Provider and Why That’s Important

Two Employee Resource Groups, Mount Sinai Interfaith and Islamic Community at Mount Sinai, Hold a Silent Vigil

Updated on Nov 14, 2025 | Community, Engagement, Featured

Rowaida Farraj, PharmD, left, and Rabbi Jo Hirschmann, BCC, FACHE

The Mount Sinai Interfaith and the Islamic Community at Mount Sinai employee resource groups gathered to hold space for collective grief and to express their shared humanity, love, respect, and understanding on Wednesday, January 10.

About 90 Mount Sinai employees, students, and trainees joined the virtual vigil held via a Zoom call.

The event, titled “Our Shared Humanity: A Silent Vigil for Mourning,” was led by Rabbi Jo Hirschmann, BCC, FACHE, Senior Director of Education, Center for Spirituality and Health at the Icahn School of Medicine at Mount Sinai, and Rowaida Farraj, PharmD, Executive Director of Pharmacy, Mount Sinai Downtown.

“We spend so much of our lives talking. We wanted to create a quiet space where we could connect with ourselves and each other,” said Rabbi Hirschmann. “Together, we made space for our grief and for the hope and comfort that can come from simply being together. It was very meaningful to do this as Mount Sinai colleagues.”

Dr. Rowaida shared similar sentiments.

“It is clear many people are hurting during this difficult time,” she said. “We all needed a safe space to be together to feel that pain but also feel the presence of our community at Mount Sinai Health System which acknowledges that pain, respects all people, and hopes for a better future. We are so grateful we were able to create this space for everyone.”

Read the prayers and poems shared during the event
Learn more about Employee Resource Groups at Mount Sinai

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

Updated on Nov 14, 2025 | Community, Engagement, 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.

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

Updated on Nov 14, 2025 | Community, Engagement, 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

A “Profound Honor”: Mount Sinai Partnership Expands Health Care to Thousands in Guyana

Updated on Nov 14, 2025 | AIGH, Community, Engagement, Featured

Rachel Vreeman, MD, MS, speaks with Frank Anthony, MD, MPH, Minister of Health, Guyana (right)

The Icahn School of Medicine at Mount Sinai is seizing “an amazing opportunity” in global public health in a three-year initiative that is expanding health care to Guyana’s more than 800,000 citizens. Launched in 2022, the initiative is a partnership among Mount Sinai, the Hess Corporation, and the government of Guyana, and it is already bringing crucial health screenings to roughly half the nation’s eligible children.

“It is a profound honor to serve the people of Guyana in this mission to give everyone the best opportunity for a healthy and long life,” says Jeremy Boal, MD, Chief Clinical Officer of the Mount Sinai Health System, who is overseeing Mount Sinai’s efforts under the initiative.

Guyana is a racially and ethnically diverse nation at the northern edge of South America, with strong historic and cultural ties with nearby Caribbean nations. The nation entered a transformative era in 2015, when nearly 11 billion barrels of crude oil reserves were discovered offshore and its government began making plans to invest in much-needed infrastructure in many areas, including health care. Guyana’s National Healthcare Initiative was launched after John Hess, Chief Executive Officer of Hess and a member of Mount Sinai’s Boards of Trustees, approached Mount Sinai about partnering with Guyana’s government and Hess to expand health care in the country. The collaboration will make health care more accessible even to its most vulnerable citizens, including pregnant people and adults living with diabetes or cancer.

Working closely with Guyana’s government, a 40-member project team of experts from the Mount Sinai Health System are providing thought partnership to the country’s leadership to implement a range of improvements to the national health infrastructure of Guyana. These teams are led by the Mount Sinai’s Arnhold Institute of Global Health and Mount Sinai International, organizations dedicated to advancing Mount Sinai’s mission of delivering innovative, high-quality health care around the globe.

