Featured | Mount Sinai Today

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.

Patients Can Now Order Movies, Video Chat With Family, Access Translation Services, and More at Mount Sinai West

Updated on Dec 19, 2023 | Featured, Mount Sinai West, Your Health

Mount Sinai West has launched an innovative, in-room patient digital experience called MyRoom Connect, which is now available on the postpartum units.

MyRoom Connect, the first of its kind at the Mount Sinai Health System, is an interactive system designed to enhance the patient experience, improve communication, and optimize care.

The system is seamlessly integrated with the patient’s in-room television and is operated by using the in-room pillow speaker/remote control. The program will be introduced on the recently renovated and expanded inpatient Rehabilitation Unit at Mount Sinai Morningside in early 2024.

With MyRoom Connect, patients can use the pillow speaker remote to:

Order meals:Patients can choose their preferred options while ensuring dietary needs are met.

View education resources: Patients can view videos recommended by the care team on a diverse range of topics. New parents are asked to watch videos on preventing shaken baby syndrome, car seat safety, safe sleep for newborns, and feeding recommendations.

Access on-demand entertainment:Patients can select from a library of 40 on-demand movies including blockbusters like My Big Fat Greek Wedding, Top Gun: Maverick, and Black Panther: Wakanda Forever.

Connect with family and friends:Patients can stay connected with loved ones through in-room video visits, which can offer comfort and emotional support when patients need it most.

Review language translation options:Patients can choose from multiple language translation options.

Use live interpretative services:Patients can access live interpretative services to bridge any language barriers and ensure clear communication with the care team.

Learn about the local area:Patients can learn more about the hospital and the surrounding area including parking options and nearby lodging.

Listen to audiobooks:Patients can access a variety of content, including relaxation options, like white noise and 360 degrees of relaxation, and audiobooks.

“We believe that MyRoom Connect will not only elevate the patient experience but also streamline the care delivery process,” said Robbie Freeman, MSN, RN, NE-BC, Vice President, Digital Experience, and Chief Nursing Informatics Officer, Mount Sinai Health System. “It empowers patients to actively engage in their health care journey while enabling our staff to deliver high-quality, coordinated, and compassionate services.”

“At Mount Sinai West, we are here to support your needs, choices, and preferences with skilled, compassionate care, and to ensure that you receive comprehensive services personalized to your goals,” said Holly Loudon, MD, MPH, Chair, Obstetrics, Gynecology, and Reproductive Medicine at Mount Sinai West.

Learn more about Pregnancy and Childbirth at Mount Sinai West

Learn about the full range of gynecology and reproductive services at Mount Sinai West

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

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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.

Clinical Neuroscience Fellow Looks Into the Brain to Improve OCD Treatments

Updated on Dec 18, 2023 | Featured, Psychiatry

Andrew H. Smith, MD, PhD

“What drives people to keep having certain thoughts and engaging in certain behaviors, well past the point when it is adaptive?”

That is the question underlying the research of Andrew H. Smith, MD, PhD, a clinical neuroscience fellow at the Icahn School of Medicine at Mount Sinai. He is studying the brain circuitry of obsessive-compulsive disorder (OCD) at the Nash Family Center for Advanced Circuit Therapeutics (C-ACT) at Mount Sinai West.

Dr. Smith has studied compulsive behavior—a feature of several psychiatric illnesses—from multiple angles. During his doctoral work at Yale University, he studied the genetics of compulsive behaviors, with a focus on compulsion in substance use. Now he is turning his attention from genetics to brain circuitry. His current work uses implantable devices to collect data about brain activity in people with OCD, with a long-term goal of improving treatments for this challenging disorder.

“Unfortunately, many patients with OCD are not where they want to be after treatment with psychotherapy and medication. What’s unique about this study is that it builds on clinical treatment. During the course of a patient’s treatment, we offer them the opportunity to partner with us on research that allows us to uncover what is happening in their brains.” –Andrew H. Smith, MD, PhD

Dr. Smith began working at the Center during his psychiatry residency in Mount Sinai’s physician-scientist program. After graduating in 2022, he stayed to expand his research experience through the T32 postdoctoral research fellowship in psychiatry. The competitive fellowship, funded by the National Institute of Mental Health, is designed to bridge the clinician-scientist gap to translate findings in neuroscience into better treatments for patients.

In his T32 project, Dr. Smith works with participants who come to Mount Sinai for deep brain stimulation (DBS) for obsessive-compulsive disorder.

“Unfortunately, many patients with OCD are not where they want to be after treatment with psychotherapy and medication,” Dr. Smith says. “What’s unique about this study is that it builds on clinical treatment. During the course of a patient’s treatment, we offer them the opportunity to partner with us on research that allows us to uncover what is happening in their brains.”

Deep Brain Stimulation for OCD

The Center focuses on innovative research to advance the use of neuromodulation for hard-to-treat neuropsychiatric disorders. Neuromodulation includes a range of interventions, from non-invasive techniques like transcranial magnetic stimulation (TMS) to deep brain stimulation (DBS), which involves surgically implanting electrodes into brain tissue.

