The Rossi July 2013

By K. H. Vincent Lau

Since 1994, Erica Friedman, MD,

has served in numerous medical edu-

cation roles at the Icahn School of

Medicine at Mount Sinai, most re-

cently as Associate Dean for Educa-

tion Assessment and Scholarship,

and Medical Director of the Mor-

chand Center for Clinical Compe-

tence. She is a recipient of many

teaching awards and project grants,

including research grants from the

AAMC, the Medical, Educational and

Scientific Foundation of New York,

Inc, and the Oregon State Attorney

General's Prescriber Education Pro-

gram.

In 2012, she served as the found-

ing faculty mentor and editor-at-

large of The Rossi. K.H. Vincent Lau,

former editor-in-chief of the Rossi,

recently spoke with Dr. Friedman

about her career, her views on medi-

cal education, and her love for the

arts.

At the time of publication, Dr.

Friedman is the Deputy Dean and

Medical Professor at Sophie Davis

School of Biomedical Education at

The City College of New York.

Early in your career, did you ever

think you would become an associate

dean of a medical school?

When I was in medical school, I

wanted to be a primary care doctor in

New England and trade goods, like

chickens, for my services. During my

internship, I got very excited about

immunology, because one of my first

patients had an intestinal bypass for

morbid obesity and developed a sar-

SEE FRIEDMAN, PAGE 7

COURTESY OF ERICA FRIEDMAN

Erica Friedman was the Associate Dean for Education Assessment and Scholarship.

Successful Match Day Celebrated at Mount Sinai Resident Matching Program (NRMP)

and find out where they will con-

tinue their training. The match proc-

ess is a complicated one: in order to

maximize the

number of filled

training programs,

the NRMP uses a

c o m p u t e r i z e d

mathematical al-

gorithm to match

preferences of the

applicants with

those of the resi-

dency program

directors.

SEE MATCH, PAGE 4

ROSSI TH

E

The Student Newsletter of the Icahn School of Medicine at Mount Sinai

Volume 3 | July 2013

A Career in Education: An Interview with Erica Friedman

By Dipal Savla, MII

Since 1952, on the third Thursday

in March, senior medical students

nationwide have

celebrated Match

Day, the culmina-

tion of an arduous,

year-long applica-

tion process to

residency pro-

grams. As a class,

these soon-to-be

physicians gather

together to open

up their envelopes

from the National

Sinai Seeks Ways to Reduce Stress Among Resi-dents, Students . . . Page 2

Are White Coat Ceremonies

Too Elitist? . . . Page 2

Essay Contest Highlights Student Perspectives on

Professionalism . . . Page 3

Being an Effective Mentor and Mentee . . . Page 11

COURTESY OF MOUNTSINAI.COM

Sinai students celebrate at Match Day.

Sinai Seeks Ways to Reduce Stress Among Residents, Students

By Ann Wang, MII

This article is part of The Rossi’s

Critical Assessment of Recent Litera-

ture Series, and reviews the following

study: Karnieli-Miller O, Frankel RM,

Inui TS. Cloak of compassion, or evi-

dence of elitism? An empirical analy-

sis of white coat ceremonies. Med

Educ. 2013 Jan.

Abstract:

White coat ceremonies have be-

come a well-established tradition in

most medical schools throughout the

United States, but the positives and

negatives of the messages they con-

vey and the principles they promote

have yet to be systematically ana-

lyzed. Detractors caution that these

ceremonies do not properly integrate

professionalism and humanism, and

can transform the white coat itself

into a status symbol.

In this study, eighteen white coat

ceremonies were analyzed. Overall,

white coat ceremonies were found to

address professionalism only in the

context of compassionate patient

care, and assigned qualities such as

humility and generosity to the white

coat.

Description of the study:

The white coat ceremony, a tradi-

tion initiated nearly twenty years ago,

has become a celebrated rite of pas-

sage for new medical students

throughout the world. A research

article published in the December

2012 issue of Medical Education takes

a deeper look at these ceremonies:

the history behind them, their pur-

pose and, especially, their problems.

The Arthur P. Gold Foundation for

Humanism in Medicine — the goal

of which, according to the Founda-

tion’s website, is to “nurture and pre-

serve the tradition of the caring phy-

sician” — designed the present-day

white coat ceremony. The first white

coat ceremony was held in 1993 at

the Columbia University College of

Physicians & Surgeons, and has since

spread to over 90 percent of medical

schools in the United States, as well

as many international schools.

Most ceremonies follow a similar

pattern. The dean welcomes the gath-

ered friends and family, a physician

faculty member gives a keynote

speech, the students recite an oath

and, finally, faculty members coat

the students one-by-one.

Detractors of the ceremony ex-

press concerns that the ceremony

does not strike a coherent balance

SEE COAT, PAGE 5

Are White Coat Ceremonies Too Elitist?

