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Afterword The Years of the Giants
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Afterword TheYears of the Giants MOUNT SINAI HAS always been full of stories about “the Giants” who roamed the halls long ago. It is interesting that these stories always relate to a time in the past, regardless of when they are told. Interns in the 1890s heard tales of the Giants, as did Interns of every succeeding generation. This changeable aspect of the Giants does not diminish the fact that there truly were leaders of medicine here. But it does point to the importance of this story in providing a common history for the people of Mount Sinai: the feeling that this is a special place with a tradition of excellence and high standards. The impact of this story has been greatest on the medical staff, in particular the young doctors who have come to Mount Sinai for training, some of whom became Giants to the next group. This is their story. From very early on in the institution’s history, obtaining a House Staff position at Mount Sinai was extremely desirable. It was also extremely difficult. From the beginning in 1872, prospective candidates would take the annual entrance examination to compete for a handful of House Staff positions. By the early 1900s, the number of applicants exceeded one hundred per year. Many of these young doctors came from City College and then Columbia University’s College of Physicians and Surgeons or, less often, the New York University School of Medicine. Because many hospitals at the time did not welcome Jewish interns, Mount Sinai had a large pool of Jewish candidates from which to choose and was able to select only the most qualified. From 1872 to around World War II, Mount Sinai had “mixed” internships lasting two and a half years. During this time, the general medicine Interns spent six months on the surgery wards, and the surgical Interns spent six months on the medical wards. The last six months of internship were spent as “House Physician” or “House Surgeon,” respectively , or as Senior Physician or Surgeon; the term varied over time. 383 Departments established their own residency training programs over the years that were in addition to the general preparation of the internship . Throughout these two and a half years, the House Staff expected work to be their life. Internship was all- consuming, and such constant, close, and intense contact with colleagues from around the Hospital enabled the staff to coalesce into a tightly knit and intellectually stimulating group. Inevitably, there were some personality clashes and disagreements, but, for the most part, relationships remained amicable. After the internship, many young doctors began climbing the career ladder at Mount Sinai, jockeying to obtain Out-patient Department assignments. Many accepted volunteer positions in the laboratories as they built their private practice on the side. Mount Sinai staff were expected to be highly involved in scientific research. To this end, some physicians were chosen for fellowships following their internships so that they could pursue postgraduate study or spend time in the laboratories , concentrating entirely on research before starting a practice. Until the mid 1920s, it was typical for many fellowship recipients to go abroad to study. As Reuben Ottenberg put it, “Postgraduate teaching in 384 THIS HOUSE OF NOBLE DEEDS House Staff, 1891. [52.54.111.228] Project MUSE (2024-03-28 21:07 GMT) America was in the horse and buggy stage. If a man wished technical training in any specialty, he generally went abroad.”1 The Emanuel Libman Fellowship Fund was one such fellowship. It was established in 1924 to “Encourage, aid, assist, foster, conduct, and endow medical and allied scientific research and investigation and to increase medical and allied scientific knowledge and education.”2 Moses Swick, who while in Berlin developed Uroselectan to visualize the urinary tract and kidneys, was just one of the physicians to make an important scientific contribution while on a Libman fellowship. Numerous other fellowships had already been established by the Trustees to encourage research, beginning with the George Blumenthal, Jr., Fellowship in Pathology, instituted in 1907. One reason that the Mount Sinai community stayed so close was because of the Mount Sinai Hospital Alumni Association, a group of physicians who had trained at the Hospital. Created in 1896, The Associated Alumni of The Mount Sinai Hospital sponsored medical talks, provided funds for the care of sick alumni and support for the library, and, on the lighter side, held an annual banquet.3 The banquets were known for...