the rossi july 2013
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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
COURTESY OF WWW.MOUNTSINAI.ORG
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!
COURTESY OF WWW.MOUNTSINAI.ORG
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
COURTESY OF ERICA FRIEDMAN
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
CONTINUED ON NEXT PAGE
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
COURTESY OF ERICA FRIEDMAN
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
CONTINUED ON NEXT PAGE
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 TheRossiNewslet-ter@gmail.com.
Follow The Rossi
on Twitter @SinaiRossi
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