Mount Sinai’s Post-Baccalaureate Research Education Program (PREP) helps prepare scholars who are interested in biomedical careers to apply successfully for doctoral programs. PREP scholars take graduate level courses, participate in career development activities, and receive personalized research mentorship. They spend one or two years in the program, with most of the experience taking place in laboratories conducting biomedical research.
Today, the program is led by Kirk Campbell, MD, Irene and Dr. Arthur Fishberg Professor of Medicine and Professor of Pharmacological Sciences at the Icahn School of Medicine at Mount Sinai and Inaugural Director of the Mount Sinai Center for Kidney Disease Innovation, and Jamilia Sly, PhD, Assistant Professor, Population Health Science and Policy, who recently renewed Mount Sinai’s grant. The PREP program focuses on growing a diverse research community and provides a launching pad for students pursuing their PhD or MD-PhD degrees.
More than a decade ago, Principal Investigators from Mount Sinai, Albert Einstein College of Medicine, and the University of Pennsylvania began an annual research symposium in May, with the programs rotating hosting duties. This year the schools participating expanded to include Cold Spring Harbor Laboratory and Weill Cornell Medical College.
Organizers say programs like PREP, which focus on developing a diverse pool of well-trained postbaccalaureates ready to engage in rigorous biomedical research-focused doctoral degree programs, have never been more important in today’s research landscape.
Mount Sinai’s Graduate School of Biomedical Sciences hosted the PREP Northeast Regional Symposium for 2024 on Monday and Tuesday, May 6-7.
The event began with a welcome reception during which students and faculty from all five institutions shared their experiences with their PREP programs. At one point, the room filled with excitement when Kaya Adelzadeh, a PREP scholar at Mount Sinai, found out she had been accepted to the MD-PhD program at the University of California, Davis. Since August 2022, Ms. Adelzadeh, who earned a Bachelor of Science in Biomedical Engineering at Boston University College of Engineering, has been a post-baccalaureate research assistant in the orthopedic research laboratories of James Iatridis, PhD, and Woojin Jan, PhD. She was cheered on by her colleagues and by PREP leaders, a reminder of what the PREP scholars are working to accomplish.
Dr. Campbell and Dr. Sly, along with Marta Filizola, PhD, Dean for the Graduate School of Biomedical Sciences, and Talia Swartz, MD, PhD, Senior Associate Dean for MD-PhD Education, delivered opening remarks. They discussed the history of the symposium, welcomed new participants, and encouraged the PREP scholars to apply for the participating institution’s PhD and MD-PhD programs.
Scholars from the five institutions shared their oral presentations. The two scholars from Mount Sinai were Taelor Matos, who shared research she is conducting with Jessica Ables, MD, PhD; in her presentation “Axonal Plasticity in Learning”, and Tony Valencia, who shared research he is conducting under the mentorship of Benjamin Chen, MD, PhDs, in a presentation “Investigating Asymmetry of HIV-1 Envelope Protein and its Impact on Packaging.”
In her keynote address, Yasmin Hurd, PhD, Director of the Addiction Institute at Mount Sinai, discussed the neuroscience of addiction. She highlighted the role of the endocannabinoid system in neuronal development, differential psychological effects of cannabinoid components and provided insights into therapeutic utility of cannabidiol in opiate use disorder.
Dr. Hurd discussed her own career journey, noting data regarding the lack of diversity in the scientific workforce. She encouraged students not to let data about who is or isn’t a scientist determine the path for their academic training and career goals. She reminded students during the question and answer session that being a good scientist doesn’t mean knowing all the answers to scientific questions, rather that a good scientist asks a lot of questions about the things they do not know.
A PREP alumni panel featured former scholars from Mount Sinai and Albert Einstein College of Medicine. The panel was moderated by Tia Robinson, a current Mount Sinai PREP scholar, and included alumni Yoselin Paucar, Stephen Ruiz, Bryan Ticoche, and Jeury Veloz. Scholars from each institution had the chance to ask questions and inquire about the experiences of PREP alumni both during and after their programs.