Initial steps: Increasing access to children’s health care, primary care for diabetics, and a “world class” pathology lab

Already underway is a national child and youth health initiative, the first primary care program for children in Guyana. Launched in August 2023, the program provides comprehensive health exams for all nursery school students in Guyana, children aged three to five years old. Within its first month the program conducted health screenings—including vision, hearing, and dental evaluation—on 50 percent of the eligible children in Guyana, and the program is now reaching every region of the country, including remote regions accessible only by boat or plane.

“We’re really proud to move this bold children’s health initiative forward with the Guyana Ministry of Health and Ministry of Education,” says Rachel Vreeman, MD, MS, Director of the Arnhold Institute for Global Health, which is guiding the program. “It provides the critical steps toward implementing a primary care system and more universal health coverage. We’re providing screenings that let us identify children’s health issues early and connect families and communities and schools with the health centers in a new way.”

Comprehensive school health screening in the indigenous community of Karasabai in Region 9, Guyana

The next step is to enhance the national primary care program for adults, which will initially focus on diabetes screenings. After developing new national guidelines on diabetes in partnership with Guyana’s Ministry of Health, Mount Sinai experts trained Guyanese health professionals to implement high quality screening and care for diabetes at every level of the health system. Under the program, which also supplies medication and equipment, the Guyanese providers will, in turn, travel across the country to train health professionals in their local communities.

“The diabetes care platform is a model for other ‘train the trainer’ programs and primary care efforts, which will expand to provide screening and care for health challenges across Guyana, including high blood pressure, cancer screening, mental health screening, and other chronic diseases,” Dr. Vreeman says. The diabetes training is accompanied by efforts to build an infrastructure of expertise, supplies, and referral pathways, explains Dr. Vreeman, noting that expanding primary care services throughout the country will prevent patients from having to travel long distances for care. The Arnhold Institute is also guiding the country in building a more robust health care workforce, as well as the eventual rollout of a national electronic health records system and national health information system strategy.

The health care initiative will also expand specialty and tertiary health care at both public and private health care facilities throughout the country, particularly in cancer and cardiovascular care. Under the partnership, Mount Sinai International is working with Guyana’s government to develop a strategic plan that will determine how and where these services will be implemented, and how they will be funded and staffed. While most of these services are still in the planning stages, a telepathology lab is expected to be in operation by January 2024. Using advanced remote technology, the lab will allow doctors in Georgetown, the nation’s capital, to work with Mount Sinai pathologists in New York to diagnose patients in Guyana.

“The technology will decrease the wait time in Guyana for high-quality pathology readings from two to three months to few days,” says Szabi Dorotovics, MD, MBA, President, Mount Sinai International, who is overseeing these efforts. “I don’t think I have to tell you how much of a difference that can make, especially in cancer care. The quality of the readings will be world class.”

Guiding quality improvements at Guyana’s largest hospital

Under the initiative, Mount Sinai is also consulting on quality and operational improvements with leaders from Georgetown Public Hospital Corporation in Georgetown, Guyana’s largest hospital, where roughly half of patients are women seeking maternity care. These include enhancements to its neonatal intensive care unit; accident and emergency services; fire and life safety procedures; information technology; pharmacy services; supplies, equipment, and technology; minor renovations to the hospital campus, and more. A major challenge faced by hospital leaders in rolling out these improvements is a lack of resources, including a shortage of nurses and equipment.

“What we have to do is work with them, given the constraints, and figure out what can we do,” says Art Gianelli, MBA, MPH, FACHE, Chief Transformation Officer for the Mount Sinai Health System, who is leading these efforts with the Mount Sinai International Group. “Maybe we can’t do what is ideal, but we can take practical steps to improve all of the areas.”

Most of these improvements involve process changes that make up the foundation of good care, explains Mr. Gianelli, some of which are already underway. “The next step is to build on this foundational work and start to drive changes in outcomes, but you have to start at the beginning.”

Hospital leaders have already made a number of quality improvements, such as installing soap dispensers throughout the building to help reduce the spread of hospital-acquired infections, and deploying hospital administrator “safety huddles” to improve awareness of potential safety issues. For Guyana’s largest and busiest hospital, where many patients travel long distances to obtain care, these changes are sure to have a positive “ripple effect” across the country, Mr. Gianelli says.

