Beyond book smarts: What this international medical school gives future doctors

For most pursuing a career in medicine, the long-haul investment in studying, training and preparing to become a physician is the fulfillment of a lifelong dream. Others have personal goals too, whether it’s to explore their Jewish backgrounds or spend time in a new location. Some choose to make the challenge a little more exciting by engaging in a new environment, being immersed in a different culture and picking up a new language. 

The benefits of studying medicine in Israel are numerous, especially at the world-renowned Technion-Israel Institute of Technology. Situated upon the Rambam Health Care Campus on the Haifa shores, Technion American Medical School (TeAMS) provides a top-notch medical education and extensive training at several of Israel’s best hospitals. At this prestigious medical school program, students get one-on-one time with leading faculty members, including two Nobel Prize winners and numerous researchers who have contributed to several medical breakthroughs and innovations. All students complete a thesis. Graduates can continue to residency programs in the U.S. 

The acclaimed academic and research repertoire attracts top students, but the students who actually enroll in TeAMS bring an extra uniqueness to the program. They are attracted to the school for unique reasons, hoping to get a more well-rounded education that will make them more compassionate and focused doctors.   Let’s meet some of the students beginning their medical careers at TeAMS this October.

Balancing Judaism and Medicine

For many observant Jews, there is a dilemma of maintaining a certain lifestyle while seeking a high level of professional training.  While Technion is not a religious institution, its location in Israel makes key issues like Shabbat, the Jewish holidays and kashrut much easier to address.

Josh Simons, an incoming student from Monsey, NY, said one of the things he liked most about TeAMS is the schedule. “It fits around the High Holidays and works perfectly for an observant student,” said Simons, who is starting medical school only one month after his release from a 14-month volunteer service in the Israel Defense Forces in the Netzach Yehuda battalion in the Kfir Brigade. Simons, who earned his bachelor’s degree in biology from Touro College in Jan. 2013, served as a machine gunner in a religious unit.

“This is unparalleled for medical schools in general and even in Israel,” described Chris Thomas, an incoming student from Syracuse, NY.  “Studying at TeAMS is both a good place to keep up my religious observance and learning, and a solution for staying in Israel long term.” 

Thomas chose medicine after shadowing and admiring his father, an emergency room physician in New York. “Medicine seemed like the most selfless profession in the world,” Thomas said, thoughtfully reflecting upon how he used to visit patients on Shabbat at Columbia Presbyterian Hospital. “This was a really profound experience – seeing the way people grappled with the experience of sickness and what a challenge that is… They meet the challenge and show incredible inner strength, bringing out faith and hope. But also at the hospital, I saw people devastated and crushed by illness. Overall, I was amazed at how much of a difference I could make by just visiting.”

 “Medicine is a sacred profession; as a healer, I can fill the charge of implementing G-d’s will in profound and meaningful ways,” Thomas said. “I am very happy to begin studying at Technion because I’ve only heard positive things, that everyone is so friendly and it sounds like a very positive environment,” he added.

Simons noted a similar thought, “It was by far the nicest program because people were so friendly and the staff is really impressive.” He recalled a “simple, pleasant and inviting” interview experience. “Plus the campus is beautiful and right by the beach,” he said with a smile.

The Diversity of Israel

Both Simons and Thomas plan to stay in Israel following graduation, like their classmate Ilana Barta, who made aliyah to Israel this past August from Teaneck, NJ. “It was good to know that I didn’t have to choose between my want to be in Israel and to be a doctor,” she said. “I was brought up in a home that emphasizes Israel as the homeland, and at the age of 8, I decided wanted to be a doctor.”

“I liked that TeAMS was a smaller program, with fewer students per class,” she explained. “My initial thought after speaking to students is that there is a more attention for each student, individual guidance and more interaction in the classroom. As a whole, the university is a really amazing, innovative place to be.”

Moreover, what attracted Barta was being at one of the most diverse campuses in Israel. Having studied foreign languages at Queens College, Barta knows Arabic, in addition to Hebrew. Barta and fellow TeAMS students participate in rotations at many of Northern Israel’s hospitals, which service Jews, Arabs, Christians, Druze, African refugees and others. 

TeAMS also caught the eye of incoming student Lydia Daniels, from the suburbs of Pittsburg, PA, because of its diversity. Daniels, who graduated with a bachelor’s in pre-med from Bob Jones University in South Carolina, was fascinated after studying about the Middle East region. 

“After my bachelor’s degree, I wanted to travel and study abroad. Because of the classes I took, I thought maybe to study in Israel,” she said. “I looked at all the different medical schools in Israel and was attracted to the family atmosphere here. I feel that we are all in this together and it not a competition.”

Daniels arrived in Israel six weeks before classes started to move into the dorms, take a Hebrew course and explore. “So far, it’s been a very good atmosphere,” she said. 

