How a new stand-alone medical school grew into one of the nation’s leading centers for scientific and medical advancement.
Four Nobel Laureates attend the dedication of the Mount Sinai School of Medicine in 1968, joining George James, MD, second from left, as he is inaugurated as the first Dean and President. The four are, left to right, Linus Pauling, George W. Beadle, Sir Peter Medawar, and Francis Crick.
Operating out of a converted garage, it was an ambitious, bold, and risky entrepreneurial venture fueled by dreams of not merely disrupting the status quo, but also changing the world in ways that could touch the lives of millions of people.
It was a start-up before there was such a thing as Silicon Valley: a new medical school looking to break the mold of medical education and biomedical research. Fifty years after opening its doors, the Icahn School of Medicine at Mount Sinai now stands as one of the top medical schools in the United States.
Rather than open a school under the safe auspices of a university—the model for the vast majority of medical schools—the trustees of The Mount Sinai Hospital decided to go it alone, planning to dramatically build on the hospital’s century-old legacy of compassionate patient care and scientific research to increase its influence on modern medicine.
“Extensive research programs must be continued to develop new drugs, new techniques, new equipment,” proclaimed Mount Sinai’s Board of Trustees in declaring its intention of establishing a medical school “to meet the growing needs of our community, to move ever forward.”
So Mount Sinai purchased an old New York City municipal bus depot at 10 East 102nd Street for $7 million, renovating it into classrooms, lecture halls, laboratories, and offices. “Mount Sinai Opens Its Medical School in Old Bus Garage,” read the less-than-auspicious headline in The New York Times on September 7, 1968.
As part of our 50th anniversary celebration, Mount Sinai has collaborated with Scientific American to prepare a special digital section about innovation.
The Mount Sinai School of Medicine, as it was then called, would be no ordinary medical school. In addition to ensuring its independence (a simple affiliation with the City University of New York helped it gain accreditation), the School’s founders were deeply committed to a new concept of community medicine. In an article titled “The Mount Sinai Concept,” published in the journal Clinical Research, Hans Popper, MD, Chief of Pathology at The Mount Sinai Hospital and a driving force behind the creation of the medical school, described the foundation of a medical education as a tripod consisting of “exact biology,” human studies, and community medicine that “strives to give in a setting of specialists good care to every patient and every disease including pre-symptomatic stages.” It was a revolutionary concept—studying a community’s medical needs and attempting to proactively prevent disease—but an early precursor to what is practiced today as population health.
From its inception, the Mount Sinai School of Medicine was committed to admitting a diverse student body, particularly lower-income students who, at the time, often could not gain the opportunity to study medicine. Not only would Mount Sinai maintain a commitment to equal opportunity and diversity of background, but also to breadth of thought that would promote a creative, intellectual environment. “We are training physicians who, with their own efforts … are going to see that problems are solved,” said George James, MD, Mount Sinai School of Medicine’s first dean. “The test of their effectiveness is the solution of the problem, not the mere multiplication of a technique.”
The first White Coat Ceremony for first-year medical students is held in 1998.
The School would go on to live up to its vision to be like no other.
With only 36 MD students in its initial first-year class, plus 23 third-year medical students and 19 PhD students, the School’s small size was designed to allow close interaction between instructors and students. When members of the faculty attempted to eliminate the pass/fail grading system, which was meant to promote learning for learning’s sake over a grade-obsessed, pressure-cooker environment, first-year student Kenneth L. Davis and his classmates were offended.
So they rebelled, recalled Dr. Davis, who 35 years later would become the School’s dean and then President and Chief Executive Officer of the Mount Sinai Health System.
The Annenberg Building is dedicated in 1974 with Vice President Gerald Ford as principal speaker.
“We came to Mount Sinai because of educational innovation, anticipating an active role in the building of this new school,” Dr. Davis wrote in the first issue of The Sinai New Press, a campus newspaper he founded as a forum of protest. Student demand “for a truly integrated curriculum—implementation of the Sinai Concept—has been met with an attempt to impose an inappropriate status quo—to smother our aspirations.”
He and other students won a meeting with Gustave Levy, Chairman of the Mount Sinai Boards of Trustees. The students prevailed and, to this day, the School’s grading system remains pass/fail.
