Mount Sinai Doctors-787 Eleventh Avenue Provides Comprehensive Breast, Spine, and Imaging Services

Updated on May 11, 2023 | Community, Featured

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Mount Sinai Doctors-787 Eleventh Avenue is a new outpatient center designed to provide comprehensive, convenient care for breast and spine patients, and imaging services.

The Center welcomes new and existing patients to a relaxing, beautifully designed facility. Home to Mount Sinai’s outstanding multidisciplinary team of surgeons, specialists, and medical support staff, the new facility allows patients to experience Mount Sinai expertise in a convenient, state-of-the art facility.

“This space was designed to emphasize collaboration across disciplines in caring for our patients,” said Lisa Mazie, Chief Administrative Officer, Mount Sinai West. “Breast Surgeons and staff work in partnership with radiologists and technical imaging specialists to coordinate cohesive care. Orthopedic and neurosurgical spine surgeons and interventional physiatrists work together in one practice with their own EOS low-dose X-ray, plain film standing X-ray, and fluoroscopy within their space.  We want to provide patients one location with varying modalities of care and expertise to meet their health care needs.”

Samuel K. Cho, MD, right, and a patient

At the same time, the facility’s design, from the artwork on the walls to the lighting and furniture, seeks to create a soothing environment for patients.

“The new location will be home to an expanding array of breast imaging services including the most advanced mammography, ultrasound, and MRI available,” said Laurie Margolies, MD, FACR, FSBI, Vice Chair for Breast Imaging, Mount Sinai Health System, and Professor, Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai.

“Patient-centered care is at the heart of everything we do,” said Stephanie Bernik, MD, FACS, Chief of Breast Service at Mount Sinai West and Associate Professor, Surgery at Icahn Mount Sinai. “This state-of-the-art facility is thoughtfully designed with patients’ needs in mind, is easy to access, and will allow more people to benefit from Mount Sinai’s world-class surgeons, radiologists, and support staff.”

Stephanie Bernik, MD, FACS, right, speaks with a patient.

Mount Sinai Spine at Mount Sinai Doctors offers a fully integrated collaboration among providers in orthopedic surgery, neurosurgery, and physiatry/pain management to provide the highest quality, comprehensive spine care.

“We have created a seamless structure that is able to provide whatever treatment and care a patient needs, regardless of spinal condition,” Jeremy M. Steinberger, MD, Director, Minimally Invasive Spine Surgery, Mount Sinai Health System, and Assistant Professor, Neurosurgery, and Orthopedics, at the Icahn Mount Sinai.

“Our doctors at the new Mount Sinai West Spine Center offer a full complement of comprehensive spine services that meet your needs using the latest minimally invasive techniques in our state-of-art facility,” said Samuel K. Cho, MD, Chief of Spine Surgery, Mount Sinai West, and Professor, Orthopedics, and Neurosurgery at the Icahn Mount Sinai. “Whether you are a teenager with scoliosis or an adult suffering with disc herniation, we are here to help you.”

For spine patients, EOS, a low-dose alternative to X-rays and CT scans, is available. EOS provides 3D, weight-bearing images that enable physicians to get the most accurate view of the spine and lower limbs in a natural standing position.

Get more information or to book an appointment with a specialist

Thinking About Becoming a Neuroscientist Someday? Start Here—at Mount Sinai’s Brain Fair for Schoolchildren

May 9, 2023 | Community, Featured

It was a most amazing field trip for nearly 600 elementary, middle, and high school students who participated in the recent 11th Annual Brain Fair on the campus of the Icahn School of Medicine at Mount Sinai, eager for a day of learning and fun.

The event, which was also open to Mount Sinai staff and the community, was held during Brain Awareness Week, a global campaign launched by The Dana Alliance for Brain Initiatives to foster public enthusiasm and support for brain science. Mentoring in Neuroscience Discovery at Mount Sinai (MiNDS) co-sponsored the Brain Fair with The Friedman Brain Institute and the Center for Excellence in Youth Education (CEYE).