COURTESY OF WWW.MOUNTSINAI.ORG

Faculty give first-year medical students white coats during the September 2012 ISMMS ceremony.

By John Rozehnal, MII

Rates of depression and anxiety

disorders among medical students

and residents have been estimated to

be nearly three times as high as in

the general population.

Mount Sinai, which has long been

at the forefront of the worldwide

struggle to identify and address these

issues, recently implemented a num-

ber of stress-reducing and wellness-

boosting initiatives. But as ‘wellness’

becomes the norm (‘wellness’: the

new catch-all term suggesting every-

thing from better work hours to free

tai chi classes in the student lounge),

educators are grappling with the ex-

tent to which it should be integrated

into medical schools and hospitals.

I recently spoke with a number of

prominent medical education leaders

at Mount Sinai about the impact of

stress in medical training, and about

the risks and rewards of the steps

taken to alleviate it.

Celia Divino, MD, residency direc-

tor of surgery at Mount Sinai, argues

that residency work hours are, to

some extent, inalterable, because the

resident’s role is not only as a trainee

but as an employee. “In many ways,

SEE STRESS, PAGE 5

COURTESY OF MOUNTSINAI.ORG

Residents’ work hours may be hard to alter.

2

Essay Contest Highlights Student Perspectives on Professionalism Each year in the first-year Art and

Science of Medicine (ASM) course,

students participate in an essay con-

test to explore professionalism in

medicine. Eric Bortnick, now a sec-

ond-year medical student, wrote the

following 2013 winning essay:

B efore I started medical

school, the sickest patient I

ever saw was my grandfa-

ther. He was recovering

from a heart valve replacement, and

was able to talk, eat, and walk - not

very sick at all. So when I arrived at

the MICU for my

clinical site visit

over a month ago, I

was not really sure

what to expect. I

met my preceptor

and we went to the

computer to look at

the patient’s chart

that we would be

seeing for the day.

After going over the

long list of prob-

lems this patient

had, and then hav-

ing the doctor tell me that they were-

n’t sure what was wrong, I began to

realize that this would be an experi-

ence I had never had before.

I’ve been fortunate to only attend

a couple of funerals in my life. One

was for my great-grandmother, a

closed casket ceremony as she was

above 90 years old. The other was for

a high school classmate who died my

senior year, a passenger in the car of

a drunk driver that crashed into a

pole and sent her unbuckled body

through the windshield. That service

was an open-casket, presumably a

choice by her family to let all of us

18 year olds know the ultimate dan-

ger of driving under the influence.

When I saw her, she looked different.

Her face was swollen and her skin a

different tone. Her image is what I

have associated death with ever since.

My preceptor showed me to where

our patient was sleeping. In my

mind, he too was in an open casket.

You had to walk through two sepa-

rate doors to even enter the room he

was in, and one window let all the

onlookers see his motionless, lifeless

body. We walked into the room, and

when I saw him up close it only fur-

thered my belief that he was dead. It

didn’t matter what the monitors on

the screen were telling me about his

heart rate and blood pressure and

respiratory rate. There was a tube

going down his throat and dried

blood filled his

mouth and spilled

onto his chin. His

yellow and red spot-

ted body reacted to

a firm touch like a

memory-foam mat-

tress, taking five

seconds to rise back

to its initial position.

His scrotum was so

swollen that you

couldn’t see his pe-

nis hiding behind

the sac. I haven’t

even mentioned the sedatives he was

given, which presumably bring his

mind to a place that no living crea-

ture will ever experience. By all ac-

counts, he was much closer to that

high school classmate of mine than

any living person I had ever spent

time with. Yep, he was dead, and I

was about to practice my physical

exam on yet another lifeless body.

“Hello.”

It is amazing how one word can

change an entire situation. My pre-

ceptor said that one word, and I was

immediately brought back to life —

no, my patient was brought back to

life, and I was brought down to

earth. Before we did anything, my

preceptor turned towards the se-

dated patient in front of us and said

hello. She closed the blinds to re-

spect his privacy, and she proceeded

COURTESY OF ERIC BORTNICK

to explain to him why I was there in

the same way that she did in the

outpatient setting of her office a

week earlier. It didn’t matter that

when — if — this guy regained con-

sciousness he would have no idea

that I was ever in his room. This was

her patient, a human being, and she

was treating him with the respect,

care, and compassion that he so

rightfully deserved. The entire time

I was practicing my exam, she had

her hand on his arm or his head, a

soft touch of a reminder that some-

one was there for him, and cared

about him. When I was finished and

we were ready to go, I said thank

you to him. I wasn’t expecting a re-

sponse, and it didn’t matter that I

wasn’t going to get one. He de-

served the same gratitude and smile

I had given all the other patients I

had practiced on.

A constant theme throughout this

year has been about how important it

is to listen to your patients. We have

heard it through patient presenta-

tions, small group discussions, and

constant lectures in ASM. By listen-

ing, we will show our patients that we

are there to help them, and more

often than not paying closer atten-

tion will help us solve the problem

and treat the case. Listening is our

main way of expressing the care,

compassion, and humanity that our

patients expect from us.

