The Mount Sinai Hospital was founded in 1852 as the Jews' Hospital in the City of New York, but it was another century before a school of medicine was created at Mount Sinai. What changed over those 100 years that made the trustees and physicians at Mount Sinai decide that it was necessary to create a school of medicine?

Over the years, Mount Sinai had built up a tremendous, and well deserved, reputation for the excellence of its patient care and clinical research programs. Many contributions were made by Mount Sinai physicians regarding the basic underpinnings and actions of various diseases.⁽¹⁾ The laboratories and wards of Mount Sinai had become a mecca for trainees interested in pathophysiology and the "chemistry" of disease. But after World War II, the world was much changed, and medicine itself was changing. Government support of science, universities and hospitals increased tremendously to help them fight the 'war' against disease. Americans were coming to believe that medicine could indeed proceed in a linear fashion to solve the nation's ills if there were only enough support. Hospitals expanded their facilities and training programs. Medical schools everywhere were overwhelmed with applications as the GI Bill put graduate education in the reach of many.

While these changes aided Mount Sinai in many ways, the Hospital had to re-assess its position in this 'new' world. This involved the addition of some clinical services, the introduction of full-time chiefs of service and the increasing presence of research laboratories and basic scientists. Still, by the end of the 1950s, it was perceived that this was not enough to keep Mount Sinai in the upper echelon of teaching hospitals in this country. Mount Sinai was then ranked 27th in the list of institutions receiving federal research money, a very high level for a general hospital. But it was clear that in the future, only institutions with a strong commitment to the basic sciences would attract the best young doctors for their residency programs. It was believed that having a school of medicine based at Mount Sinai was important to ensure the continuing quality of physicians in the training programs and on the staff. Only then could Mount Sinai be assured of providing the highest quality patient care.

The first official proposal to establish a medical school was made to the Mount Sinai Hospital trustees in January 1958. The trustees decided to pursue the matter further to determine the viability of the concept and the possible cost. To this end, Dr. Hans Popper, director of Pathology, and Dr. Alexander Gutman, director of Medicine, went to Chicago to sound out the leaders of the Association of American Medical Colleges on their feelings about the hospital founding a school. Although the group acknowledged Mount Sinai's reputation as a clinical leader, they hesitated over the idea of a hospital creating a school without the participation of a university, something that had not been done since the Flexner Report of 1910. There was also the issue of raising the needed funds to provide the physical facilities, staff, endowment, and equipment required to create and operate a medical school.

These problems and reservations notwithstanding, a group of physicians and trustees went ahead with the tremendous task of defining the needs of the school, planning a philosophy and then a program, and building the support necessary to establish the school. Several names stand out in this connection. On the medical side: Hans Popper, Horace Hodes, Alexander Gutman, Paul Klemperer, and George Baehr, among others. The trustees involved included Gustave L. Levy, chairman of the Board of Trustees; Milton Steinbach, the first president of the Mount Sinai School of Medicine; Alfred Stern, chairman of the Development Committee; and many others who worked to raise funds and plan for the future of Mount Sinai. It was understood that Mount Sinai was creating the school so that the institution could maintain its high standard of excellence into the future, and that only a program of equally high quality would do.

While dealing with all of the practical issues involved in founding a school, Mount Sinai was defining an ideal of what a new medical school could be. Hans Popper articulated the early feelings of the planners in what later became known as the "Mount Sinai Concept." This was the "balancing [of] biologic thinking in medicine with a concern for the whole patient," encompassing three objectives for medical education:

[the] introduction of quantitative biology into medicine with inherent area-specialization; ...counteraction of the depersonalization of the organ-specialized physician by the broadening influence of social sciences and human studies; ...community medicine which, by experimentation, strives in a setting of specialists to give good care to every person and every disease beginning in the presymptomatic stage.⁽²⁾

The belief grew that the best way to achieve this new kind of medical teaching was to create at Mount Sinai a new kind of medical institution, a university of the health sciences. This institute would provide "a medical school supported by a strong teaching hospital, a graduate school of biologic sciences, a graduate school of physical sciences, a graduate school of human studies representing a concentration of those departments of social sciences and human scholarship as they are relevant to health care"⁽³⁾. Mount Sinai wanted to create this type of environment on the Mount Sinai campus, with or without a university affiliation.