Angelica Minier-Toribio, a fifth-year Neuroscience PhD student and MiNDS volunteer, was ready for the throngs—among them was Jordan, a fifth-grader at CEYE partner school PS 171 Patrick Henry. He stopped by her booth, curious to learn how the brain sends electrical impulses to muscles and controls movement.

Fifth-grade student Jordan, with classmate Julian looking on, gets a lesson from Angelica Minier-Toribio on how the brain sends electrical impulses to muscles and controls movement.

Ms. Minier-Toribio placed two electrodes on Jordan’s arm and three on herself, and asked, “Do you feel anything?” as she used a battery-powered device to record electrical impulses from her own arm muscle, which she amplified and gently directed to his arm muscle. Jordan could feel—and see—his fingers and hand move involuntarily. He recounted after the demonstration that his arm and fingers “felt tingling” and that he saw how “electricity can control your muscles.”

MiNDS, a program that was launched by PhD neuroscience students at Mount Sinai’s Graduate School of Biomedical Sciences, aims to make neuroscience education more engaging and accessible to the public. Denise Croote, PhD, who was active in MiNDS as a neuroscience graduate student, is now its faculty supervisor. The CEYE, directed by Kenya Townsend, has been in existence for nearly 50 years, hosting both school-year and summer programs for youth from racial and ethnic backgrounds that are underrepresented in medicine and science.

Adding to the excitement—this was the first in-person Brain Fair in the three years since the COVID-19 pandemic first ravaged New York City. Appearing at the event were Eric J. Nestler, MD, PhD, and Paul J. Kenny, PhD. Dr. Nestler is Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, and Dean for Academic Affairs at Icahn Mount Sinai, and Chief Scientific Officer of the Mount Sinai Health System. Dr. Kenny is Ward-Coleman Professor and Chair of the Nash Family Department of Neuroscience and Director of the Mount Sinai Drug Discovery Institute.

The Friedman Brain Institute hosted additional activities around Brain Awareness Week. Among them:

  • The Art of the Brain, an annual exhibition of photographs, paintings, illustrations, and videos that celebrate the beauty of the brain and nervous system as seen through the eyes of some of the world’s leading researchers. Veronica Szarejko, the Director of Art of the Brain and the exhibition’s curator, says faculty, trainees, and staff from 14 departments and institutes across Mount Sinai submitted 52 works.

The Art of the Brain celebrates the beauty of brain science.

The virtual exhibition, launched on March 22, is available to Wednesday, May 31. Over the years, the exhibition has received world-wide acclaim for showcasing how science—and art—are revealed as researchers study the brain. Take a museum-style tour of the exhibition.

  • Stories of Brain and Beyond, a special Mount Sinai storytelling event in which five scientists shared true, personal stories of their scientific paths. Created through a collaboration between The Friedman Brain Institute and The Story Collider, and spearheaded by neuroscience postdoctoral fellow Aya Osman, PhD, and Abha Karki Rajbhandari, PhD, Assistant Professor of Psychiatry, and Neuroscience, this event was performed live, on-stage, at Caveat, a New York City performance space. From the tragic to the hilarious, the storytellers explored the deeply human side of science.

Scientists shared personal stories of their scientific paths during a live event at Caveat, a New York City performance space.

At the Brain Fair, 100 volunteers, which included 60 MiNDS members, 28 CEYE high school students, and 12 Neuroscience faculty were on hand to interact with the students. The volunteers were stationed at more than 20 booths that offered unique learning experiences. Visitors were able to see real specimens of a healthy—and diseased—human brain; stop by an “Ask an Expert” booth; learn about balance and optical illusions, taste and smell, and hand-eye coordination; and walk through a giant inflatable model of the brain, an immersive and educational experience.

A popular activity for the schoolchildren was the hands-on opportunity to remove a “brain tumor” using the same technology that Mount Sinai brain surgeons rely on in their operating rooms—the 3D robotic exoscope. This is a device that has a high-definition digital camera system and magnifies the brain’s neural and vascular structures, allowing neurosurgeons to remove tumors with greater precision.