Two rounds of poster presentations gave PREP scholars opportunities to share their research with peers from other schools and to practice their presentation skills. Mount Sinai had eight scholars participate in the poster sessions. This was followed by an awards ceremony recognizing the PREP scholars with the top oral and poster presentations. Alexandra Ramirez, University of Pennsylvania PREP, received an award for the Best Oral Presentation. She has been accepted to Icahn Mount Sinai’s PhD in Neuroscience program as a student starting this fall. Kendall Moore, Icahn School of Medicine PREP, won for Best Poster Presentation.
In closing remarks, Dr. Campbell and Dr. Sly reiterated why collaboration is so important between PREP programs, and they encouraged scholars to continue their great work and to look forward to next year’s symposium.
Learn more about our PREP program to see how it can guide your journey to joining a doctoral program in biomedical sciences.
Top, from left: Rheoneil Lascano, MSN, FNP, Vishal Kapur, MD, David Song, MD, Prakash Krishnan, MD, FACC, FSCAI, Raman Sharma, MD, and Moinuddin Syed, MBBS. Bottom, from left: Dr. Song, Samin K. Sharma, MD, Annapoorna S. Kini, MD, Dr. Kapur, Dr. Krishnan, and Raman Sharma, MD.
A team at the Mount Sinai Fuster Heart Hospital has successfully performed the first procedure in the United States using an innovative drug-eluting, below-the-knee resorbable scaffold.
The team was led by Prakash Krishnan, MD, FACC, FSCAI, Assistant Professor, Medicine (Cardiology and Radiology), and Director of Endovascular Interventions at The Mount Sinai Hospital’s Cardiac Catheterization Laboratory. The Food and Drug Administration approved the device in April.
“FDA approval of this long-awaited new technology of a dissolving bioabsorbable scaffold is a remarkable addition in the treatment of lower limb arterial blockages where balloon and regular stents results are suboptimal, and these scaffolds are poised to restore blood flow for a long time,” says Samin K. Sharma, MD, Director of Interventional Cardiology for the Mount Sinai Health System. “We are proud of Dr. Krishnan, who played a major role in getting this innovative device approved.”
More than 20 million people in the United States are living with peripheral artery disease (PAD) yet there have been limited treatment options. The new procedure is the first to treat people with chronic limb-threatening ischemia (CLTI) below-the-knee, a severe stage of PAD. The goal is to prevent amputation, heart attack, and stroke among these patients.
For individuals battling chronic limb-threatening ischemia, blocked vessels restrict blood flow to the lower extremities. While balloon angioplasty serves as the current standard of care, recurrent blockages often necessitate further intervention.
Unlike traditional metal stents, the drug-eluting below-the-knee resorbable scaffold is a temporary implant. Crafted from naturally dissolving material, this scaffold gradually disappears after opening a clogged artery, presenting a significant advancement in sustaining open arteries below the knee.
“A resounding applause to the team at Mount Sinai Fuster Heart Hospital for their relentless pursuit of excellence in advancing patient care,” said Dr. Krishnan. “Many times doctors tell patients amputation is the only option, so this new technology is a game changer.”
As the country celebrates the cultural diversity of Asian Americans, Native Hawaiians, and Pacific Islanders in May for Asian/Pacific American Heritage Month, it is time for a reminder for members of those communities to keep up with their cancer screenings. Specifically, experts at the Mount Sinai Health System are calling on Asian American and Pacific Islander (AAPI) people to be vigilant about breast and colorectal cancer screenings.
“Breast cancer is the leading cause of cancer death for women worldwide, and the second leading cause of cancer deaths for women in the United States,” says Desiree Chow, MD, Assistant Professor of Medicine (General Internal Medicine) at the Icahn School of Medicine at Mount Sinai. “However, for Asian Americans and Pacific Islanders, these groups have been found to consistently score lower than their non-Hispanic white counterparts for breast cancer screening.”
A similar theme echoes in colorectal cancer, notes Sanghyun (Alex) Kim, MD, Chief of Colon and Rectal Surgery at Mount Sinai Beth Israel, Mount Sinai-Union Square, and Mount Sinai Morningside. “Not only are we seeing lower screen rates for AAPI communities in colon cancer, but over the last 20 years, we’ve seen a twelvefold increase in colon cancer rates in these populations,” says Dr. Kim. “This is why it’s very important for physicians who see AAPI patients to be proactive in reminding them to be screened regularly.”