Dr. Davis would soon find his niche at the School of Medicine. When the opportunity arose to choose electives, he connected with the pharmacological sciences department to pursue his interest in neuroscience involving the chemistry of catecholamines—a group of neurotransmitters that includes epinephrine, norepinephrine, and dopamine. Working closely with Sherwin Wilk, PhD, transformed Dr. Davis’s Mount Sinai experience. “This department saved me,” he said. “I spent every afternoon working in his lab.” By the time of his graduation, Dr. Davis had written more than 10 papers on catecholamine chemistry and depression and was well on his career path to becoming an influential neuroscientist. “The opportunities were there to do science at an intense level,” he said. “Mount Sinai changed my life because it began my scientific career.”
A transformational step
The opening in 1973 of the Annenberg Building—at the time, the largest structure for a medical school in the world—was transformational for the School of Medicine. “That’s the turning point. It‘s a huge research building; we needed to fill it with scientists. We went from a ‘mom and pop’ shop in a garage to a full-scale tower with a real medical school,” said Dr. Davis.
Kenneth L. Davis, MD, MSSM ’73
The Mount Sinai School of Medicine grew steadily for the next two decades. Then, in 1996, Mount Sinai and New York University announced a plan to merge their hospitals and medical schools. Numerous differences led to the deal’s unraveling, and in the aftermath, Mount Sinai and its School of Medicine faced a financial crisis.
In April 2003, Dr. Davis, then Chair of the School of Medicine’s Department of Psychiatry, was tapped to become Dean of the School of Medicine. Ten weeks later, Peter May, Chairman of the Mount Sinai Boards of Trustees, asked Dr. Davis to also assume leadership of the entire Mount Sinai Medical Center.
“I realized how deep within me this school’s welfare is. And I wanted to do something about it. If I had a goal, it was to make sure such a crisis never happens again,” said Dr. Davis. “I knew I had an irreversible bond to this place. I wasn’t going to let it go down. I wasn’t going to let it go down.”
Dr. Davis turned to Dennis Charney, the Dean of Research who was to become the School of Medicine’s next leader, to develop a strategic plan for creating interdisciplinary research institutes that would attract top talent to the School to conduct groundbreaking studies, advance scientific knowledge, enhance medical education, and benefit Mount Sinai patients. Using the strategic plan as a basis, Drs. Davis and Charney and the trustees engineered a gritty turnaround, emphasizing growth rather than the cost reduction recommended by a consultant. The highly successful fundraising campaign, launched in 2007, culminated with donations from investor Carl Icahn that totaled $200 million, leading to the School’s renaming as the Icahn School of Medicine at Mount Sinai.
In 2013, the Medical School is renamed Icahn School of Medicine at Mount Sinai in honor of Trustee Carl Icahn.
Carrying on the ambitious approach that first inspired the School’s founding, Dr. Charney, the Anne and Joel Ehrenkranz Dean and President for Academic Affairs of the Mount Sinai Health System, has implemented his strategic plan by recruiting brilliant, ambitious investigators who believe the impossible is possible, and are willing to take the necessary high-risk conceptual leaps. Those recruits include mathematicians and computer scientists who are working to fulfill the promise of precision medicine by using Mount Sinai’s two supercomputers to exploit secrets of the human genome. “It’s not enough to get NIH (National Institutes of Health) grants and publish in prestigious journals. You have to make discoveries that change the lives of our patients. That’s the ultimate outcome measure we have to hold ourselves to,” said Dr. Charney.
Among the many contributions to biomedical sciences that have emerged from the School of Medicine’s laboratories are:
• Development of the first genetically engineered vaccine, for influenza
• Mapping of the influenza virus genome and progress toward a universal flu vaccine
• Identification of a biochemical predictor of preterm labor and delivery
• Development of an ultrasound-guided technique for insertion of radioactive seeds into the prostate for treatment of prostate cancer
• The first use of cholinesterase inhibitors to treat Alzheimer’s disease and improve cognition
• Discovery of a peptide that stimulates release of insulin from beta cells in the pancreas, which helps patients control their diabetes and prevent complications • Development of the first “black-blood” MRI, which allows cardiologists to identify thickening of the artery wall
• Development of Fabrazyme® to treat individuals suffering from Fabry disease, a rare but devastating metabolic condition
• A new technique for administering ketamine, a drug that can effectively treat depression in a matter of hours
• The discovery that immune cells start to be dysfunctional very early during tumor formation, suggesting that immunotherapy can be effective much earlier than currently believed
Adding to the wide-ranging intellectual environment at Mount Sinai are its multi-talented students, many of whom arrive without a traditional premed background. The Donald and Vera Blinken FlexMed Program grants early assurance of admission to applicants after two years of college, permitting exceptionally promising students from any field of study to pursue their undergraduate passions and then bring their perspectives to the School. “All of our students contribute a great deal to the creativity and innovation of the School. They contribute to the idea of openness of thought and perspective on what we’re doing, why we’re doing it, what type of risks we’re willing to take,” said David Muller, MD, Dean for Medical Education and the Marietta and Charles C. Morchand Chair for Medical Education. “It’s important to question dogma, to be skeptical about what you’re hearing, so you can challenge it in a constructive way because that’s what drives change,” said Dr. Muller.