Fatima uses the Synaptive Medical Modus V, a 3D robotic digital exoscope, assisted by Evelyn Richardson, Senior Clinical Applications Specialist, Synaptive Medical.

Fatima, also a fifth-grader at PS 171 Patrick Henry, was one of many eager students who stopped by. With a neurosurgery operating room team member guiding her, Fatima put on the same 3D glasses used by Mount Sinai neurosurgeons as she attempted to delicately remove, under high magnification, a tiny strawberry seed—”the tumor”—from a fresh strawberry. Her classmates, also wearing 3D glasses, stood around and watched as she carefully, and successfully, completed the task. One of her teachers who was looking on said with delight: “Fatima is a brain surgeon now!”

Not yet—but the Brain Fair certainly opened up the possibility for Fatima and the others to consider eventual careers in neuroscience.

Scroll through this slideshow for more photos.

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AI Spotlight: Forecasting ICU Patient States for Improved Outcomes

May 8, 2023 | Featured, Research

AI Spotlight: Forecasting ICU Patient States for Improved Outcomes

Girish Nadkarni, MD, MPH, and Faris Gulamali

Artificial intelligence (AI) and machine learning (ML) have seen increasing use in health care, from guiding clinicians in diagnosis to helping them decide the best course of treatment. However, AI still has much unrealized potential in various health care settings.

Mount Sinai researchers are exploring bringing AI into intensive care, and developed Spatial Resolved Temporal Networks (SpaRTeN), a model to assess high-frequency patient data and generate representations of their state in real time.

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The work was presented at the Time Series Representation Learning for Health workshop on Friday, May 5, hosted by the International Conference for Learned Representations, a premier gathering dedicated to machine learning.

Hear from Girish Nadkarni, MD, MPH, Irene and Dr. Arthur Fishberg Professor of Medicine at the Icahn School of Medicine at Mount Sinai and the leader of the SpaRTeN research, and Faris Gulamali, medical student at Icahn Mount Sinai and member of the Augmented Intelligence in Medicine and Science lab, on what lay behind creating the model and what it could achieve for patients.

What was the motivation for your study?

A growing amount of research is indicating the need to redefine critical illness by biological state rather than a non-specific illness syndrome. Advances in genomics, data science, and machine learning have generated evidence of different underlying etiologies for common ICU syndromes. As a result, patients with the exact same diagnosis can have entirely different outcomes.

What are the implications?

In the ICU, representations of a patient can be used to guide personalized treatments based on personalized diagnoses rather than generic treatments with empirical diagnoses.

What are the limitations of the study?

In this study, we only looked at using one type of data at a time in real time. For example, we looked primarily at measures of intracranial pressure. However, the ICU has many types of data being output simultaneously. Future work hopes to integrate all the different types of data such as electrocardiograms, blood pressure, and imaging to improve patient representations.

How might these findings be put to use?

These patient representations are being combined with data on medications and procedures to determine how to optimize patient treatment based on underlying state rather than common illness syndromes.

What is your plan for following up on this study?

In this study, we focused primarily on creating the algorithm and showing that it works for the case of intracranial hypertension. In future studies, we would like to integrate multiple data modalities such as imaging, electrocardiograms, and blood pressure as well as intervention-based data such as medications and procedures to determine precise empirical interventions that lead to improvements in short-term and long-term patient outcomes.

Learn more about how Mount Sinai researchers and clinicians are leveraging machine learning to improve patient lives

Computational Neuroscientist Opens Doors for New Ideas and Talent to Thrive

When Can a Patient Come Off a Ventilator? This AI Can Help Decide

For 24th Year, Mount Sinai Receives Top Safety Rating for Cardiac Catheterization

Updated on Apr 14, 2023 | Cardiology, Featured

Annapoorna S. Kini, MD, left, and Samin K. Sharma, MD.