Left: Desiree Chow, MD. Right: Sanghyun (Alex) Kim, MD.
What are the disparities in cancer screening rates among different races/ethnicities?
While breast and colorectal cancer screening rates have steadily grown over the years, Asian American and Pacific Islander (AAPI) populations screen at a lower rate than the non-Hispanic white population. Here’s a snapshot of how each group screens for those cancers from 2008 to 2018, according to a report from the Centers for Disease Control and Prevention (CDC).
Source: Health, 2019, National Center for Health Statistics, CDC
As the COVID-19 pandemic hit, screening rates declined in 2020—by as much as 97 percent for breast cancer for AAPI communities compared with the previous five-year average, according to an April 2023 memo from the CDC. To address the decline in screening among certain populations, the agency is partnering with health care providers to resume timely use of preventive tests for early detection of breast, cervical, colorectal, and lung cancers.
Drs. Chow and Kim share their thoughts on the importance of being up to date with breast and colorectal cancer screenings, respectively.
Why are we calling for our AAPI communities to be vigilant about breast and colorectal cancer screening?
Dr. Chow: In general, Asian American women tend to have dense breasts, which is an independent risk factor for breast cancer and it decreases the ability for mammograms to detect small lesions. So in addition to the higher risk, Asian Americans having lower rates of screening, which is concerning and needs to be addressed.
Dr. Kim: Some 20 years ago when I went into colorectal surgery, the number of surgeries for colorectal cancer for Asian Americans was lower than for their white, Hispanic, or Black counterparts. Since then, that number has increased 12 times—not 12 percent—in America. On top of that, AAPI individuals are known to be less up to date on colorectal screening. Part of it could be a greater focus on other kinds of cancers—such as stomach and liver—instead, and part of it could be attributed to a tendency to play down illnesses and not be very good at following up with doctors.
Who should be thinking about screening? How often should it be done?
Dr. Chow: The United States Preventive Services Task Force (USPSTF), the body that sets guidelines for screening in the country, has recently updated their recommendation for women to start screening for breast cancer at the age of 40, every two years. However, there are other factors that could push one to start screening earlier or screen more frequently, and that is a conversation to have with a health care provider. These could include having a family history of breast cancer or having a genetic predisposition to breast cancer, such as a BRCA gene mutation.
Dr. Kim: The USPSTF recommends screening for colon cancer as early as the age of 45. Colonoscopies are the gold standard and would only have to be done every five to ten years. There are stool-based tests, which would have to be done every one to three years to provide comprehensive detection. This recommendation is the same for both men and women, although men have a higher prevalence of colon cancer. If a patient has a family history of cancer—could be of various types, including pancreas, stomach, liver, breast, endometrial or bladder—that person should consider early screening as well. A simple guideline would be: whatever age the family member had the cancer, the patient’s screening should be done at an age 10 years below that—thus for a patient whose family member had pancreatic cancer at age 50, the patient should get a colonoscopy at age 40.
What is involved in breast and colorectal cancer screenings? Is it painful/time-consuming?
Dr. Chow: The mammogram is the only screening method that has been shown to decrease mortality related to breast cancer. The best way to get a mammogram would be to get a referral from your primary care provider, or your OB/GYN. Under the Affordable Care Act (ACA), public and private insurance must provide preventive women’s health screening with no cost sharing. For those who do not have health insurance, there are ways to obtain low- or no-cost mammograms, as New York City and New York State have programs, such as free mammogram buses, that provide such screening.
The procedure itself is pretty simple, and a technician helps the patient position their breast in a machine that takes images of the breast tissue. Most women do not report significant pain—perhaps some discomfort as they might have to hold certain positions for imaging. But from start to finish, a patient could be in and out of the clinic in about 30 minutes.
Patient service representative Monet Douglas at the Mount Sinai Mammogram Screening Unit Truck
Dr. Kim: For stool-based tests, such as Cologuard®, a patient sends a stool sample to a lab, where it’ll be studied to see if it contains blood products and/or polyp components. However, such tests might miss some polyps, hence a need to do them more frequently. A colonoscopy, in which a tube with a camera is put into the rectum and colon, can not only discover polyps and cancerous tumors, but also treat and remove them. Under the ACA, colorectal cancer screening must be covered by public and private insurance without cost-sharing.