Events moved quickly. A provisional charter was received in June 1963. A separate board of trustees for the school was created. Gustave Levy, President of the Board, announced the planning of the school to the news First Charter, June 28, 1963 media and promised that the first students would enter in 1968. Site visits were made to other institutions, and outside agencies visited Mount Sinai. In 1964 the first six departments of the school were established: Medicine, Surgery, Obstetrics and Gynecology, Pathology, Pediatrics, and Psychiatry, the program directors becoming acting chairmen and professors-the first faculty of the school. In February 1966, 500 more faculty members were appointed; when the school opened in fall 1968, the faculty numbered 1,500.

An important element in planning for the school was the development of the physical facilities to support the new functions, an incredibly expensive undertaking. Each of these new faculty members needed an office; most needed laboratory space and specialized equipment. It was envisioned that a medical school tower building would be erected in the center of campus. In 1964 a grant proposal was submitted to the federal government to help cover construction and renovation costs. Although the proposal was rated very highly, no funding was forthcoming. Committed to their promise to open the school in the fall of 1968, in mid-1966 the trustees purchased an old bus garage on 102nd Street. This was renovated in record time to become the Basic Sciences Building, large enough to hold the first- and second- year classes until the tower building could be built. Still, the federal money was essential. The grant proposal was revised and resubmitted in February 1966. On July 31, 1967 an affiliation agreement was concluded between Mount Sinai and The City University of New York. In September 1967, the federal government announced an award of $26 million to the Mount Sinai School of Medicine, the largest such grant up to that time.

Another vital aspect of these early years was raising private funds to help provide the physical facilities, endowments, salaries, equipment, and supplies necessary for modern research. The original "guesstimate" was that $5 million would be needed to start the school. When a formal fundraising campaign was mounted in 1965, the goal was $56 million. This was quickly enlarged to $102 million, and finally settled at $152 million. That figure was reached in 1976. An important start in raising the needed private funds was made in 1965 when the eight children of Mrs. Moses Annenberg gave $1 million each in her honor toward the construction of the tower.

Selecting the First Dean

Another important facet of founding the school was the selection of a dean. The charter documents list Hans Popper as dean, and he served as the acting dean from 1962. A search for a permanent dean was begun in 1963. In this time many people were considered, and some ultimately came to Mount Sinai as faculty or advisors, including Dr. Irving Schwartz, a well-respected physiologist who was the first to be tapped as a dean. He arrived early in 1965 and gave advice on planning and direction. He was heavily involved in the organization of the Graduate School for Biological Sciences and was appointed the Graduate School's first dean.

In June 1965, Dr. George James, Commissioner of Health in New York City, was announced as the first dean of the Mount Sinai School of Medicine. Dr. James was a fortuitous choice. He had years of administrative experience as a public health official, with an intimate grasp of the workings of the government and politicians at all levels, an invaluable skill when negotiating the rapidly changing regulatory and fiscal environment of the 1960s and 1970s. He was also a recognized leader in community medicine, one of the legs of the tripod of medical education constituting the Mount Sinai Concept. His appointment to the deanship coincided with his selection as the acting chairman of the new Department of Community Medicine, a clear sign that this was to be an important and active department.

The school over which Dean James was to preside had three major components: the under-graduate medical school, the Graduate School for Biological Sciences, and the Post-Graduate School of Medicine. These units encompassed the training of MD students, house staff, fellows, practicing MDs, Ph.D.s, and MD-Ph.D.s. In October 1967, the Page and William Black Post-Graduate School offered the first course of the Mount Sinai School of Medicine

The 1960s and early 1970s were primarily structural years concerned with concrete issues: buildings; fund-raising; university affiliation; receiving accreditation; establishing new departments; hiring faculty; developing governance rules, procedures, and committee structure; setting up mechanisms for accepting and promoting students; creating curriculum; designing and printing catalogs. Everything was a first. Formalities were not yet established, and there was hope for a successful blending of innovation with traditional medical school practices.