For the 24th consecutive year, The Mount Sinai Hospital’s Cardiac Catheterization Laboratory or its interventionalists have received the highest two-star safety rating from the New York State Department of Health (NYSDOH) for percutaneous coronary interventions (PCI), also known as angioplasty. PCI—one of the most common procedures for patients with coronary artery disease—opens blocked arteries and restores normal blood flow to the heart.

In a highlight of the report, Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, received the two-star rating for significantly lower 30-day risk adjusted mortality for PCI in all cases and in non-emergency cases. She was the only interventionalist in the state to receive this rating in both categories, while performing 2,844 procedures in the latest period reported, December 1, 2016, to November 30, 2019.

“This NYSDOH report is again a testament to the top quality work being done in The Mount Sinai Hospital Cardiac Catheterization Laboratory by the dedicated interventionalists, making it No. 1 in the nation in volume and quality,” says Samin K. Sharma, MD, Director of the Mount Sinai Cardiovascular Clinical Institute, and Senior Vice President of Operations and Quality for Mount Sinai Heart.

Mount Sinai’s exceptional ratings appeared in the latest NYSDOH report, released in April 2023, on the risk factors associated with PCI at 65 hospitals across New York State. The NYSDOH began publishing PCI safety ratings in 1995, in reports designed to help patients make better decisions about their care based upon a statistical review of each hospital’s data.

“Despite taking on some of the most challenging referrals, our Cath Lab has received the double-star rating again. I believe that our efforts as educators and investigators—in our conferences, live cases, publications, educational applications, and clinical trials—bring us to the forefront of the field,” says Dr. Kini, the Zena and Michael A. Wiener Professor of Medicine.  “We are looking forward, toward the horizon, and are always seeking the best practices and proven methods to provide our patients with the best outcomes.”

During the three-year period, The Mount Sinai Hospital had a risk-adjusted PCI mortality rate of 0.85 percent for all of its cases—emergency and nonemergency—significantly lower than the statewide average of 1.22 percent, while performing the largest number of procedures (10,347). For nonemergency cases, Mount Sinai’s PCI mortality rate was 0.50 percent, compared with the statewide average of 0.79 percent

 

Read more about The Mount Sinai Hospital’s Cardiac Catheterization Laboratory

Mount Sinai Neuroradiologist Collaborates on New Opera About a Long-Ago Pandemic

Updated on Apr 13, 2023 | Featured

Jarrett Porter and Joyce El-Khoury in the Odyssey Opera performance of Awakenings. Photo by Kathy Wittman

The COVID-19 pandemic is the most significant public health crisis of our time. However, from 1916 to 1927, there was another pandemic that shaped and ended lives—encephalitis lethargica, or sleeping sickness, which afflicted more than one million people worldwide, causing 500,000 deaths. Of those who recovered, many were left in a catatonic state, speechless and motionless. Most of these patients were warehoused in mental health or hospital facilities, with no ability or means to treat them successfully.

The story of three of these patients in the Bronx, and their physician, Oliver Sacks, MD, is the subject of an opera by a Mount Sinai neuroradiologist, Aryeh Lev Stollman, MD, and his composer husband, Tobias Picker. Awakenings made its debut in June 2022 at the Opera Theatre of St. Louis and its East Coast premiere in Boston in February 2023 with Odyssey Opera in a limited run at the Huntington Theatre. The opera was recently featured in The New Yorker and The New York Times.

Oliver Sacks, a neurologist, was struck by the similarities between encephalitis lethargica and Parkinson’s disease. He advocated to hospital management that L-dopa, an experimental drug used to treat Parkinson’s, might be an effective way to treat these patients. He was given permission to treat one patient as a test. The patient, Leonard, made a spectacular recovery, and Dr. Sacks gained authorization to treat many more patients. Unfortunately, the effects did not last, and most patients relapsed into their former trance-like state.