A colonoscopy does involve some preparation. The patient is instructed not to eat for about half a day, and to take a concoction that would rinse out the bowels. For the actual procedure, the patient is put to sleep and the doctor would examine the colon and rectum for polyps or signs of cancer. If polyps are removed, or cancer tumors are biopsied, there might be some pain or bleeding afterwards, but for most patients, colonoscopies are very well tolerated. The actual procedure itself takes about 30 minutes, although a patient might take an hour to recover after the exam.
What might be the consequences for not being vigilant about breast and colorectal cancer screening?
Dr. Chow: Missed breast cancer is the biggest consequence. By the time women feel a lump in their breast, the cancer is at a later stage, is harder to treat, and may have already spread to other parts of the body. The point of screening is to detect these cancers at an early stage, when they are still easily treatable and even curable. At an early stage, a patient is more likely to be offered breast conserving surgery, where only a portion of the breast is removed, rather than a mastectomy, where the entire breast is removed.
Dr. Kim: The thing about colon cancer is that it is a preventable cancer. If you can screen and detect signs before it presents as colon cancer, you can avoid more intensive treatment. When the cancer has penetrated into deeper layers of the colon, the surgery needed means you’ll lose more length of colon. If the cancer has advanced even more and spreads out of the colon, you will need not only surgery, but chemotherapy and radiation, and these are very intense on the body. For patients who get rectal cancer—that risk is higher for smokers—if not picked up early, there’s a chance to lose the anus, and that could mean needing a colostomy bag—a pouch in which stool comes out of the abdominal wall.
Any other advice for our AAPI communities to stay on top of their cancer screening?
Dr. Chow: I’ve noticed that some segments of the AAPI population might be less willing, or less able, to access health care. They should still try to form a close relationship with a primary care doctor, so that the doctor is aware of their risk factors and can advise them accordingly. For Asian Americans specifically, there’s a misconception that Asian women don’t get breast cancer as frequently. That’s not so true anymore, as the incidence of breast cancer has been steadily rising since 2000. And lastly, there’s a misconception that if a patient leads a healthy lifestyle, with no family history of breast cancer, they won’t get it. That’s great in that they’re at lower risk, but the majority of breast cancer cases are de novo, meaning the mutation happens for reasons we don’t know. If you meet the guidelines for breast cancer screening and have not done it, do seek it out as soon as you can.
Dr. Kim: I’ve noticed among my Asian patients that the cultural tendency of not wanting to speak up about pain or discomfort is actually working against them for their health. Keeping concerns to yourself hinders proper care. Another thing I’ve noticed is that some—usually older, immigrant individuals—trust their doctors too much and expect their doctors to know and handle everything, while others—sometimes younger, American-born individuals—don’t trust their doctors enough, might have a distrust of the system, or believe they know their body better than the doctor does. Either extreme is not good. The solution to break through to both is patient education and building trust. First, getting information out there about why cancer screening is important helps patients understand the risks. Then, the primary care doctor needs to build a close relationship with the patient, so that the patient actually goes to the screening, but just as importantly, trusts the doctor enough to come back for any follow-ups.
Hepatitis is inflammation of the liver—an organ we depend on to digest nutrients, filter blood, and overcome infection. There are many different types of hepatitis, including hepatitis A, B, C, D, and E, with symptoms that include fever, abdominal pain, nausea, jaundice (yellowing of the skin and eyes), and fatigue.
However, most people with chronic viral hepatitis do not experience any symptoms and often do not know they have the infection even while it silently damages their liver. Hepatitis B and C are among the most common types of hepatitis. While they both affect the liver, they are very different.
Douglas Dieterich, MD
In this Q&A, Douglas Dieterich, MD, Professor of Medicine (Liver Diseases) and Director of the Institute for Liver Medicine at the Icahn School of Medicine at Mount Sinai, explains the differences between hepatitis C and B, how they are transmitted and treated, who is at risk, and more.
What is the difference between hepatitis C and B?