The process of rebuilding Mount Sinai to accommodate the school was central during these early years. Six buildings were razed to make way for the Annenberg Building. Construction was delayed and the building did not open in 1971 as planned, but in the fall of 1973. Departments had to make do with old or temporary quarters. Faculty recruitment was made more difficult by the lack of laboratory facilities.

For all the problems, progress was rapid. As the trustees had promised, the school opened in September 1968, a short five years after chartering, with a first-year class of 36 students, four of whom were women. There was also a third-year class, unusual in a new medical school but permitted as a clear affirmation of the clinical faculty's many years of teaching experience with the students of other schools. This third year group became the first graduating class on May 27, 1970.

The Mount Sinai Concept had received a great deal of attention in the 1960s as a new philosophy in the training of physicians. But what actual shape did it take in the curriculum? For the first two years of study, an Introduction to Medicine course was developed. It was originally assigned 468 hours in the curriculum. A goal of this course was to allow the students to see the relevance and interdependence of the basic sciences and the clinical sciences. Patient contact began in the first year. Teaching was multidisciplinary and system oriented. The laboratories were also multidisciplinary; teachers came to the students' lab instead of the students traveling to many different labs. The Community Medicine and Psychiatry departments were active in instruction, helping to provide the humanities component that was viewed as vital to developing physicians for the future. It was felt that a concentration of the basic science courses would free time for the students to take electives, allowing them to work closely with physician mentors to begin to explore the special areas of medicine that interested them and to learn what it was like to be a doctor. Some of the basic science instruction time was to be retrieved by science lectures in the clinical years.

As Dr. James' term progressed, the rosy financial picture of government support began to change. The interest derived from the Annenberg Building fund helped postpone some of the impact of reduced federal funding. In 1971 that source of funds was gone, and the medical center posted a deficit. Cutbacks were made on programs; many hoped-for projects were not pursued, and many pieces of equipment were not purchased.

A different imperative issue was the need to change Mount Sinai's perception of itself from that of a hospital to that of an academic health center with a medical school at its core. This matter of self-perception was paramount, affecting the relationships of all groups to each other and to the medical center: trustees, administration, the growing full-time and voluntary faculty. The administrative plan called for a president of the medical center, who served as the chief executive officer of the school and the hospital, reporting directly to the trustees. The dean and the director of the hospital would be the chief operating officers of their areas and vice presidents in the medical center, reporting to the president. As it turned out, the offices of the dean and the president were combined for many years.

On March 19, 1972, Dr. George James died suddenly of a heart attack. Dr. James had accomplished a tremendous amount in his seven years at Mount Sinai. The school's initial accreditation by the Liaison Committee on Medical Education was for seven years, a triumph that pleased Dr. James immensely. His sense of humor and management style had endeared Dr. James to the various constituencies at the medical center. His death in March, and the death of Solomon Berson, chairman of the Department of Medicine, a few short months later, sent shocks through Mount Sinai.

At Dr. James' death, Hans Popper was appointed acting dean and president Dr. Hans Popper and was later formally installed in these offices. But Dr. Popper had no great desire to remain in these positions. He had recently retired as the chairman of the Department of Pathology and as a pioneering researcher in hepatology; he was looking forward to serving a Fogarty Fellowship at the National Institutes of Health. He urged the rapid formation and success of a search committee to replace him. While speaking to Dr. Thomas C. Chalmers at the National Institutes of Health, trying to explain his delay in serving the Fogarty Fellowship, Dr. Popper discussed his situation. A few weeks later, Dr. Chalmers accepted the trustees' invitation to become the third dean and president of Mount Sinai.

Dean James' tenure had established the groundwork of the school, but other layers of the structure, such as governance, salaries, the ratio and roles of full-time and part-time faculty, still needed attention. In 1977, Samuel Davis became the first director of the Mount Sinai Hospital since 1904 who was not a M.D. He had a management background and worked with Dr. Chalmers on a major planning effort involving trustees, administration, and staff. This long-term effort, including nine months devoted to defining the medical center's mission statement, helped stimulate thinking on the roles of the hospital and the school.