On its surface, this is fairly easy to

do, and it separates a great physician

from a good one. We change our

moods based on the mood of the pa-

tient, we smile when they smile, we

keep eye contact. We ask good ques-

tions, not just about the illness, but

also about the patient’s family and

interests. Listening is not what sepa-

rates an extraordinary physician

from a great physician. An extraordi-

nary physician is one who listens

when the patient can’t speak, or does-

n’t even know we are in the room.

—Erik Bortnick, MII

3

Fourth-Year Students Head to Diverse Futures After Match Day MATCH, FROM PAGE 1

Match Day 2013 was the largest

match event in NRMP history, with

25,463 applicants successfully match-

ing to first year residency positions.

From the Icahn School of Medicine

at Mount Sinai, 139 graduating sen-

iors matched to 68 institutions in 22

states. More than half of all students

matched to programs in New York,

and more than a quarter will remain

at Mount Sinai.

Demetri Blanas, a fourth year

medical student who was accepted

into the Institute for Family Health/

Mount Sinai Harlem Residency Pro-

gram in family medicine, is thrilled.

Staying at Mount Sinai, he says,

“allows me to continue working with

community organizations that I have

developed strong ties with during my

time here as a medical student.”

The most popular specialties cho-

sen by the class of 2013 were Internal

Medicine (22%), Anesthesiology (9%),

Emergency Medicine (8%), General

Surgery (8%), and Pediatrics (6%).

Three students matched into child

neurology, a field with only 123 spots.

Recent graduate, Daniela Sloninsky,

matched into Mount Sinai’s inte-

grated “Triple Board Program” in

pediatrics, psychiatry, and child psy-

chiatry. Only nine such programs

exist nationwide. “I chose triple board

because I wanted to be able to ap-

proach the child as a whole, address-

ing patients' physical ailments, men-

tal health, and family contexts. I plan

to do mainly child psychiatry but am

very interested in the interplay be-

tween medical and psychiatric illness,

especially helping kids and families

cope with illness.” Dr. Sloninsky said.

In the United States, primary care

was more popular than ever before.

As compared to 2012, 400 more

United States medical students

matched into pediatrics,

internal medicine, and

family medicine pro-

grams. Mount Sinai saw

the same trend, with 32

percent of graduates

matching into these spe-

cialties.

Rehema Kutua, who

matched into the pediat-

rics program at Chil-

dren’s National Medical

Center in D.C., hopes

eventually to work in

global health with a fo-

cus on community

healthcare in sub-

Saharan Africa, where

she’s from. Dr. Kutua


More than a quarter of this year’s graduates will remain at The Mount Sinai Hospital for residency.

4

says that Mount Sinai was incredibly

supportive of her interests from the

start of her education. “I found great

mentors in the leadership, ” she said.

However, not all graduates will be

starting residency this July. Tom

Flaherty, for instance, the class

speaker at this year’s graduation cere-

mony, will spend the year working as

a writer for the Dr. Oz Show. Dr.

Flaherty previously worked at a local

radio station, created his own enter-

tainment show, and was extensively

involved in The Zone, the show put

on by Mount Sinai’s Kravis Children’s

Hospital.

“When I heard about the Dr. Oz

Show job, it seemed to be a great way

of continuing to do something I en-

joy so much,” he says, “as well as gain

experience in media in a much lar-

ger production than I have been in-

volved in before. It also enables me

to use the skills and knowledge that I

have gained in the last four years at

med school. So it’s the perfect mix.”

Dr. Flaherty plans to begin a resi-

dency program in family medicine

the following year.

The Class of 2013 joins a success-

ful and distinguished network of

alumni, and the entire community at

Mount Sinai is extremely proud. Con-

gratulations!


Internal medicine was by far the most popular specialty chosen.

New Study Empirically Analyzes Traditional White Coat Ceremonies

Stress and Burnout Threaten Residents

STRESS, FROM PAGE 2 residency is not a controllable situa-

tion,” she suggests, “this is a voca-

tion.”

Nonetheless, in 2003, a number of

studies came to the conclusion that

patient outcomes were consistently

poorer when patients were treated by

residents who had been working for

extended hours and hadn’t had

nearly enough

sleep. The conse-

quences were

impressive: na-

tionwide, new

and better hours

( w o r k d u t y

hours) were im-

plemented, and

the maximum

workweek was

reduced from one

h u n d r e d t o

eighty hours. Fur-

ther adjustments

in 2011 decreased

the maximum

length of a single

shift to sixteen

hours.

Mount Sinai has gone even fur-

ther to institute additional mecha-

nisms to reduce stress and improve

overall wellbeing. For instance, Dr.