Hepatitis C virus (HCV) and hepatitis B virus (HBV) are vastly different viruses. Hepatitis B is highly contagious through sex, using drugs with shared straws and needles, blood transfusions, and even saliva, which can put people living in the same household at risk. The good news is hepatitis B is entirely preventable with a vaccine, which has been around since 1991. The Centers for Disease Control and Prevention now recommends universal vaccination for hepatitis B for all adults under 60 who did not get vaccinated by their pediatrician starting in 1991. People over 60 can also request the vaccine and should, especially if they have ongoing risk factors. If people do get hepatitis B, there are very good drugs to control it and to suppress the virus down to zero so it doesn’t do any damage or infect others. We also have exciting clinical trials happening to study medications that can cure Hepatitis B.
Currently, there is no vaccine for hepatitis C, which is a different class of virus. It actually belongs to a class that you may have heard of—West Nile virus, dengue fever, yellow fever, and Zika, which has been in the news the last few years. None of those become chronic, however, while hepatitis C does. Over time, it can cause the same liver damage that hepatitis B can, including liver cancer, which can lead to death. The good news is, it’s now easily curable. We have fantastic new drugs for hepatitis C—most patients need to take only 8 to 12 weeks of easy-to-take pills with virtually no side effects and a 99 percent cure rate. It’s absolutely important to find out if you have hepatitis C or B because we can cure hepatitis C and control hepatitis B.
What do I need to know about hepatitis D?
Hepatitis D, also known as hepatitis Delta virus (HDV), is the most severe form of viral hepatitis. This is a type of hepatitis that can only infect people who have hepatitis B. Approximately 70 percent of people who have hepatitis Delta will develop cirrhosis (liver scarring) within 5 to 10 years of infection. This is a much higher and faster progression than for most people with hepatitis C and hepatitis B.
Hepatitis Delta can only function in a body that is also infected with hepatitis B. Not everyone with hepatitis B has hepatitis Delta, but everyone with hepatitis Delta also has hepatitis B. That’s why we recommend everyone with hepatitis B get screened for hepatitis Delta too.
New effective treatments for hepatitis Delta are coming soon and are already available to some patients, depending on their specific health situation. Our providers can screen you for hepatitis Delta and help get you onto treatment if needed.
Who is at risk for contracting hepatitis B and C, and who should get screened?
The CDC recommends all adults be screened for hepatitis B and C at least once in their life, even if they don’t think they have any risk factors. Many people have been exposed but don’t know it. The major method of transmission for hepatitis B, globally, is from mother to infant at birth. Other people who are at risk are those who have never been vaccinated—primarily people born before 1991—and we see that happening now. When people born before 1991 come in contact with people who have hepatitis B, they can catch it quite easily. Hepatitis C is more difficult to catch. The major risks for hepatitis C are having had a transfusion of blood or blood products, such as gamma globulin, before 1992, or using IV drugs or intranasal drugs. Just snorting drugs with a straw is enough to spread Hepatitis C. People who have unprotected sex—especially men who have sex with men—are also at risk for hepatitis C. It’s very important to get diagnosed early so you can get treated and cured. If you know you have ongoing risk factors, you should be screened at least once a year.
Why is hepatitis more common in New York City?
About 48 percent of the people who live in New York City were born outside of the United States. Many of those people come from countries where hepatitis B or C is endemic, and that’s the major risk factor for hepatitis B. Endemic means that a high percentage of people in an area have the disease and therefore the risk of getting the disease is high. The New York City Department of Health and Mental Hygiene estimates that 243,000 New Yorkers, or 2.9 percent of the population, have chronic hepatitis B. The Department also estimates that approximately 86,000 New Yorkers, or 1 percent of the population, have chronic hepatitis C. If we catch viral hepatitis early, we can help you prevent liver scarring and liver cancer.
What is the best way to prevent hepatitis B and C?
The best way to prevent hepatitis B is to get vaccinated for hepatitis B. The CDC now recommends everyone aged 18 to 59 be vaccinated for hepatitis B. If you weren’t vaccinated as a kid, it’s easy to check if you have antibodies to hepatitis B, or if you have hepatitis B, we can treat that. Ask your doctor about testing and vaccination.