Dr. Sacks wrote a book, Awakenings, in 1973, detailing the cases of 20 patients. Dr. Stollman and his husband became friends with Dr. Sacks after being introduced at a dinner party in Manhattan in 1993. Mr. Picker had Tourette syndrome as a child, and over the course of his friendship with Dr. Sacks, was helped by him, both in accepting his condition and learning to live with it. Dr. Sacks noticed that Mr. Picker, who wrote the music, was relieved of his symptoms while playing piano, which Dr. Sacks wrote about in his book describing the therapeutic effects of music, Musicophilia.

Dr. Stollman, who is also an award-winning novelist, wrote the libretto for Awakenings. “We based the story on Dr. Sacks’ book, but because he wrote about 20 separate patients, we chose three main patients and created their interaction with each other and Dr. Sacks,” Dr. Stollman says. “Dr. Sacks realized that his book wasn’t just a collection of case histories, but rose to the level of allegory or myth. It’s symbolic of our own lives and what we go through. Even if we’re not afflicted like these patients, we have our own awakenings and then have to return to everyday life. So we framed this story in the myth of Sleeping Beauty, and Dr. Sacks is the prince who awakens our characters. However, Sleeping Beauty doesn’t have to go back to sleep, but these patients do.”

In the opera, as Leonard responds to his treatment and awakens, he sings:

It’s a lovely feeling!

A lovely feeling.
To walk. To talk.

I have watched you every night and every day for years.
How many years have I been imprisoned in that chair?
I could only live in books,
And live through other people’s lives.
It’s a lovely feeling.
A lovely feeling!
I am reborn.

“The opera was ready to premiere in June 2020 when the pandemic struck,” Dr. Stollman says. “Every opera company closed, and Awakenings had to be delayed. Perhaps audiences can now understand a little better and can relate through their own experience, coming out of this pandemic.”

Tobias Picker, left, and Aryeh Stollman, MD, at their wedding at the U.S. Supreme Court in Washington, D.C. Photo by Jon Fleming

In the opera, Dr. Sacks has an awakening of his own, coming to an awareness of his own identity as a gay man. But he feels he is not ready to fully embrace that fact, singing, “I am no longer the man I was / But I have not truly awakened yet.” “When Dr. Sacks came out, it took him a long time, but he wanted to do that before he died,” Dr. Stollman says. “In the end, he was a proud gay man. And we were fortunate to be his friend.”

While Dr. Sacks’ book was also the basis for a film starring Robin Williams and Robert De Niro, the opera written by Dr. Stollman and Mr. Picker is a fresh and original take on the story, enriched by their personal friendship.

As a neuroradiologist, Dr. Stollman reads CT scans and MRIs for neurological diseases and disorders of the spine. “My background in medicine certainly helped in writing the story, but I think writing and medicine are both life-affirming pursuits. As a doctor, you have an intense engagement with life. You can learn more about a patient in a few minutes than perhaps their closest friends know about them. And writing reflects the more intense and emotional aspects of our lives. They’re not that different, in some ways.”

Dr. Stollman has written several novels, including The Far Euphrates, which won the Lambda Literary Award and has been translated into German, Dutch, Italian, Portuguese, and Hebrew. His second novel, The Illuminated Soul, won the Harold U. Ribalow Prize for Jewish literature from Hadassah Magazine.

Read more Stories from Mount Sinai Today

Shaping the Future of LGBTQ+ Medicine

Updated on Jun 1, 2023 | Diversity and Inclusion, Featured

Fellows of the LGBTQ+ Medicine Fellowship from left to right, Jean Carlo Rodriguez-Agramonte, MD; Alexander Boulos, MD; Roy Zucker, MD.

Throughout the day, the flow of patients at Mount Sinai Health System’s Institute for Advanced Medicine clinics is nonstop, says Jean Carlo Rodriguez-Agramonte, MD. “But I couldn’t be happier, seeing these patients and knowing I’m helping them,” he adds.