While Guyana’s health care initiative is still in its early phases, it is providing valuable insight into how to target, at a national level, social determinants of disease. This will allow the country to address problems early and provide community-based prevention strategies, according to Dr. Vreeman.

“Our teams feel really privileged to be serving as this partner for Guyana’s Ministry of Health,” says Dr. Vreeman, Chair of Global Health and Health System Design at the Icahn School of Medicine at Mount Sinai. “It’s an amazing opportunity to be able to bring up to scale some of the most evidence-based practices for what works in global settings. Through this initiative, Guyana is improving access to care, especially for marginalized and vulnerable children, and for people living in remote communities who have often experienced systemic inequities.”

Learn more about the Arnhold Institute for Global Health

Transforming the Face of Pharmacy by Training Knowledgeable, Efficient Techs

Nov 30, 2023 | Community, Engagement, Featured

The first cohort of six students graduated from the Mount Sinai Health System Pharmacy Technician Training Program. The students holding certificates are, from left: Christian Cuatlal-Zempoalteca, Jacqueline Pierce, Millagros Verdejo, and Ekelly Huntley. They are joined by, from left, Irina Usherenko, PharmD MBA; Elone Winston, MPH, CPhT; Susan Mashni, PharmD, BCPS; John Ugbogbo, MS, RPh; and Brian Radbill, MD. Students Oprah Reid and Aishatou Coulibaly are not shown.

Pharmacy technicians serve as crucial team members who work alongside pharmacists to maximize the pharmacist’s scope and efficiency.

As technology and training have evolved, technicians have taken a more significant leadership role in hospital pharmacy operations. However, there is a severe shortage of qualified pharmacy technicians across the country.

To address the issue, the Mount Sinai Health System Pharmacy Technician Training Program launched earlier this year with support from Susan Mashni, PharmD, BCPS, Senior Vice President and Chief Pharmacy Officer, Mount Sinai Health System.

The program was begun under the leadership of Irina Usherenko, PharmD, MBA, Vice President, Pharmacy, Mount Sinai Morningside and Mount Sinai West, and Elone V. Winston, MPH, CPhT, Project Manager II, Mount Sinai Health System.

“We want to fill the pharmacy tech vacancies from within the Health System while providing career advancement opportunities to our Mount Sinai colleagues. Our goal is to fill those vacancies with the best trained, most qualified personnel,” said Dr. Usherenko. “Specifically, we need certified pharmacy techs who are registered and licensed in New York State and have hospital-based training or experience.”

To do that, they decided to create a comprehensive training program that would be accredited by the American Society of Health-System Pharmacists (ASHP).

“There are only four other ASHP-accredited programs in New York State,” said Mr. Winston. “We designed a program with didactic, simulation, and onsite rotations. It is what is necessary so that pharmacy technicians are prepared to work in a complex environment that operates 24/7.”

The first cohort of six students graduated in September. Students were recruited from Strive NYC and the Manhattan Educational Opportunity Center (MEOC)—organizations focused on providing pathways to life-changing careers that provide financial empowerment and stability.

Each student completed more than 400 hours of intense study that includes online classroom work, time in a simulation lab, and hands-on experience in the Mount Sinai Morningside pharmacy. The online topics included basic anatomy and physiology and pharmaceutical terminology. In the simulation lab, students learned about dispensing and filling prescriptions, sterile compounding, and hazardous medications. They also gained experience working in retail and hospital pharmacies.

The students must pass a certification exam before applying for licensure and registration. Once that is achieved, the technicians are ready to work in a hospital environment with a starting salary of close to $70,000 per year.

The training for the first cohort was provided tuition free, and the students were given a small stipend during their experiential phase of the training.

The next group of students is being recruited from existing hospital staff including Environmental Services, Throughput, Patient Accounts, and the Emergency Department. The 1199 Training Fund will support these students and they will continue to work part-time during the training program. There were more than 400 applicants for 15 spots.

To learn more, contact PharmTechTraining@mountsinai.org.

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