Hepatitis C is mostly spread blood to blood. Shared needles—if you’re using IV drugs, and shared straws if you’re using intranasal drugs—things like that—are really high risk for spreading hepatitis C. Getting a tattoo or piercing from an unlicensed technician may also put you at risk if they are not properly cleaning their needles. If you are using drugs, don’t share needles, don’t share straws. And get tested for hepatitis C, because if you have it, we can cure it. Once cured, you can become reinfected with hepatitis C, so it’s very important to continue avoiding infection after getting cured, which means not sharing needles or straws and practicing safe sex, and only getting tattoos and piercings from licensed technicians.
What resources are available at Mount Sinai for screening and treatment of hepatitis?
We have numerous resources dedicated to screening and treatment of hepatitis B and hepatitis C at Mount Sinai. We’re the largest independent liver program in the country. We have liver clinics all over Manhattan and the metropolitan area—from Long Island to Westchester. Our care coordinators will support you from screening through treatment and cure, working closely with your provider to ensure you get the best care.
Johannes Schwaiger, Mount Sinai patient and Broadway musician, with fellow Broadway musician and wife Tessa Lang
About a decade ago, Broadway musician Johannes Schwaiger noticed a hoarseness in his voice, which he initially dismissed as allergies. A visit to a doctor that spring identified the real culprit—a tumor in the back of his throat. The subsequent care Mr. Schwaiger received at Mount Sinai, which included minimally invasive surgery and voice therapy, saved both his life and his voice.
“Now, thinking back, 11 years ago, I am completely cancer free and have followed my passion of music, in my case, singing, with a newfound purpose—to bring people together, and find those things that unite us,” he says.
On Thursday, June 6, the singer, who has performed on Broadway, including in Cats, will tell his story—one about “all kinds of love”—in a performance titled “All the Love in the World,” at the Kaufman Music Center in New York City. Mr. Schwaiger will perform alongside his wife, fellow Broadway musician Tessa Lang, who encouraged him to see a doctor when he began experiencing symptoms and stayed by his side through cancer treatment and his journey back to health.
“She is my angel,” says Mr. Schwaiger, explaining that his ordeal with cancer was also hers. On stage, the couple will tell their story of love, hope, and survival through a selection of American, French, and Italian love songs.
“We’ve woven a tapestry of all the ways people love, and the journey that love takes, the highs and the lows, and the pursuit of love, no matter what the journey is,” says Ms. Lang of their upcoming performance.
For the couple, the journey began when Mr. Schwaiger received a diagnosis of stage IV head and neck cancer in 2013, and his worst fear—losing his voice—became a real possibility. “I underwent a CT scan, and the results were devastating,” he remembers.
Many patients who undergo surgery for head and neck tumors need a tracheotomy, a surgical opening in the neck that allows them to breathe through a tube.
“I walked around in a daze between disbelief and realty,” recalls Mr. Schwaiger.
The musician began singing at the age of nine in Munich, Germany, his hometown, and his international career went on to span operas, oratorios, concerts, and musical theater. The possibility of losing his voice “felt like losing my life,” he says.
The diagnosis also came as a shock to Ms. Lang. “Johannes was just so healthy, he grew up on a farm. There was never anything wrong with him, so that’s why this was just so unusual,” she says.
Mr. Schwaiger’s doctor referred him to Mount Sinai, where doctors performed laser surgery, a minimally invasive procedure, removing about 85 percent of the tumor without harming the surrounding tissue, eliminating any need for a tracheotomy. After the surgery, he underwent chemotherapy and radiation to remove the remaining cancer, which was provided under the expertise of his oncology team at The Tisch Cancer Institute at Mount Sinai.
“What I so much loved about Mount Sinai is they didn’t proclaim doomsday,” he recalls. “They said, ‘You have a good chance of healing, and that’s what we are going to do.’”
While the treatment cured him, the radiation to his throat made speaking and swallowing difficult, and Mr. Schwaiger’s voice was again in jeopardy. However, with guidance from Cathy Lazarus, PhD, Associate Professor, Otolaryngology, Icahn School of Medicine at Mount Sinai, he was able to keep his voice—and his career. In her research and clinical practice, Dr. Lazarus specializes in restoring function in head and neck cancer patients.