When Dr. Chalmers assumed his position at Mount Sinai late in 1973, it was already clear that the 1970s would be very different from the 1960s. Federal money was drying up, inflation taking its toll, the competition for grant funds increasing. Research was slowed as equipment grew older without the expected government funds to replace it; space in the newly opened Annenberg Building quickly filled. At the same time, the aging hospital facilities needed refurbishing and rebuilding. As the class size grew, the affiliated hospitals and staff took on a heavier part of the teaching load. The affiliates of this time-The Mount Sinai Hospital, the Bronx Veterans Administration Medical Center, Beth Israel Medical Center, the City Hospital Center at Elmhurst, the Jewish Home and Hospital for Aged, and North General Hospital-became vital components of the teaching program of the school. This development of the multi-site teaching programs was an important element in the 1970s and 1980s.

One curricular area that troubled Dr. Chalmers and his successors was finding instructional methods other than the lecture. Problems had developed with the multi-disciplinary teaching program, making it hard to maintain the early uniqueness of the courses. With each adjustment of the curriculum, Mount Sinai moved toward more traditional teaching models. Still, some of the innovations that made Mount Sinai distinctive were retained, including emphasis on the humanities and the value of community medicine. Although the road was bumpy, again and again Mount Sinai affirmed its commitment to moral values in medicine. In the mid-1970s, the students began a project called HUMED to provide a stronger humanities component. The student project grew into a larger effort by the Department of Medicine for undergraduate and graduate students, with teaching by psychiatrists and an ethicist, one of the first in a department of medicine. By 1988, an ethicist was formally added to the school faculty, one year after a Humanities and Medicine program was begun to attract humanities students to careers in medicine.

With all of these concerns, much was accomplished during Dr. Chalmers' ten-year tenure. Thirteen new appointments were made on the department chairman level. These vacancies were viewed as opportunities, as well as challenges. Both Medicine and Surgery were vacant when Dr. Chalmers arrived and were filled the next year. Nine other chairs were later filled: Pediatrics (1976), Dermatology (1975 and 1979), Ophthalmology (1975), Pathology (1978), Radiology (1978), Anesthesiology (1979), Administrative Medicine (1979), and Obstetrics and Gynecology (1981). Physiology became vacant in 1979, with an acting chairman until 1984. Urology was without a permanent director from 1982 until after Dr. Chalmers left.

Under Chalmers' direction, two new departments were created: the Department of Biostatistics in 1975, now called Biomathematical Sciences, and the Department of Geriatrics in 1983. Both were innovations. The Department of Geriatrics was the first in a medical school in the United States. Under this department, Mount Sinai established the first, and still the only, mandatory rotation of medical students in a nursing home. Planning and evaluation were themes throughout the Chalmers years. The Clinical Excellence Committee, which operated from 1974 to 1976, exhaustively reviewed the programs and activities of the medical center. Their report led to the establishment of a program of departmental reviews by outside experts, using self-study reports. The Clinical Excellence Committee report also served as the basis for the voluminous self-study performed for the Liaison Committee on Medical Education (LCME) site visit of February 1977. Mount Sinai became the first medical school in the country to receive a ten-year accreditation using the self-study model, an important achievement.

During the 1970s, faculty relations were a pervasive concern. Indeed, medical practice by full-time salaried school faculty was a common issue facing all medical schools. The first Mount Sinai faculty practice plan was proposed in 1969 and was greeted with near-universal dissatisfaction. Groups met frequently over the next few years to devise something better, succeeding in 1973 with the Medical Service Plan. In 1974-1975, this program was reviewed by the Clinical Excellence Committee. A revised plan, issued in 1976, was an important step forward and remains the basis for the Faculty Practice Associates (a new name chosen in 1981) that is in effect today.