Divino implemented a wellness pro-

gram as a mandatory part of Mount

Sinai’s surgery residency. Her pro-

gram addresses stress, burnout, and

time management issues, and helps

residents maintain balance between

their lives inside and outside the op-

erating theater. Dr. Divino attributes

the impressively low dropout rates at

Sinai’s surgery residency program to

the support and strong mentorship

offered by this program.

But the question remains: to what

extent must we all simply take a

deep breath and learn to tough it

out? “It’s easy to identify the problem

in the extreme,” says Peter Shearer,

MD, the director of Mount Sinai’s

emergency medicine residency pro-

gram, “but it’s harder to know where

the sweet spot is when you’re some-

where towards the middle.”

In other words, reducing the work

week hours from one hundred to

eighty seems reasonable, but what

about eighty to seventy? Will the

quality of training and medical care

decline?

“How many

cases of appendi-

citis does an ER

resident have to

see to really get

it?” continues Dr.

Shearer. “If you’ve

already seen five

that week, it’s

frustrating to be

there hours on

end, late into the

night, to see a

sixth and seventh.

Are these cases

really making

you a better doc-

tor? We don’t

know. We don’t really know what

qualifies as ‘teachable’ moments.”

Mount Sinai’s Emergency depart-

ment recently changed their shift

durations from twelve hours to nine,

and increased the amount of overlap

between shifts. This focus on well-

ness provides a bonus in improved

continuity of care.

But the work is still hard, as many

argue it should be. “On some level,”

argues David Muller, MD, Dean of

Medical Education at Icahn School of

Medicine, “I want the work-life bal-

ance to be unique for medicine. It’s

gratifying to get a call over Thanks-

giving and to have to go take care of

someone. That’s part of what’s

unique about being a doctor. That

said, whatever the hours, there has to

be a way to preserve your sanity and

your dignity.”

COURTESY OF ORIT MILLER ET AL.

The study grouped words and phrases used in ceremonies into four categories, shown above.

5

COAT, FROM PAGE 2 between humanistic and professional

values. The ceremony, they argue,

highlights the privileges and prestige

that can be associated with the medi-

cal profession rather than focusing

on the humanism of the doctor-

patient relationship. The white coat

itself can be shaped by these ceremo-

nies into a hierarchical symbol that

ultimately sets physicians far apart

from their patients.

The authors aimed to empirically

analyze the rituals and vocabulary

used in white coat ceremonies. First,

they divided the 112 United States

medical schools that conduct white

coat ceremonies into groups: schools

that grant MD vs. DO degrees, and

then further into public vs. private

institutions.

A random selection of schools in

each group were contacted and asked

to provide videos, programs, and

other written materials used during

their ceremonies. Data was collected

from a total of 25 schools.

To analyze the data, the authors

used four different approaches. First,

the format of each ceremony was

qualitatively described. Second, each

key word or phrase used by the

SEE COAT2, PAGE 6

Sinai departments shift focus to wellness of trainees

On some level, I want

the work-life balance

to be unique for

medicine. That said

… there has to be a

way to preserve your

sanity and your

dignity. — DAVID MULLER, DEAN

OF MEDICAL EDUCATION

Humanism and Professionalism Meld in White Coat Ceremonies COAT2, FROM PAGE 5

speakers was categorized as address-

ing professionalism, morality, hu-

manism, or spirituality. Third, all

references to the white coat itself

were categorized as describing the

coat as either a symbol of humanism

or a mark of

privilege and ob-

ligation. Finally,

common narra-

tives and the im-

pact of the key-

note speeches

were studied.

U n s u r p r i s -

ingly, the authors

noted many com-

m o n a l i t i e s

among ceremo-

nies. For exam-

ple, the majority

of both keynote

speakers and the

faculty that coated the students had

previously received awards in teach-

ing and humanism. The speakers

highlighted concepts of gratitude,

humility, and empathy, and were

often open about mistakes and vul-

nerabilities they’d experienced in

their own careers.

Although statements related to

obligation and privilege were com-

mon, many were put in the context

of physicians’ obligation to help their

patients, or related to the privilege of

treating and maintaining the trust of

patients.

Based on these results,

the authors concluded that

white coat ceremonies do

not show inherent conflict

between professionalism

and humanism and do not,

as they put it, “celebrate

the status of an elite class.”

David Muller, MD, Dean

for Medical Education at

the Icahn School of Medi-

cine at Mount Sinai

(ISMMS), acknowledges

that tension between professionalism

and humanism is, to some extent,

always lingering in the customs and

traditions of the white coat cere-

mony.

“We talk a lot about the personal

and intimate side of medicine, and at

the same time

we're putting

these cold, sterile

coats on our stu-

dents,” he says of

the ceremony.

“We’re forcing

them into this

weird space be-

tween the two.”

However,

he argues that the

struggle to bal-

ance the two is an

ongoing but im-

portant compo-

nent of a physi-

cian’s career, and both professional-

ism and humanism are necessary to

be a good physician.