“It was tremendously helpful,” he says, adding that the therapy also helped him regain his ability to swallow and eat normally.
Mr. Schwaiger, who teaches at the American Musical and Dramatic Academy in New York City, describes the care he received from Mount Sinai as “divine intervention.” In 2015, he shared his story with fellow cancer survivors at a luncheon at Mount Sinai-Union Square. To show his appreciation for all who helped him during his ordeal, he decided to tell his story through a series of songs, which were “all about healing,” he says.
“I started to look at my voice from a different lens and found a new purpose within,” he says.
It is a new purpose Mr. Schwaiger will convey when he takes the stage with Ms. Lang for the All the Love in the World concert this June.
“This concert is a testament to the journey I walked through and the love that endured and helped me to overcome and heal,” he says.
Get Your Ticket to the “All the Love in the World” Concert
The “All the Love in the World” concert is a benefit in support of Dreamgates, a nonprofit organization that uses performing arts events to bridge cultural divides and embrace artistic co-creation in a global community. It will take place Thursday, June 6, at 7:30 pm at the Kaufman Music Center in New York City. Tickets are available here.
Are you a cancer patient?
Free tickets will be set aside for the first 10 cancer survivors who contact Mount Sinai. Those interested should email David Schwab at david.schwab@mountsinai.org with the subject line: “All the Love in the World.”
Alex Ky-Miyasaka, MD, Professor of Surgery at The Mount Sinai Hospital, seeing patients at the Chinatown clinic in Manhattan.
Asian American, Native Hawaiian, and Pacific Islander Heritage Month, also known as Asian/Pacific American Heritage Month, is observed in May in the United States. It celebrates the culture and historical contributions of Asian Americans and Pacific Islanders (AAPI) to the country, as the month marks the arrival of the first Japanese immigrants in 1843 and commemorates the completion of the transcontinental railroad in 1869, whose tracks were largely laid by Chinese immigrants.
AAPI people in this country are extremely diverse and represent a wide range of races and ethnicities, socioeconomic and educational backgrounds, and ability to access health care. In New York City, this group encompasses more than 1 million people from more than 30 different ethnicities, speaking more than 50 different languages. Providing effective health care to such a varied group can be challenging, but it is important for health care institutions and providers to keep diversity at top of mind as they connect with patients.
“It is our responsibility to ensure we’re evaluating how we can best provide care to all of our patients,” says Amanda Rhee, MD, Professor of Anesthesiology, Perioperative and Pain Medicine, and Inaugural Director of the Center for Asian Equity and Professional Development at Mount Sinai. “There’s a growing body of evidence that people receive different care based on gender, disability, and language spoken.” When it comes to conversations about the differences in care that patients receive, AAPI communities are often left out—for example, some may not know that 24 percent of AAPI individuals in New York City live in poverty, and as a result might be unable to access appropriate care, says Dr. Rhee, citing a report on poverty in New York City.
“Specifically for Asian Americans and Pacific Islanders, from our patient satisfaction surveys, we know that our patients are telling us that we have room to improve, and how we can deliver care for them better,” says Dr. Rhee. “I say this in the overarching context of approaching all our patients with an open mind, so that we can understand anyone’s background better, and do our best to meet people where they are.”
In this Q&A, Dr. Rhee explains the importance of culturally sensitive and compassionate care, and how Mount Sinai is working to improve that competence.
Why is it important to consider cultural needs of a patient when providing care? Might there be consequences for failing to do so?
Communication between our clinical teams and patients is so critical, not only for the medical side of the care, but also compassion and empathy. Cultural and language barriers could present a challenge for some of our AAPI patients. There could be certain sorts of traditions that may seem different to our clinical providers or teams, which could appear obstructive.
For example, in some Asian cultures, there’s a belief that drinking warm fluids can help people who are feeling ill, and they or their family members might want to bring in warm soups and drinks for the patient. But if the patient is in a situation where they should not eat or drink anything, such as before a procedure, these well-intentioned family members may not understand that, and conflicts and challenges in communication can lead to confusion and dissatisfaction. It would be better if our clinical teams, patients, and family members could better align expectations and help understand each other better.
What does it take for a health system or organization to provide culturally sensitive and inclusive care?