After medical school, Daniels hopes to work in the developing world, to serve a community and be immersed in the health and the culture to people around the world. “The human body is just amazing and the more I learn about it, the more it amazes me, and I want to bring my knowledge to the different areas of the world that need a whole lot of help.”

Such experiences make doctors more balanced and equipped to treat patients; they excel in the academics, have a grasp of research and technology, develop into more open-minded and compassionate people and gain hands-on experience.

P.A. health minister makes landmark visit to Hadassah Hospital

A Palestinian Authority minister of health visited Hadassah Hospital in Jerusalem reportedly for the first time.

Dr. Hanu Abdeen, accompanied by other senior officials from the Palestinian Authority, visited the hospital on Sunday and met some of the dozens of Palestinian physicians who are doing their residency training there.

The hospital said Abdeen was the first P.A. health minister to visit the facility.

Abdeen met with the hospital's acting director-general and director of Hadassah-Ein Kerem, Dr. Yuval Weiss, in the pediatric hematology-oncology department, where 30 percent of the patients are Palestinian.

“Hadassah considers cooperation with our Palestinian neighbors a top priority,” Weiss said. “Medicine is a bridge to peace. There are no borders when it comes to treating patients.”

European doctors: U.S. colleagues support circumcision out of bias

Thirty-eight physicians from Europe wrote a paper alleging that “cultural bias” was behind the pro-circumcision stance of the American Academy of Pediatrics.

The commentary, published Monday on the website of the U.S.-based Pediatrics journal, disputes a report by the academy last August that  “benefits of newborn male circumcision outweigh the risks but the benefits are not great enough to recommend universal newborn circumcision.”

The European reply, titled “Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision,” says that “seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious. The report’s conclusions are different from those reached by physicians in other parts of the Western world.”

In the academy's report, the benefits attributed to circumcision — including protection against HIV, genital herpes, genital warts and penile cancer — are “questionable, weak, and likely to have little public health relevance in a Western context and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves,” the European authors wrote.

A large percentage of non-Jewish males in the United States are circumcised, whereas in Europe the custom is limited almost exclusively to Jews and Muslims.

The European physicians found only one argument put forward by the American Academy of Pediatrics to have “some theoretical relevance”: the possible protection circumcision offers against urinary tract infections in infant boys. But, they wrote, this “can easily be treated with antibiotics without tissue loss.”

Approximately half of the European physicians are from Scandinavian countries, where several political parties have stated their opposition to circumcision as a form of “child abuse” or an unwanted phenomenon of immigration by Muslims.

From TB to T-Cell

Sometimes, adversity strikes gold. In Los Angeles, three major medical institutions, including Cedars of Lebanon and Mount Sinai — the independent hospitals that merged to form Cedars-Sinai Medical Center — and the City of Hope sprang from Los Angeles’ Jewish tuberculosis problem.

Cedars-Sinai’s story begins at the turn of the 20th century, when Eastern European Jews afflicted with tuberculosis (then called consumption) headed to Los Angeles, seeking a dry climate and clean air. Long before antibiotics were available, these "lungers," as the transplants were nicknamed, arrived in droves from the East Coast and expanded the city’s Jewish population from 2,500 to 10,000 by 1910, explained Steve Sass, president of the Jewish Historical Society of Southern California.

The local Jewish leadership — Hebrew Benevolent Society (eventually Jewish Family Service) and B’nai B’rith lodges — grappled with the obligation to care for these ailing Jews. Hebrew Benevolent Society President Jacob Schlesinger convinced his reluctant father-in-law, Kaspare Cohn, to help.

Cohn, a prominent businessman who founded what has since become Union Bank, converted a house he owned at 1443 Carroll Ave. in Angeleno Heights — now Echo Park — into the Kaspare Cohn Hospital. On Sept. 21, 1902, the hospital opened with eight patients and Dr. Sarah Vasen, one of Los Angeles’ first women doctors, as its medical director.

One of Los Angeles’ first suburbs, Angeleno Heights was the Beverly Hills of its day. It had the city’s largest concentration of Queen Anne homes.

"The neighbors did not take to having patients with a contagious disease in their midst," Sass said.

As a result, a City Council resolution barred the facility from treating consumption. So Kaspare Cohn Hospital opened a 50-bed tuberculosis facility on Stephenson Avenue (now Whittier Boulevard) in 1910.

The new hospital was twofold in its significance to the Jewish community. Not only was the hospital treating Jews with tuberculosis, but it was also haven for Jewish physicians.

"Unfortunately, it was difficult for Jewish doctors to get on staff at other hospitals," Sass said. "Even into [the 1930s and 1940s], it became a place where Jews could practice when they couldn’t get hired elsewhere because of anti-Semitism."