“You can't have professionalism

without humanism,” he said. “You

can be humanistic, but if medical

professionalism isn't part of that hu-

manism, you're just another nice per-

son. The lesson is not to separate the

two. They have to coexist.”

Michael Marin, MD, Professor and

Chair of Surgery, Vascular Surgery at

ISMMS and the keynote speaker at

ISMMS’s 2012 White Coat Ceremony,

believes that professionalism and

humanism should coexist not only

during the ceremony, but during a

physician’s career.

“I see no conflict between profes-

sionalism and humanism,” he said.

“One can be extremely professional

in the practice of medicine and be

equally kind, caring and human.”

Critique of the study:

The study provides an impres-

sively thorough empirical analysis of

white coat ceremonies throughout

the country. However, the authors do

not address how schools might evalu-

ate their own white coat ceremonies,

and what steps the organizers of such

ceremonies can take to ensure that

the emphasis remains strongly on

humanism and compassionate pa-

tient care.

The authors also do not go into

detail about the differences that were

found between public and private

institutions, or between those institu-

tions granting MD vs. DO degrees.

Further studies might analyze the

differences among white coat cere-

monies that take place in different

countries, and, going even further,

assess the overall balance between

professionalism and humanism

found not only in white coat ceremo-

nies but in medical school curricu-

lums themselves. How closely, for

instance, do the ideals and concepts

taught throughout the four years of

medical school adhere to the ideals

conveyed at the white coat ceremony?

6

One can be extremely

professional in the

practice of medicine

and be equally kind,

caring and human. — MICHAEL MARIN,

PROFESSOR AND CHAIR OF

SURGERY, VASCULAR

SUGERY

COURTESY OF WWW.MSSMENROLLMENT.COM

Many White Coat Ceremonies invite keynote speakers who have been awarded for teaching and humanism.

An Interview with Former Associate Dean Erica Friedman FRIEDMAN, FROM PAGE 1

-coid-like illness. I consumed the lit-

erature on sarcoid and became fasci-

nated with immunology, and decided

to do a fellowship in Rheumatology.

Since I’d been in a five-year BS/

MD program, I’d had no time to do

research during college or medical

school so, during my fellowship, I

became involved in basic science re-

search. After my fellowship, I did

research on the complement path-

way and its interactions with platelet

function, both at NYU and at New

York Medical College (NYMC). A

little later, I transitioned into clinical

research: I studied Lyme disease

since Westchester County was a hot-

bed for symptomatic Lyme disease

during the late 1980’s and early

1990s. So, in short, my focus for a

little over a decade was on both basic

and clinical research.

At NYMC, I found myself always

interested in teaching and I helped

out with a number of rheumatology

electives. Eventually, in 1993, I wound

up officially involved in medical stu-

dent teaching and administration for

the department of medicine and then,

a year later, was recruited by Dr. Larry

Smith to come to Mount Sinai for the

same role. At the time, Larry was the

internal medicine residency program

director and was vice-chair for educa-

tion in the department of medicine.

Soon after, I was selected to par-

ticipate in a medical educator train-

ing program called the Harvard-

Macy Program for Physician Educa-

tors. Finally, the light bulb went off,

and I had a frame-shift in terms of

the focus of my career. I realized that

teaching was without question what I

wanted to do.

What exactly was your role at Mount

Sinai?

I was lucky in having Larry Smith

as my boss. He subsequently became

the Dean of Medical Education. As he

moved up in the medical school, he

brought me with him. He encour-

aged me to explore my interests in

the importance and benefits of stu-

dent peer-evaluation and self-

assessment. I applied to the Harvard-

Macy Program with a project focused

on these things and, through the pro-

gram, learned a lot about education-

related research.

I took what I’d learned and applied

it to Mount Sinai’s internal medicine

clerkship. My ideas and programs

were later adopted by the pediatric

and surgery clerkships, as well. Soon

after, and largely because of my Har-

vard-Macy project, I was asked to be

the new Director of Assessment for

the medical school. I then became

Assistant and then Associate Dean for

Assessment, and subsequently took

over the Medical Director role for the

Morchand Center.

Can you tell me more about the Har-

vard-Macy program?

Harvard Medical School was

funded by the Josiah Macy Founda-

tion to create this program and to

recruit and create a network of physi-

cian educators across the country. I

attended during the second year of

the program. When the money from

Macy ran out, Harvard began to re-

quire tuition and significantly ex-

panded the number of participants.

The idea was to recruit, one after

another, people from the same insti-

tutions, so that, eventually, they

would create small communities of

medical educators within each medi-

cal center and across the country.

The Institute of Medical Education

and many department chairs from

many institutions have consistently

supported the participation of faculty

members in this program. There are

many, many faculty members at

Mount Sinai who have completed the

program.

Can you tell me the details about

your project on assessment? How did

it change the way assessment was

conducted in medical school?