The uncertainty of government support gave urgent impetus to the planning efforts. Scrutiny was brought to bear on the aging clinical facilities and cramped research quarters. From this grew a hospital rebuilding program aimed at improving patient care areas and, in addition, at freeing and modernizing some research space. A new fundraising campaign was initiated to support this rebuilding and to increase the endowment funds of the school. Ground was broken for the I. M. Pei designed Guggenheim Pavilion in 1986.

By 1982 Mount Sinai appeared to be at the end of the beginning. With the rebuilding plans, the changed regulatory environment, and the now established maturity of the school, Mount Sinai seemed at a watershed, poised for a new start toward the recently defined objectives.

One aspect of this was the desire of the trustees to separate the offices of dean and president, with the president as the chief executive officer of all three Mount Sinai institutions, as had been the original plan. To do this, a change in leadership was made. Dr. Chalmers retired from his administrative duties to become a Distinguished Service Professor of the school. After a nationwide search, in June 1983 Dr. James Glenn became president of the three institutions and acting dean of the school. In July 1984, Dr. Lester Salans was named dean. This appointment did not last into the fall, and Dr. Glenn resumed the position of acting dean. Mount Sinai again began the search for a leader for the school, in 1985 appointing Nathan Kase, who was then chairman of Mount Sinai's Department of Obstetrics, Gynecology and Reproductive Science, as the new Dean. In June 1987, Dr. Glenn submitted his resignation. Mount Sinai began another long search for its second chief executive officer and fourth high-level appointment in as many years. On December 6, 1988, John Wallis Rowe, MD was inaugurated as the fifth president of the Mount Sinai Medical Center.

The 1980s at Mount Sinai School of Medicine were marked by a new tone of growth, achievement, and looking ahead. Many internal problems were resolved under Dr. Chalmers, allowing the arrival of Dr. Glenn and then Dean Kase to usher in a period of planning and movement into new areas. The rebuilding of the hospital and an extensive marketing campaign signaled Mount Sinai's more aggressive stance.

From his appointment in 1985, Dean Kase emphasized a commitment to strengthening the basic sciences and the research efforts of the medical school. It was decided to build for the future by selecting a few areas of biomedical knowledge that held promise, such as molecular biology, the neurosciences, and immunology, and to develop multidisciplinary research programs in these fields to serve as a focus for growth. Although part of a trend of interdepartmental research cooperation that already existed at Mount Sinai, these multidisciplinary centers pushed this trend further, as well as helped to define where these new disciplines will go. New departments and multidisciplinary centers created during this period include: the Brookdale Center for Molecular Medicine (1985), the Dr. Arthur A. Fishberg Center for Neurobiology (1986), the Department of Cell Biology and Anatomy (1989; had been Anatomy only); the Department of Human Genetics (1992); the Department of Health Policy (1995); and the Institute for Gene Therapy and Molecular Medicine (1996). From 1986 to 1996, the size of the basic science faculty doubled; 27 new chairmen and program directors were recruited.

During the years under Dean Kase, there was a determination to create a more defined academic environment. This resulted in the restructuring of some departments, new appointment and promotion guidelines, the review of academic titles and the revision of the faculty and student handbooks. Admission standards were raised over the years, and steps were taken to reduce student indebtedness at graduation. A student residence hall was opened in 1984. In 1988, the school began to require that students pass Part I of the National Boards in order to advance to the third year. In 1996, the first Annual Student Research Day was inaugurated to give the students experience in presenting research work and recognition for that work. Academic convocations have been held each year since 1986 to recognize professors in newly endowed chairs.

During Dr. Kase's years, the School was twice faced with accreditation from the Association of American Medical Colleges. In 1986, a ten year accreditation was granted. Beginning in 1994, a thorough self-study was initiated to prepare for the 1996 visit. This review led to important changes in the curriculum: fewer large lectures, more small group work, modified problem based learning was included and more computer-assisted instruction. Again, the school received an outstanding review. The site visitors noted that in that ten year period, there had been a 140% increase in peer-reviewed research grant funds, and a 370% increase in support from faculty clinical practice.