Caring for LGBTQ+ people forms the bulk of Dr. Rodriguez-Agramonte’s training as part of the LGBTQ+ Medicine Fellowship at the Icahn School of Medicine at Mount Sinai. The third fellow since the program’s inception, he rotates through various specialties—internal medicine, adolescent medicine, and endocrinology, to name a few—through a year of training to learn skills needed to provide competent care for LGBTQ+ populations.

“The kind of care we’re trying to impart is one that is focused on addressing the patient’s identity,” says Erick Eiting, MD, Medical Director for Quality of the Center for Transgender Medicine and Surgery, and program director of the LGBTQ+ Medicine Fellowship. The fellowship is now gearing up to recruit its fourth fellow in the upcoming academic year.

Learn more about applying for the LGBTQ+ Medicine Fellowship

When Mount Sinai created the fellowship in 2020, it was one of the first two such programs in the country—the other was at the University of California, Los Angeles. “There’s a dire need for fellowships such as ours,” Dr. Eiting says. “That there were none prior was shocking given the legacy of health crises with the LGBTQ+ population in this country.”

Erick Eiting, MD

Only about a third of medical students have had any sort of LGBTQ+ training, and even that might be in the form of lectures that span one day, notes Dr. Eiting. “We need to step up and shape the future of LGBTQ+ medicine,” he says.

At the core of that effort is addressing disparity. Studies have shown that rates of depression, suicidal ideation, substance use, and HIV are significantly higher in LGTBQ+ populations, and yet access to health services to address those issues continue to be difficult for these communities, says Alexander Boulos, MD, MPH, who was the second program fellow. “Having a physician who’s well-trained to be sensitive to the patient’s gender identity and sexual orientation can help ensure proper testing, or asking the right questions,” he says.

The LGTBQ+ Medicine Fellowship has evolved over each iteration, and continues to challenge itself to grow. “Just as we train each fellow, we try to have each fellow help us expand the offerings we have,” Dr. Eiting says.

With a goal of diversity, the program is aiming for greater representation in gender, racial, and socioeconomic background from future fellows.

“Having people with rich and diverse backgrounds will bring about the ‘rising tide phenomenon,’ where a rising tide lifts all boats,” says Dr. Eiting. Just as a fellow receives instruction from the institution, so too does the fellow teach and be able to share experiences with staff who work alongside them, he adds.

Additionally, the fellowship seeks to ensure relevance amid rapidly changing technology in the health field. For example, Mount Sinai recently launched a telehealth program for pre-exposure prophylaxis (PrEP) for HIV, and Dr. Eiting hopes future fellows might be able to think creatively about technological innovations. “Telemedicine has great potential for LGBTQ+ medicine. How can we take it further?” Dr. Eiting asks. “That’s a goal: to always be thinking about how we can increase access more.”

Read more about the experiences of current and past LGBTQ+ Medicine Fellows

Jean Carlo Rodriguez-Agramonte

Alexander Boulos

Roy Zucker

Jean Carlo Rodriguez-Agramonte, MD; 2022-2023 LGBTQ+ Medicine Fellow

What drew you to the fellowship?
When I was applying, there were only two such programs of its kind: one at Mount Sinai and one at UCLA. But what was a particular draw for Mount Sinai was that there was a large Latino population, especially Puerto Rican, in New York. There’s a saying that Puerto Rico almost feels like a borough of New York City. But coming from there, I was interested in continuing to treat and understand that population.

What were some of your takeaways from the fellowship?
The amount of patients I’ve seen here and the availability of resources is incredible and humbling. As a physician, you don’t get sidetracked from your goal of treating patients simply because of the lack of resources.

For example, when a patient comes in here, they get to have their labs done immediately, instead of having to wait weeks. Then, I get the results first, and I’m able to explain the results to them. It feels more personal and leads to better communication. Sometimes, when patients get their results first without any guidance, it leaves them with a lot of questions and causes unnecessary stress.