In the mid to late 1990’s, prior to

Dr. Smith’s tenure, there were only a

few administrators overseeing the

CONTINUED ON NEXT PAGE

7


Dr. Erica Friedman pictured with children Noah and Becky Asch during a recent trip to Ethiopia.

CONTINUED FROM PREVIOUS PAGE

medical school program and there

not a great deal of administrative

support, and so the only assessments

going on were those at the end of the

course or clerkship, right after stu-

dents took their final exams.

Although those evaluations were

sent back to the course directors, we

had little other evidence to determine

how well we were meeting our educa-

tional goals. With support from the

Dean’s office, I was able to implement

the current Compass 1 and I changed

a formative standardized patient as-

sessment in year 4 to the current

summative Compass 2 assessment.

In addition, I implemented pro-

grammatic assessments including

assessments of our graduates during

their residency, a periodic alumni

survey, and the graduation and in-

tern’s surveys. I also developed the

process of summarizing all course

and clerkship evaluations and provid-

ing the data to the course and clerk-

ship directors, their Department

chairs, key administrators, and our

Executive Curriculum Committee to

ensure that student feedback was

carefully reviewed.

I also developed and implemented

the Curriculum Content Review

T a s k f o r c e

(CCRT), to enable

the faculty to re-

view every course

and clerkship.

This allowed

us to ensure that

our curriculum

was providing the

appropriate level

of depth and de-

tail to prepare

our students for

residency and to

provide meaning-

ful feedback to

course directors,

clerkship direc-

tors and curricu-

lum oversight

committees about the strengths and

weaknesses of the curriculum.

Your most recent title is the Associate

Dean of Education and Scholarship.

What kind of work does that entail?

I have been responsible for all of

the assessments at a course and

clerkship level, at a faculty level, and

at a programmatic level. The LCME

has specific re-

quirements that

we document to

show we are

meet ing our

goals, including

required assess-

ments of the con-

tent of our cur-

riculum and our

student perform-

ance.

I have also

been involved in

the Institute of

Medical Educa-

tion, helping with

faculty develop-

ment programs,

facilitating recog-

nition of both faculty and medical

student educators and creating a

mentorship program for junior fac-

ulty.

I also oversee the medical content

areas of the standardized patient pro-

grams at the Morchand Center,

which includes the medical school

assessments, but also the assessments

we do for other medical schools and

residency programs and other inde-

pendent clients.

Do you enjoy having so many roles?

Yes, it’s wonderful because it’s

constantly stimulating. Every day is

different in terms of what my tasks

are and who I’m interacting with,

from students to faculty to course

directors.

Do you still get to see patients?

Gradually, over the last decade,

my commitment to education and

administration has increased and my

time in patient care has decreased. I

have very little patient contact now,

and most of it is in volunteer situa-

tions like EHHOP [East Harlem

Health Outreach Program, the stu-

dent-run health clinic at Icahn


8

Art and medicine

… both increase our

sense of doubt and

help us appreciate the

strangeness and

brilliance of the

human experience. — ERICA FRIEDMAN,

FORMER ASSOCIATE DEAN

AT ICAHN SCHOOL OF

MEDICINE AT MOUNT SINAI


Dr. Erica Friedman with her close friend Michelle Abreu at Mission Chinese, a restaurant in NYC.

CONTINUED FROM PREVIOUS PAGE School of Medicine at Mount Sinai],

and Mount Sinai’s human rights

clinic that screens asylum seekers.

How did your role working with asy-

lum seekers come about?

An old colleague of mine was ac-

tively involved in human rights.

About six years ago, he recruited fac-

ulty to help screen asylum seekers. I

took a two-day weekend class on how

to interview, assess and document

asylum seekers for court, and how to

obtain independent referrals.

As part of the global health pro-

gram here, Dr. Asgari started a hu-

man rights clinic, and I began work-

ing with him, teaching students how

to interview and write up a testimony

for asylum seekers. After he left, the

program was re-started by Dr. Holly

Atkinson, who is a colleague and

close friend of mine. Now I am part

of the administrative board that’s

expanding the Human Rights Clinic

program at Mount Sinai.

You’ve received several grants in the

past for education research and de-

velopment, including an AAMC

grant and the Mannix Award from

the Medical, Educational and Scien-

tific Foundation of New York Inc.

Can you tell us about a project

you’ve been particularly proud of?

The project that has meant the

most to me was focused on the im-

plementation of a chronic illness cur-

riculum. The project was an expan-

sion of the Seniors as Mentors (SaM)

project that was started by Valerie

Parkas and Rosanne Leipzig as part

of ASM 1.

The program paired students with

elderly patients to help students un-

derstand the impact of chronic dis-

ease. We ultimately decided to ex-

pand the program beyond geriatric

patients in order to provide students

with a broader perspective.