There was also much attention to the type of student Mount Sinai accepted and the type of doctor Mount Sinai created. Applications for enrollment increased tremendously during Dr. Kase's tenure, resulting in a series of high caliber classes. In order to achieve a diverse student body, efforts were expanded to recruit more women and minority students. The Mount Sinai graduating class of 1993 was the first in New York State to have a female majority. The School also sought to recruit students from varying backgrounds to try to create well rounded, compassionate physicians. In 1987 the Humanities and Medicine Program was established with five leading undergraduate universities to encourage students majoring in the liberal arts to consider a career in medicine. A similar Engineering and Medicine program was also later instituted.

The mid-1990s saw an increased national emphasis on primary care education for undergraduate and graduate medical students. Mount Sinai developed an innovative approach by having specialists lecture on the basics in their field that generalists need to know. There was also the re-introduction of a first year interdisciplinary course, and the development of a combined Medicine/Pediatrics residency program. A Graduate Medial Education Consortium was established at the School to better integrate the medical education experience among all of the School's affiliated teaching hospitals and to provide a broader base of clinical experiences, including more in primary care. Training sites were expanded to include practitioner's offices, more outpatient settings and group practices to provide increased exposure to a variety of primary care settings. Through these changes, the School has made strides in producing more generalists.

Technology has played an increasing role in instruction over the years, from the early short circuit televisions used in the first days of the school, to today's computers and teleconferencing. Computers and computer-assisted instruction for students first consisted of a student self-testing program developed at Mount Sinai for the surgical subspecialties, with additional programs added later. In the mid-1980s, a 20 percent reduction in formal lecture time in the first two years of medical school was implemented to allow the students time for more self-instruction and study using computer-assisted programs. Medical school and Alumni Association support helped the Levy Library to increase the number of computers available for student use and to create a computer classroom for instruction. Another new instructional method was implemented in 1989 with the inauguration of using simulated patients in teaching. The Morchand Center for Clinical Competence was created soon after to house this program.

The increasing emphasis on the basic sciences has bolstered the efforts of the Graduate School for Biological Sciences to provide high quality instruction in scientific research. In 1996, the School received a renewal of its NIH support for the Medical Scientist Training Program (M.D.-Ph.D.). That year it also instituted two new programs: the Molecular and Cellular Biological Sciences and the Molecular Basis of Disease Center.

The Mount Sinai Hospital has always been known for its strong research programs. This reputation was part of what made the institution so attractive a base on which to build a medical school. It was hoped that Students with the school, in particular the Graduate School for Biological Sciences, there would result an even higher level of research activities, grant funds, and scientific contributions. This interest in the basic sciences was re-affirmed during the Kase years by a re-focusing on the sciences, with a concomitant drive to hire new basic science faculty and to create multidisciplinary centers for research and the training of graduate students and fellows. To affirm its continuing commitment to high quality scientific research, in 1996 the school completed a new research building on campus to help attract the growing faculty of basic scientists and support their efforts. As a result, over these years there has been a large increase in grant funding for research and the Mount Sinai School of Medicine has moved up in the rankings of institutions receiving NIH funding.

Mount Sinai School of Medicine has accounted for a number of significant contributions to medicine in its first few decades. These include: pioneering work in liver disease, led by Hans Popper with others in the hepatology program; the work of the Division of Environmental Medicine in the Department of Community Medicine, with Dr. Irving Selikoff, including the delineation of the tumor-causing effects of asbestos; important genetic contributions, especially in the mechanisms and treatment of Jewish genetic disorders; the development of synthetic insulins by Dr. Panayotis Katsoyannis; pioneering efforts in the assessment and treatment of Parkinson's disease, led by Dr. Melvin Yahr; and research on the in vitro differentiation of tumor cells into normal cells, begun here by the late Charlotte Friend. There has been continuing work on areas of long-term interest at Mount Sinai, such as inflammatory bowel disease, cardiology, and the treatment of cancer.