Community tensions muddied relations between The Jewish Federation precursor — Federation of Jewish Charities — which supported Kaspare Cohn Hospital, and two groups of unassimilated Yiddish-speaking, immigrants that wanted more done regarding Jewish tuberculosis. In 1910, the Hebrew Consumptive Relief Association raised the funds to build its own hospital in Duarte.

What started out as the Tents of Hope in 1913 — literally tents in lieu of buildings — evolved into the City of Hope. Meanwhile, Bikur Cholim created a two-room hospice in 1923 that became the Mount Sinai Home for the Incurables. Initially on Breed Street in Boyle Heights, Mount Sinai moved into a larger Bonnie Beach Place complex in 1926.

"It brought everything from optometry to dentistry to radiology to the neighborhood," Sass said.

Kaspare Cohn Hospital moved to Fountain Avenue in Hollywood in 1930. At the request of Cohn’s heirs, the hospital changed its name to the neutral-sounding Cedars of Lebanon in order to raise funds in the broader community. The new name was a biblical reference to the curative properties of Lebanese cedar branches.

Dr. Leon Morgenstern, who for more than four decades served as chief of surgery in Cedars-Sinai’s cardiology department, started out at Cedars of Lebanon in 1952.

"Cedars was more academic and research oriented," Morgenstern said. "Mount Sinai was more of a populist hospital. It was very difficult to get on the Cedars staff — they wanted only the top specialists. Those who couldn’t get on staff went to Mount Sinai."

In 1955, Mount Sinai moved to Cedars-Sinai’s current Beverly Boulevard location. Alternative sites, such as on Mulholland Drive and in Century City, were considered, but Beverly Boulevard proved central to where the Jewish community had moved. The Hyman and Emma Levine family (of which former Congressman Mel Levine and Dina Schechter are descendents) contributed the property, on which the original building stood until the 1994 Northridge Earthquake.

By the 1960s, discussions to merge Cedars and Mount Sinai into one medical complex was stirring up local Jewish machers.

"The Jewish community was going through a period of soul-searching," Sass said. "They were questioning whether to pour more money into institutions supporting Jewish continuity, as opposed to institutions which do not serve specifically Jewish interests and help the community at large."

The merger process spanned the period from 1961 to 1971. During that time, Irving Feintech, who in 1948 joined Mount Sinai, where his brother, Norman Feintech, was president, served as the Joint Conference Committee chair.

"It was just not easy at the time," Feintech said. "It was going to cost us $130 million. We had to find out how we were going to get that money.

"Before we went to the banks, we had to show that we had the community’s support," he said. "Ultimately, the community felt it was necessary. We didn’t need two hospitals going after the same money."

Steven Broidy Sr., Cedars-Sinai board chairman, convinced Union Bank Chairman Harry Volk to lend the capital, with the Cohn family’s blessing.

"It was a pretty smooth transition," Feintech said of combining the two hospitals’ staffs and cultures.

On Nov. 5, 1972, Cedars-Sinai Medical Center held its official groundbreaking for its 1.6-million-square-foot, 1,120-bed hospital. By April 3, 1976, the first patients were transferred to Cedars-Sinai’s obstetrics and gynecology and pediatrics departments.

"The move to Beverly Boulevard cemented Cedars-Sinai’s Jewish identity," Sass said. "By just the very statement of a Star of David on the building, it was clear what the identity of the hospital was."

With the move came a host of gestures catering to its Jewish patients and visitors: kosher food, mezzuzot, a full-time Jewish chaplain and the Jewish Contributions to Medicine Mural in Cedars-Sinai’s Harvey Morse Auditorium.

The mural resulted from two years of planning by a 60-member mural committee headed by Morgenstern. Painted by the late Terry Schoonhoven, it showcases Jewish men of science through the ages: Asaph Harovfe, Maimonides, Garcia da Orta, Dr. Jonas Salk, Sigmund Freud and Stanley Cohen, a Nobel Prize winner in physiology and medicine who was present at the mural’s May 2, 1999, dedication. Cohen represents the Nobel laureates in physiology and medicine, 42 of whom are of Jewish heritage.

"We narrowed [the mural’s personages] down to 40 figures," Morgenstern said. "It could’ve been more than 200."

Morgenstern noted Cedars-Sinai’s accomplishments, such as the breakthroughs in his department: the first open-heart surgery in 1955, the discovery of Prinzmetal angina coronary disease and Dr. Jeremy Swan and Dr. William Ganz’s catheter, which revolutionized cardiac monitoring. Feintech, who has had five bypass surgeries at Cedars-Sinai, also noted neurological and laproscopic advances.