Being surrounded by so many experts here at Mount Sinai, it doesn’t feel like you’re constantly running into walls. Patients sometimes expect you to know everything, but we don’t know everything. At least here, I know where to tell my patients to go to, even if I don’t have all the answers.

What were some challenges or highlights faced during the program?
I got dropped into a population I wasn’t used to seeing a lot of, such as the transgender population. I had a lot of learning to do on how to properly care for them. Not just medically, but also on things such as using the proper pronouns, and centering their identity as part of the care.

A highlight for me was being able to treat Latino patients at a deeper level. In general, it’s very difficult to provide preventive care without understanding the person’s underlying culture, since so many nuances are unsaid. But I’ve had so many Spanish speakers say to me, “I’m so glad I can speak to you on my own terms. Because you get it.” That connection feels special to me each time I hear it.

What do you hope to achieve after the fellowship?
I hope to implement the things I’ve learned here in Puerto Rico, particularly regarding providing better transgender care. I also hope to be part of the conversation there for improving medical education on LGBTQ+ populations. Just as it is here, medical school systems there lack inclusive care instruction.

Part of why I wanted to go into family/internal medicine and pediatrics is that I like the “figuring out the puzzle” part of medicine. Unlike in surgery, where all the complicated part of diagnosis is done and you’re fixing the problem, in family medicine, you’re talking and listening to patients and figuring out what is wrong. Similarly, I want to figure out where the missing parts are in research and education, and find the answers.

Alexander Boulos, MD, MPH; 2021-2022 LGBTQ+ Medicine Fellow

What drew you to this fellowship?
Ever since medical school, I’ve been involved in increasing awareness of LGBTQ+ health issues, giving training and competency lectures to faculty, staff and residents about the LGBTQ+ patient, and even starting a PrEP clinic at the Veterans Affairs in the Bronx to help increase access to medication that can be used to prevent HIV for at-risk patients living in underserved communities.

I realized that I’ve been working in LGBTQ+ medicine all this time and not even knowing it. When I discovered the existence of this program while completing my preventive medicine residency program here at Mount Sinai, I knew it was the perfect opportunity to help set the tone for the rest of my career.

What were some of your takeaways from the fellowship?
I remember vividly, after my first day of this fellowship, calling my family and friends and saying, “I’ve never seen so many gay patients in my life!” And I was absolutely loving it. How was it that I was already a resident and hadn’t had much exposure to LGBTQ+ patients?

In the program, I was able to rotate and learn from experts in almost every field, including infectious disease, endocrinology, plastic surgery, urology, OB/GYN, psychiatry, adolescent medicine, and addiction medicine. The scope of experiences I had was nothing short of amazing. I got to scrub in for gender-affirming surgeries, including vaginoplasty, chest masculinization, and facial feminization. I’ve worked with experts in HIV/AIDS treatment, provided gender-affirming hormone therapy to transgender and gender-diverse patients, and even cared for intersex pediatric patients.

Why do you think LGBTQ+ fellowships are important?
Especially today, there are many places in the United States where health care access for LGBTQ+ communities continues to be a challenge. We’ve seen a recent wave of anti-transgender bills passed throughout the country that serve to block and/or limit access to gender-affirming care.

Programs such as this one are important for changing the future of medicine, as it serves as a bold statement about the need for more training and resources to serve a community that has all too often been left out on their own. We need more doctors to be advocates for LGBTQ+ patients and to be aware of their specific health needs, just as we are trained to do so for every other patient.

Unfortunately, that training isn’t quite the norm yet, and I’m here to help change that. I’ve found my purpose in this field and I want to help make a difference for my community.

How do you intend to make that difference, after your residency?
As I gear up for graduation and make my way out in the real world, I plan to continue serving the LGBTQ+ community clinically as a primary care physician, focusing on HIV/AIDS treatment, PrEP management, anal cancer screening, and gender-affirming care.

In addition, I hope to play a part in medical education reform where we can incorporate important LGBTQ+ competency trainings in medical school curriculums. Doctors and medical students need to be more comfortable treating LGBTQ+ patients, and they’ve shown that they are open to learning.