Other valued contributions include: the replication of the hepatitis B virus in tissue culture by George Acs; Edwin Kilbourne's efforts, later in association with Peter Palese, on the genetic organization of the influenza virus and the development of a vaccine against this virus; research on the cloning and crystallization of immunoglobulin receptors by Jay Unkeless; work in fetal transfusion, led by Richard Berkowitz, along with other work in the Department of OB/GYN on fertility; and work on genetic organization and cloning of blood coagulation factors by Yale Nemerson. In 1991, two landmark discoveries were announced. The gene for Marfan Syndrome, an often fatal connective tissue disorder, was identified by Francesco Ramirez, and a new test to detect women at risk for giving birth to premature babies was reported by Charles Lockwood.

In 1997 Dean Nathan Kase retired. Dr. Arthur Rubenstein, formerly of the Department of Medicine at the University of Chicago was appointed to succeed him. On July 17, 1998, after extensive discussions, the creation of Mount Sinai-NYU Health was announced. As part of this reorganization, the Mount Sinai School of Medicine remains a separate entity but the university affiliation has changed from The City University to New York University.

At the end of the 1990s, a new curriculum plan was conceived that would begin in the Fall of 2000. This comes another step closer to a return to the intentions of the 1960s plan: integrated courses, small group lectures, self study, students seeing patients from the first year and an overall emphasis on life long learning. Technology continues to play a role as computer-based programs and simulations are implemented into the curriculum. Departmental self-studies take place, with outside peer review to ensure the excellence of the departments.

In September of 2001 Dr. Rubenstein stepped down as Dean and Dr. Nathan Kase assumed the position as Interim Dean. This was a difficult period for the School as the Hospital's merger with NYU began to unravel and the financial situation of Mount Sinai deteriorated in the tough fiscal climate. It was decided to return to campus-based governance and Mount Sinai began the process of reintegrating the School and the Hospital. Dr. Kenneth Berns was brought in as the new President and CEO of the Medical Center and oversaw a series of evaluations by outside consultants. The implementation of these sometimes painful recommendations resulted in a streamlining of the School's organizational structure, with many centers and institutes being folded back into the traditional departments. Programs were evaluated for their effectiveness and potential and some projects were cancelled and others were changed to become more self-supporting. The key areas of cancer, gastroenterology, the neurosciences and cardiology were identified as fields where Mount Sinai would concentrate its efforts over the near future.

In the fall of 2002 a new Dean was announced, Kenneth Davis, Chairman of the Dept. of Psychiatry at Mount Sinai since 1986. Dr. Davis is a graduate of the Mount Sinai School of Medicine, Class of 1973, and brings many years of insight to bear on Mount Sinai's problems. He assumed the Deanship in January 2003. Two months later, it was announced that Dr. Berns would be stepping down as President of the Medical Center to allow Dr. Davis to assume that position as well. This is a return to the form of governance that existed in the beginning years of the School when the offices of the Dean and President were combined.

In 2005, it was announced that Dennis S. Charney had been named Dean for Academic and Scientific Affairs, to run the School day-to-day to free up Dr. Davis for other duties, including a new fundraising drive about to begin. On March 1, 2007, Dennis S. Charney was appointed full Dean of Mount Sinai School of Medicine. Ken Davis remains the President and Chief Executive Officer of the Mount Sinai Medical Center.

In this brief overview of Mount Sinai's early years, it is not surprising how different everything is today. It should not be surprising how many things remain or return to be the same. Today, with the rebuilding of Mount Sinai, there is again the excitement of starting over. This brings with it many strains, but there is the perception that Mount Sinai is strong as it enters a new era, still a leader in American medicine.

1. The November 1952 issue of The American Journal of Medicine was dedicated to "the men who over the course of a century laid the foundation for the clinical reputation of The Mount Sinai Hospital in New York in the medical world." Amer J Med 1952, 13(5), p.517.
2. Popper H. The Mount Sinai concept. Clin Res 1965, 13(4):500-504, p.502.
3. Popper H. New objectives in medical education. Ann NY Acad Sci 1965; 128:478-479, p.478.

History of The Mount Sinai Hospital adapted with permission from an article by Kase, N, Niss, B. An overview of the history of the Mount Sinai School of Medicine of The City University of New York, 1963-1988. Mt Sinai J Med 1989;56:356-366.