A new campaign is launched in 1985 to rebuild the hospital’s facilities, including an I. M. Pei-designed pavilion named for the Guggenheim family, supporters of the hospital from the early 1900s.
Mount Sinai’s Graduate School of Biomedical Sciences, which grants PhDs and master’s degrees and is home to a large number of postdoctoral trainees, is also a core component of the Icahn School of Medicine. The Graduate School seeks to add advanced scientific perspectives, knowledge, and skills beyond those typically found in medical training, including computational thinking, problem-solving, teamwork, commercialization, and entrepreneurship, said Marta Filizola, PhD, Dean of the Graduate School of Biomedical Sciences.
Being part of a stand-alone medical school, rather than a large university, is a strength, according to Dr. Filizola.
“We fully benefit from a nimble and responsive administrative structure that allows us to quickly implement transformative changes,” Dr. Filizola said. “Since our faculty are exclusively focused on graduate and post-graduate education, we are able to provide the time, resources, expertise, and personalized training experience that brings out the absolute best in a trainee.”
Creating a culture of innovation
Central to the culture of innovation at Mount Sinai is an attitude that gives researchers the freedom to fail—the opportunity to pursue their best ideas, which may or may not lead to the next great discovery. The School and its leaders passionately believe failure is a component of learning, an opportunity for growth that will yield solutions. “I want people who are not satisfied with the status quo. They have a courageous, scientific mind that will push the envelope,” said Dr. Charney. “I’m not happy if my department heads are telling me they’re satisfied, everything is all okay.”
Gary Rosenberg, PhD; Enrique Riggs, DDS; Gary Butts, MD; and New York City Mayor David Dinkins at Harlem Week, 1992
This approach has paid off. Mount Sinai researchers collectively have generated more funding from the National Institutes of Health than any other stand-alone medical school. The Icahn School of Medicine ranks No. 2 in total research funding per Principal Investigator among U.S. medical schools and 14th in overall National Institutes of Health funding.
To facilitate the translation of Mount Sinai research discoveries into new diagnostics and treatments for patients, the School has hired leading technologists, intellectual property attorneys, and business executives with deep start-up experience, some transplanted from Silicon Valley. In 2017, that team, part of Mount Sinai Innovation Partners, generated 211 patents, 144 new inventions, 162 industry-sponsored and collaborative academic research agreements, and 53 new licenses and options for use of Mount Sinai scientists’ research. Mount Sinai has spun out nine companies, including the recently launched Sema4, which is dedicated to improving diagnosis, treatment, and prevention of disease through deep data analysis using knowledge and technology from the Department of Genetics and Genomic Sciences.
“We are determined to positively impact patient lives,” said Erik Lium, PhD, Executive Vice President of Mount Sinai Innovation Partners. “We’re taking concrete steps to accelerate the translation of commercially relevant technologies that can serve as the foundation for new products and therapies.”
One of the most innovative organizations
The School’s commitment to innovation and creativity recently led Nature magazine to name Mount Sinai one of the 10 most innovative research organizations in the world, based on contributions to published research that are later cited by other organizations in patent development. Fast Company magazine named the Icahn School of Medicine among the “World’s Top Ten Most Innovative Companies in Big Data” in 2014 and again in 2016, highlighting the School’s recruitment of top talent to map patients’ genomes, its investment in supercomputers for data analysis and research, and the BioMe™ database of genomic samples from 44,000 patients.
“I’m most proud of creating a culture of innovation that enables us to do great things here: basic science breakthroughs, discovery of new drugs, designing new health systems, and improving ways of caring for the poor,” said Dr. Charney.
That culture of innovation will be the foundation for the Icahn School of Medicine’s future. A half-century after fighting to ensure Mount Sinai would become more than just another medical school with a traditional approach to education, Drs. Davis and Charney have a vision for the next 50 years: for the School to be a leading innovator that can generate better scientific understanding and improved treatments that will diminish suffering, cure diseases, prolong life, and continue to change the world.