I also hope to increase my community outreach engagement to the LGBTQ+ population directly and find new and innovative ways to teach and inform the community about important health issues, such as ones they might find too uncomfortable bringing up to their provider. I’m excited to see what the world has in store for me, but one thing I do know is that it all started here.

Roy Zucker, MD; 2020-2021 LGBTQ+ Medicine Fellow

How did you get involved with the first fellowship?
I had been working in LGBTQ+ medicine in Tel Aviv for about seven years, and was in the infectious disease program at the Tel Aviv Sourasky Medical Center (Ichilov). Mount Sinai has a collaboration with my hospital, and Mount Sinai’s dean of education came to Ichilov to discuss setting up a one-month observership program at its Institute for Advanced Medicine.

I participated in that program and realized physicians seemed to only be looking at their own disciplines, and no one was looking at LGBT care holistically. For example, a transgender patient will get the best care with a transgender medicine practitioner, but if HIV is involved, another provider would need to be involved.

I thought, “Why not a training program where providers are taught to look at the broader picture of LGBTQ+ care—including the spectrum from transgender medicine to psychiatry to HIV care?” I wrote an email to David Reich, MD, President of The Mount Sinai Hospital, not expecting a response. In five minutes, I got an email back, and soon we started discussing starting up the program. A year and a half later, I became the first fellow.

What were some of your takeaways from the fellowship?
Unlike in Israel, the patients at Mount Sinai are much more diverse. The exposure to the patient diversity really challenged me as a physician in how I get to treat and address patients. There were initial cultural and language differences, but patients were patient with me. On the professional side, because I had already been treating patients and involved in LGBTQ+ medicine for many years, I felt I had a lot to offer to people working alongside me. While Mount Sinai was giving me expanded knowledge, I also felt people could learn from my experience in Israel too.

While the term “leadership” might be overused in America, I felt it was really on display at the Health System level, and also at the Icahn School of Medicine. Their commitment to health care delivery and excellence has led to great name recognition in Israel, where being affiliated with Mount Sinai is an impressive achievement.

What are you working on today?
Since August of 2021, I have been the Director for LGBTQ Health Services with Clalit, the biggest health service organization in Israel overseeing 5 million patients. We created LGBTQ+ clinics in Tel Aviv, Jerusalem, and Haifa.

I am also Director for LGBTQ Health Services with Ichilov in Tel Aviv, and in partnership with city hall, we’re about to open an LGBTQ community health center that integrates medicine and community initiatives. A focus of this center involved “clinical champions”—people within Ichilov who are specialized in a specific branch of LGBTQ medicine such as geriatrics or adolescent medicine, who will focus on research and education.

These are some current steps, but I am hoping to guide what the future of medicine might look like for LGBTQ+ people.

What might that future look like?
Even in 2023, LGBTQ+ patients are still hesitant to access health care services because they’re afraid of exposing themselves and are not comfortable discussing their sexuality with providers. Patients are going to hospitals when their conditions become an emergency, not before, when things can still be prevented. We need to provide accessibility on the patients’ terms—if they’re only comfortable in an LGBT-defined space, it should be there.

But in the long term, I hope that LGBTQ+ care goes beyond just about providing accessibility and addressing discrepancies, but more into “community-oriented” care. This means thinking about LGBTQ+ populations across all ages—how they’re exposed to LGBTQ+ topics, how they age and their mental health, etc. For example, if you’re talking about sexual health and gender identities at a younger age, having that acceptance early on affects mental health outcomes later in life. When you put it there from the beginning for young people, they don’t feel as on the fringe.

As someone who has an entrepreneurial soul, I found Mount Sinai embraced that spirit. I came to New York and people here at the program helped take an idea from my head and made it real. The biggest motivational word of mine is “no”—when someone says “no,” all the more I want to make it happen. Mount Sinai certainly helped with the obstacles to make my dream happen.

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