With the SaM program as the

starting point, we were awarded the

grant from the AAMC and went on

to implement the current Longitudi-

nal Clinical Experience (LCE) course,

which is now an integral part of the

curriculum.

To switch gears a bit, can you tell us

a little about your life outside of

medicine?

I grew up in Philadelphia, but I

was always a little bit in love with

Manhattan. Now that I live here, it is

so easy to take advantage of every-

thing the city has to offer.

I’m a “foodie” — I love to cook

and try new restaurants and food. I’m

also an avid solo exerciser — I swim

and walk several miles every day.

And I love art and music. I’m a mem-

ber of several museums and visit

them frequently.

I feel really lucky to have come to

Mount Sinai for many reasons, but

Mount Sinai was the primary reason

that I moved to Harlem. Living

where I live it’s easy to have a life

outside of medicine, even with only a

little bit of free time.

That reminds me about the NYC

Cultural Consults program that was

featured in a previous issue of The

Rossi. We had a chance to speak with

the student leaders of that program.

Can you tell us about how it came to

fruition, from your of view?

One of the best parts of my job at

Mount Sinai has been to be able to

help students implement projects

that they have dreamed up them-

selves - like The Rossi! For the NYC

Cultural Consults program, Sar

Medoff and Adam Philips ap-

proached me through Sar’s Humani-

ties in Medicine mentor, Robert Ac-

cordino, to talk about the creation of

the program. I was really excited to

be part of it. The idea was entirely

the students’, but I’m good at logis-

tics and process.

It was my role along with Basil

Hanss to make sure the project had

financial and faculty support. I also

contributed by helping select the

speakers and provide the wine. But it

absolutely could have come about

without me! It’s really the brainchild

of Sar and Adam.

What is the role of culture and art in

medicine?

I was fortunate to attend a pro-

gram recently, called “Do the arts

and humanities make us human?”.

The panelists included Anna Deavere

Smith, Richard Armstrong (the direc-

tor of the Guggenheim), and the Rev-

erend Dr. Jane Shaw.

I think the arts enable us to get

outside of ourselves and develop

“moral imagination,” or the ability to


9

COURTESY OF WWW.MSSM.EDU

One of Dr. Erica Friedman’s roles was serving as the Medical Director of the Morchand Center.

CONTINUED FROM PREVIOUS PAGE put aside our own issues and get deep

inside the thoughts and feelings of

others. It’s the difference between

sympathy and empathy. Art and

medicine are similar in that they

both increase our sense of doubt and

help us appreciate the strangeness

and brilliance of the human experi-

ence.

I’ve been an avid reader since I

was little. I used to read in bed under

the covers with a flashlight when my

mother made me go to bed early.

And I would consume a book in two

days. So for me it

was a way to

learn about the

world outside of

my own experi-

ence. That’s also

why I love to

travel.

I think that’s

really what art

allows us to do. It

helps us gain a

different perspec-

tive on our lives

and the lives of

others. I think

that’s really im-

portant for physicians in particular,

in order to better understand our

patients.

You’ve worked with medical students

on many successful projects. Do you

have any tips regarding mentorship?

I believe the key to good mentor-

ing is to first listen — really listen —

to the student’s idea, and then to

challenge the student to define what

they hope to achieve, what the ex-

pected outcomes are and what re-

sources they’ll need to achieve them.

It’s also important to have a strict

timeline and, during the process, to

continually question and refine the

project, keep pushing to make it the

best it can be.

What are some of your philosophies

on teaching and teaching administra-

tion?

10 In terms of teaching, I believe

that both faculty and students are

learners, and that we are constantly

learning from each other. We learn

both through our teaching and

through our interactions with our

students.

In terms of administration, I like

to think that I’m inclusive and a good

team player. I want to challenge and

empower faculty to be better and

more effective educators. I realize I

need to model what I expect others

to do, whether it’s helping with basic

tasks like Xeroxing or making coffee

or fol lowing

through on com-

mitments. It’s

important to be a

true team player.

From an adminis-

trator point of

view, what do you

see as the major,

current trends in

education that

faculty should be

aware of?

The curricu-

lum needs to

evolve so that it is

student-driven, and is also more effi-

cient in engaging student learning

and in meeting major outcomes.

What’s important is to understand

that you can’t have a curriculum that

expects every student to come out

the other end the same way. Students

must be allowed the flexibility to

focus on their areas of interest and to

learn at their own pace.

We can’t presume that everyone

can learn the same material in the

same time frame. At the same time,

we should constantly be challenging

our students to explore and learn as

much as possible, above and beyond

any expectations we may set.

What advice do you have for students

interested in medical teaching or

administration?

It’s a lot easier now than it was

several decades ago to choose a ca-

reer as a medical educator or admin-

istrator. The LCME helped facilitate

this change by mandating a signifi-

cantly increased infrastructure of

educators at medical schools. Fur-

ther, most academic medical centers

now recognize the importance of

educators and administrators and

have developed clinician/educator

tracks that recognize and promote

these individuals.