Today, Feintech, and Robert Silverstein, co-chair Cedars-Sinai’s Campaign for the 21st Century. The project began with a $140 million endowment fund, and is currently working to raise $180 million of the $360 million needed for new buildings and programs. The S. Mark Taper Foundation Imaging Center will have its dedication on Oct. 16, with a critical-care tower scheduled for completion in three years.

"Cedars-Sinai is going to continue as the leader in hospital patient care in the future," Feintech said. "We’ll just keep moving ahead like we have in the past."

"What’s amazing about this whole story," Sass said, "is that from the challenge of Jewish tuberculosis came two internationally recognized institutions of medical research, Cedars-Sinai and City of Hope. Even though a century has passed, the Jewish mission has stayed intact. That history is something they can be proud of. It’s the legacy of our Jewish community."

Physician, Heal The Soul

Physicians played a significant role in the Holocaust, and today’s doctors can learn from the ethical failures of that period, according to an article recently published by Dr. Joel Geiderman, co-chair of the emergency department (ED) of Cedars-Sinai Medical Center.

"I’ve always taken an interest in the Holocaust and its lasting effects, because my mother was a survivor," Geiderman said. With 23 years of emergency medicine at Cedars-Sinai under his belt, he has always taken an interest in the philosophies of bioethics but became "passionately" involved five or six years ago. Now, he serves on the ethics committees of Cedars-Sinai and the Academy of Emergency Medicine. "Most of us know about the medical experiments, the doctors in the camps," he said, "but as I started reading about this, about the history, I was blown away."

In "Physician Complicity in the Holocaust: Historical Review and Reflections on Emergency Medicine in the 21st Century," Geiderman sets out a series of moral failures he attributes to German physicians before, during and after WWII. Published in the March issue of Academic Emergency Medicine journal, the two-part article enumerates ethical challenges requiring greater vigilance from today’s physicians.

"So much of the Holocaust is unexplainable. But when you start to break it down, step by step, it starts to make sense in a perverse way," Geiderman said. "So much of what doctors contributed to the horror came out of economic opportunism, greed and convenience."

The first part of the article traces the German medical establishment’s slippery slope, from being healers toward full participants in genocide. Starting long before Hitler came to power, Geiderman shows how German doctors embraced the false science of eugenics, or "racial hygiene." This made it easier to accept, with the rise of National Socialism, the exclusion of Jewish physicians from the practice of medicine (which also advanced many non-Jewish doctors’ careers).

When the Nazis passed the Sterilization Act, doctors not only participated in designing the program to forcibly sterilize the "genetically diseased," they exceeded the government’s goals for implementation. Throughout the regime, ordinary physicians acted as instruments of racist Nazi policies; doctors became murderers, and later made efforts to hide the truth about their activities.

In Part Two of his "Physician Complicity" article, Geiderman examines the ethical challenges faced by his colleagues in emergency medicine today. He worries about doctors being asked to serve as agents of the state, as with mandatory reporting laws for patients whose injuries might be caused by foul play or infectious disease. He considers the denial of modesty to patients when "reality television" films in an emergency room. He considers the various ways in which patients are dehumanized by their doctors, who may refer to them by room number, by their ailment or even by nasty nicknames. Economic pressures affecting the practice of medicine and technology that allows for genetic screening, testing and even genetic engineering also pass through Geiderman’s bioethical radar.

"These are not Holocaust analogies," he says of Part Two, adding that in the article, "I took a neutral stance on physician-assisted suicide. Personally, I’m against it. But I don’t think it’s useful to play the so-called Holocaust card in these debates."

The doctor compares his research and writings to reflection on the Holocaust in other fields. "In ‘Au Revoir les Enfants,’ the French director Louis Malle described the Holocaust through his childhood eyes in a French monastery … while others responded by building new lives or even a new nation. For me, as an emergency physician who has spent 25 years in an ED, dedicated my most recent years to the study of bioethics, and who is the son of a survivor, Part Two is the natural expression of my feelings or philosophy."

It is a decidedly practical sort of philosophy for a doctor of emergency medicine to study. "What’s become really clear to a lot of us who advocate bioethics is that you have to have considered these issues in advance," Geiderman says. "In emergency medicine, there’s not always a lot of time to call in an ethical consult." He views the product of his historical and ethical research as timeless. "Unlike hard science, where the science will change, this will never change."

Though his research relies on previously published materials, and his description of physician complicity in the Holocaust is carefully documented, Geiderman says some peer reviews of his work came back with incredulous comments — doctors who could not believe such events could have happened. He writes: "The keys to preventing such a recurrence lie in understanding and teaching the lessons of the past; in speaking, teaching and writing about ethics; in incorporating ethical principles and professionalism into our medical practices, and in being willing to stand up and make personal sacrifices for the ethical principles in which we believe."

And, as he says, "Certain things need to be learned over and over again."