Normalizing things or traditions that seem different, and highlighting the diversity of the people whom we take care of, is an important way to do that. Having really engaging educational sessions or tabling events at an institution are effective ways to help providers understand how these different traditions are meaningful in these different cultures—and understanding these differences can have an impact on whether a patient gets better or not. And I think that better understanding also leads to more empathy and improved connections between provider and patient.
What work might be needed to improve AAPI communities’ care experience?
An important piece boils down to building trust. Patients and their families want to know they are being listened to. Our clinical teams have to be open-minded to cultural differences and communicate to patients and their families that they’re there to help and receive feedback. Once that trust is established, when we need to explain how certain rituals or traditions might run counter to care, that advice might be better received by the patients and family members.
What has Mount Sinai been doing toward providing culturally sensitive care for AAPI communities?
In recent months and years, Mount Sinai Health System has dedicated resources and launched initiatives toward improving competence and cultural sensitivity for its AAPI patients. Here’s a snapshot of what we have done:
Asian Health Services Initially launched at Mount Sinai Beth Israel to serve the population in Chinatown and lower Manhattan, the team providing personalized care for AAPI communities has been expanded systemwide, across all eight hospitals. Asian Health Services includes multilingual Asian providers in different medical specialties, medical interpreters, and culturally competent staff to help patients navigate health care. The website has been updated to include information about specialists, their locations, and languages spoken.
Guidance on translation services Mount Sinai has been working with its Language and Communication Access Services to provide more culturally competent translation and interpretation services for AAPI patients, including guidance on cultural differences and cues. The service is provided free of charge and can be arranged through clinical teams to be made available during care.
Cultural cue handouts for providers Cultural cue handouts that were originally available for providers under Asian Health Services are in the process of being rolled out systemwide. These resources include information about differences between traditional remedies and Western health care and various cultural norms that might affect decision-making.
Educational events For Asian/Pacific American Heritage Month, there is a series of events to celebrate and raise awareness of AAPI culture, held across all eight hospital campuses. These seek to deploy education in a meaningful way, by highlighting similarities and differences across cultures. The Center for Asian Equity and Professional Development also hosts webinars and events throughout the year.
Curriculum for cultural sensitivity training In its early stages, the Center for Asian Equity and Professional Development is developing a program to train providers who wish to be more informed about caring for AAPI patients. The goal is to eventually improve health equity among AAPI communities.
Partnerships with community organizations Mount Sinai is working with community partners, such as the Chinatown YMCA, to provide health information and education. These include preventive care, tips on healthy living, and resources to access care at Mount Sinai.
“I hope that what we can build is heightened awareness about the specific needs of our AAPI patients,” says Dr. Rhee. “I would hope these efforts will create a way of thinking for all of our care providers to identify any kind of disparity that a patient may be experiencing, so that we can address challenges in this space for all of our patients.”
Amanda Rhee, MD, Professor of Anesthesiology, Perioperative and Pain Medicine, and Inaugural Director of the Dean’s Center for Asian Equity and Professional Development at Mount Sinai
Who are the Asian Americans/Pacific Islanders in New York City?
Asian American/Pacific Islander (AAPI) is a broad term, but it is not a monolithic description of their experiences and situations. In New York City, the largest and one of the most diverse cities in the country, understanding the diverse socioeconomic and health access conditions of AAPI people is crucial to population health. Pulling from two city agency reports, here’s a snapshot of Americans and immigrants of Asian and Pacific Islander descent in New York City.
>1 million
AAPI people in NYC; 14 percent of the city’s 8.5 million population.
>30 different ethnicities
A group speaking more than 50 different languages.
13 percent
of immigrants of Asian/Pacific Islander descent are undocumented, compared to 16 percent of NYC immigrants overall.
46 percent
of AAPI households report having limited English proficiency, compared to NYC’s overall average of 23 percent. For Asian/Pacific Islander immigrants specifically, that number is 59 percent.
40 percent
of AAPI individuals in NYC on average have income below 200 percent of the federal poverty level, compared to the city’s average of 39 percent. However, subgroup variances are large, with lows including Filipino (20 percent) and Japanese (23 percent) individuals, and highs including Bangladeshi (58 percent) and Pakistani (53 percent) individuals.