In addition, education research

has become a valued endeavor, and

while there isn’t a lot of funding for

it, certainly there are outstanding

venues for publication. Also, many

educators are incredible role models

for students.

I can remember my best teacher

from medical school, even though

that was thirty-five years ago! I think

educators have an incredible impact

on students. Student-to-student

teaching has also become a big com-

ponent of medical school and resi-

dency curriculums. There are stu-

dents-as-teachers and residents-as-

teachers programs throughout the

country.

If a student was interested in be-

coming a career educator, it would

be important early in medical school

to identify a mentor who also has

chosen to focus on education. The

other important aspect is to appreci-

ate that there is a science to being an

educator. Explore best practices, like

how to give a good lecture or create a

useful survey or assessment tool.

What is the single best piece of ad-

vice you can give to medical stu-

dents?

Be confident in yourself, and be-

lieve that you are capable of making

change — big change. I would like

you never to lose the belief that,

with enough passion, drive, and ef-

fort, you can make the changes that

you wish to see in your own lives

and in the lives of people around

you.

Thank you very much for the inter-

view, Dr. Friedman.

Be confident in

yourself, and believe

that you are capable

of making change —

big change. — ERICA FRIEDMAN,

FORMER ASSOCIATE DEAN

AT ICAHN SCHOOL OF

MEDICINE AT MOUNT SINAI

By Kamini Doobay, MII

Mentorship has been an integral

part of education for centuries: Plato

learned from Socrates, Thomas

McCrae from William Osler, Mark

Zuckerberg from Steve Jobs, Britney

Spears (among so many others) from

Madonna.

Although education — particu-

larly medical education — has come

to take on a myriad of different

forms in recent years, mentorship

remains a central component of

medical school, not to mention virtu-

ally all other undergraduate and

graduate programs.

Peer-to-peer, alumni-to-peer, and

faculty-to-student mentoring are all

common within academic settings.

Mentors play an integral role in

many of our lives.

If you’re interested in paying it

forward and mentoring others, con-

sider these tips adapted from litera-

ture written about faculty-student

mentoring programs:

While students can often serve as

informal mentors to one another,

students interested in mentoring

can also participate in formal, in-

tentional, and structured pro-

grams. Seek out these programs

or create one if it doesn’t exist.

Matching each mentee with an

appropriate mentor is key.

Thoughtful matching is often

critical to the development of suc-

cessful mentor-mentee relation-

ships, and ought to take into con-

sideration the professional and

personal interests of both parties.

Once you have a mentee, set aside

protected meeting times for men-

toring sessions.

Try to serve as a mentor to one

person over a long duration of

time so the relationship spans the

mentee’s professional and per-

sonal milestones.

Schedule meetings at regular in-

tervals to provide structure, sup-

port and predictability while mak-

ing room for spontaneous meet-

ings when necessary.

Mentoring has the potential to

change others’ lives by nurturing

professional and personal devel-

opment. Therefore, make sure to

provide mentees with tangible

and practical resources (for exam-

ple, lists of scholarships or volun-

teer opportunities) as well as

moral support.

The mentor-mentee relationship

is one of imbalanced power. As a

mentor, you should remember

your role and respect the mentee’s

personal boundaries.

Regular conversation about the

mentor-mentee relationship

should take place. Some questions

that can be used to help evaluate

the relationship may include:

- Is the mentee getting what he/

she wants out of the relationship?

- Is the mentoring relationship

contributing to the mentee’s pro-

fessional development?

- Is he/she becoming independent

rather than dependent on the

mentor?

Seek out formal resources or

training programs to help you

become a better mentor.

When possible, collect data to

evaluate and assess whether you

were an effective mentor.

References:

Allen, Tammy D. and Lillian T. Eby

(eds). "Best Practices for Student-

Faculty Mentoring Programs."The

Blackwell Handbook of Mentoring.

Blackwell Publishing, 2007.

Sambunjak, D., Straus, S. E., & Maru-

sic, A. (2006). Mentoring in academic

medicine. Journal of the American

Medical Association, 296,1103–1115.

Being an Effective Mentor and Mentee Mentorship is crucial to successful medical education

EDITOR-IN-CHIEF

Alexa M. Mieses

ASSOCIATE EDITOR Alison Thaler

EDITOR-AT-LARGE Daniel Caplivski, MD

LAYOUT EDITOR Ann Wang

WRITERS Kamini Doobay

K.H. Vincent Lau John Rozehnal

Dipal Savla Ann Wang

The Rossi was founded by students at the Icahn

School of Medicine at Mount Sinai in 2012 and is

published quarterly at http://icahn.mssm.edu/

education/institute-for-medical-education/medical-

student-quarterly-report .

Do you have questions? Comments? Story ideas?

Email [email protected].

Follow The Rossi

on Twitter @SinaiRossi

11

Documents

The Rossi July 2013