Under the direction of Helen Mayberg, MD, Founding Director of C-ACT and Professor, Psychiatry, Neurology, Neuroscience, and Neurosurgery, Dr. Smith is collaborating with a multidisciplinary team of experts including Martijn Figee, MD, PhD, Associate Professor, Psychiatry, Neurology, Neuroscience, and Neurosurgery; Ignacio Saez, PhD, Assistant Professor, Neurology, Neuroscience, and Neurosurgery; and Xiaosi Gu, PhD, Associate Professor, Psychiatry, and Neuroscience and Director of Mount Sinai’s Center for Computational Psychiatry.

“In my previous research in computational genetics, I learned a lot about the genetic building blocks of compulsive thoughts and behaviors. This study allows me to pursue a line of research that directly involves working with patients who really need our help,” Dr. Smith says.

The first-line therapy for OCD involves medications and psychotherapy, followed by non-invasive neuromodulation tools like TMS. When patients don’t see significant improvements from those therapies, they may be candidates for treatment with DBS.

“With DBS, we can target the deep regions of the brain that we think are holding patients back and keeping them stuck in thought and behavioral loops,” Dr. Smith says.

Researchers at the Center were already studying DBS in patients with OCD, evaluating them over the course of treatment using a battery of cognitive tests. That study is allowing the researchers to better understand which cognitive processes—such as mental flexibility or sensitivity to environmental stimuli—are changing during treatment, as a person’s symptoms improve over time. In his fellowship research, Dr. Smith is adding to that work by exploring how brain activity changes as people’s cognitive processes and behaviors change during treatment.

Such research only became possible recently, when the U.S. Food and Drug Administration cleared the use of a new generation of DBS devices that record neural activity over time, in addition to providing brain stimulation.

“Once these devices are implanted, we can study people’s brain changes directly, in a way that has never been done in patients,” Dr. Smith says. “This device allows us to ask new scientific questions in a very direct way.”

DBS for OCD and Beyond

By connecting the dots between brain activity, cognitive processes, and behaviors, Dr. Smith hopes the research will paint a more detailed picture of OCD in the brain.

“Our goal is to more fully understand how brain stimulation is leading, bit by bit, to changes in what the brain does when faced with obstacles,” he says.

The research is also an opportunity to learn more about the underlying brain circuits involved in other illnesses, including the compulsive use of substances.

“If we can learn more about the neural circuits driving compulsive thinking and behavior, we can fine-tune non-invasive interventions such as medication or TMS. Ultimately, it may help us develop better treatments for more patients, so we don’t need to rely on surgery and DBS,” he says.

The T32 fellowship is a two-year program, so Dr. Smith considers this research a pilot study to demonstrate how the new implantable devices can be used to better understand compulsive behaviors. Those data will support his application for an NIH Career Development (K) Award, which he hopes will enable him to further this line of inquiry and launch his independent research career.

“The T32 fellowship program is designed to give candidates the time and space to define their intellectual contribution to the department. It has allowed me to build on the strength of the expertise at Mount Sinai without duplicating what anyone else is already doing,” Dr. Smith says. “I am thankful to be able to work with such an incredible interdisciplinary team of mentors, doing research that can optimize techniques for helping the patient sitting in front of me.”

Learn more about the Nash Family Center for Advanced Circuit Therapeutics

Mount Sinai Recognized for Spine and Neuroscience Programs

Updated on Dec 15, 2023 | Featured

Mount Sinai Health System secured a distinguished position on Becker’s Hospital Review’s “Hospitals and Health Systems With Spine and Neuroscience Programs to Know” list for 2023, which recognizes programs in the United States renowned for excellent outcomes, leading surgical techniques, and cutting-edge research.

“This recognition underscores our dedication to advancing neurosurgical and neurological patient outcomes now and for the future,” says Joshua B. Bederson, MD, Leonard I. Malis, MD / Corinne and Joseph Graber Professor of Neurosurgery and Chair of Neurosurgery at Mount Sinai Health System. “With the continued recruitment of outstanding neurosurgical talent, and the expansion of specialized clinical programs and technology in New York City and Long Island, we have enhanced accuracy and safety, and improved outcomes.”

Joshua B. Bederson, MD

The Department of Neurosurgery has 50 specialists and 120 advanced practice providers providing expert clinical care, offering treatments for a variety of neurological conditions such as brain tumors, vascular malformations, spinal disorders, epilepsy, neurotrauma, pain management, and neuromodulation.

The report in Becker’s noted the Department has 191 active neurosurgery-led trials that offer clinical trial management and cost-effective patient solutions. The Department is ranks No. 1 in New York State and No. 15 in the nation for research funded by the National Institutes for Health, according to the Blue Ridge Institute for Medical Research. It has maintained a 19 percent market share in New York City’s neurosurgery inpatient market since 2016.

Mount Sinai was recognized by Becker’s for outstanding achievements including:

A commitment to advancing innovation and technology through state-of-the-art facilities housing advanced technologies that improve patient outcomes; collaboration with AI-powered diagnostic tool Viz.ai to harness technology solutions in care; and leading the world in adopting “machine-vision” systems for open spine and brain surgery.
An outstanding residency program and three fellowship programs with a track record of producing top clinical leaders.

This was the latest recognition for the Department of Neurosurgery. The Mount Sinai Hospital was ranked No. 8 in Neurosurgery in Newsweek’s “World’s Best Specialized Hospitals 2023.” The Mount Sinai Hospital was ranked No. 9 in Neurology and Neurosurgery in the nation in 2023-2024 by U.S. News & World Report®.

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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.”