In the US, some Orthodox women in medicine still plagued by discrimination

NEW YORK — Miriam Knoll didn’t make the decision to attend medical school lightly. Both of her parents are physicians, so she knew becoming a doctor was possible. But in her Orthodox Jewish community, some voices say that the career choice is unrealistic for a woman who wants to get married and have children.

“When my mom went to medical school, women were only a quarter of all medical students and certainly, frum women were a very tiny percentage,” Knoll told The Times of Israel, using the Yiddish word for Orthodox Jews. “That number is growing, and yet frum women still find themselves being asked, ‘Why are you going into medicine?’”

Knoll ended up graduating from New York University’s school of medicine in 2011. She is now a radiation oncologist at Montefiore Nyack Hospital and a mother of four. She’s also president of the Jewish Orthodox Women’s Medical Association (JOWMA), which provides essential support to some 200 Orthodox Jewish female physicians and medical trainees. Its membership has been growing since its establishment in 2019.

With an eye to the next generation, JOWMA volunteers also mentor close to 100 young Orthodox Jewish women in high school or college who are interested in medical careers.

“A lot of women in our community get married young and have children while in medical school and early on in their residencies, and that’s very uncommon [among non-Orthodox medical students],” said Knoll. “That makes it very difficult, but we want to be able to do both.”

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A network of support

Dr. Miriam Knoll. (Courtesy)

In addition to JOWMA, several more organizations offer support to the thousands of Orthodox Jewish women working in various areas of medicine.

Brooklyn native Rochel Leah Lehrer is a physician assistant (PA) in neurosurgery at Westchester Medical Center in New York. When at age 11 Lehrer lost her younger brother after he was hit by a car outside his school in Brooklyn, she knew she wanted to “make people feel better and try to heal everybody.” She has been working in the field for some 20 years.

“I started PA school [at Touro College] when I was 20,” Lehrer said. “We were only two frum girls in my class.”

Physician assistants, Lehrer explained, have a wide range of responsibilities in the hospital including examining patients, ordering lab diagnostics, prescribing medication, and performing assessment and treatment plans. They also participate in and publish clinical research. In 2021, the profession was named the best career in the US News and World Report.

Lehrer and her colleague Adena Homnick founded the Jewish Association for Physician Assistants some 18 years ago. The organization is now recognized as a special interest group of the American Academy of Physician Assistants.

Physician assistant Rochel Leah Lehrer, left, says she wouldn’t have her job in neurosurgery at Westchester Medical Center in New York if it weren’t for the help of her family, including daughter Esther Neuman, right, who helped take care of her younger siblings when Lehrer was out on long shifts. (Courtesy)

“We noticed that there was a group for every race and religion, but there was nothing for Jewish physician assistants,” Lehrer said. “Our goal is to reconnect with each other through continued education, job networking and social events.”

“It feels like family, a warm and comfortable environment,” she said.

Chaya Milikowski was 26 and pregnant with her third child when she began feeling a strong desire to go back to school. Not knowing what she wanted to study, she decided to flip through the Bureau of Labor Statistics occupational handbook, which lists career options from A to Z, and ultimately decided to go for nursing.

“You engage a lot of different sides of you,” Milikowski said. “There is the compassionate social side where you’re helping patients and families through some very difficult times, but there is also the intellectual aspect, especially working in critical care, where things can change from minute to minute and you need to be very perceptive.”

Since 2015, Milikowski, a mother of five, has worked as an intensive care unit nurse practitioner in a small community hospital in Maryland. She is a board member of the Orthodox Jewish Nurses Association, which has over 415 members in 19 chapters across the United States.

The group runs an active Facebook group with 2,600 followers and organizes nursing conferences and webinars, career events and a mentorship program for new nursing graduates, among other initiatives.

Shabbat, sheitels and motherhood

Society’s general bias against mothers in medicine, Knoll believes, remains the main challenge for Orthodox women in the field. The perception that “women are not leading medicine, they are not the chairs of departments, they are not running conferences at the same level as men,” she said, is a problem for all women, “but when you have kids at a younger age, it’s harder.”

In my community, most girls don’t go to college but my parents realized that it was something I really needed

Dr. Chana Weinstock Neuberger was single when she started medical school. Still, she and her parents were hesitant about her pursuing a career in medicine.

Medical oncologist Dr. Chana Weinstock Neuberger speaks on a panel at the annual American society of clinical oncology conference. (Courtesy)

“In my community, most girls don’t go to college but [my parents] realized that it was something I really needed,” said Weinstock Neuberger, a JOWMA founding board member and former vice president. “I was doing a very out-of-the-box thing in my community.”

Weinstock Neuberger is an oncologist. When she first started her professional path, she questioned whether she’d be able to get married and have a family while being a physician. She now has four children.

“I think there is still some hesitation for women doing this, even in the Modern Orthodox world,” she said. “The pressure to get married, it’s on everyone, but it’s possibly magnified in the [ultra-Orthodox] community.”

Lehrer, who currently lives in Monsey, New York, said she couldn’t have succeeded in her career path without her family’s support.

“I used to be out of the house for three shifts of sometimes 16 hours,” Lehrer said. “My parents assisted with childcare when I worked long shifts, my in-laws were also supportive, my husband helped with homework and dinners and as my kids got older, the older kids would pitch in and help with the younger children.”

Among other challenges, Milikowski said many Orthodox Jewish nurses often find themselves in a “tight situation” when it comes to observing the Sabbath.

“The hospital is a 24/7 operation and very often there are mandatory weekend requirements. Bringing up that you are a Shabbat observer on an interview is a huge topic, it comes up all the time,” she said, using the Hebrew word for the Jewish day of rest.

ICU nurse Chaya Milikowski in personal protective equipment to protect against COVID-19. (Courtesy)

While hospitals should not discriminate on the basis of religion, Milikowski said that in reality, “There have been plenty of Orthodox Jews who show up for an interview and as soon as they mention that they can’t work Friday nights or Saturdays, the interview is over.”

As a compromise, many offer to work almost every Sunday. “It’s important to show the hospital that yes, we have limitations schedule-wise but we are not looking to take advantage of that. We are willing to pull our weight,” she said.

She also pointed out that “as an Orthodox nurse who keeps kosher, you are not able to make the same sort of connections with your colleagues.”

“You’re not going to be able to go out for drinks after work, and many who have families won’t necessarily create the same sort of camaraderie,” she said.

“I gave up my dream career, a radiation oncology residency, because they could almost accommodate my Shabbat request, but not fully,” Weinstock Neuberger said. “It’s why a lot of Orthodox men and women don’t go into medicine.”

I gave up my dream career, a radiation oncology residency, because they could almost accommodate my Shabbat request, but not fully

Recently, however, Weinstock Neuberger was approached by the Accreditation Council for Graduate Medical Education and got involved in a diversity awareness initiative to develop a curriculum to educate residency program directors on the considerations of Orthodox Jewish physicians.

“It’s so important to have medical professionals who are Orthodox,” Weinstock Neuberger said. “Because there is a certain level of trust and communication that you have [with the community], and that’s why there is an effort to include many different races and backgrounds and ethnicities in medical school.”

Medical oncologist Dr. Chana Weinstock Neuberger at the annual American society of clinical oncology conference. (Courtesy)

In all three New York area hospitals where Lehrer has worked, she felt very welcome as an Orthodox Jew. She has never had to come into the hospital on Shabbat, but has covered all Sunday shifts and legal holidays to make up for her absence.

At one of her previous workplaces, colleagues even made sure to order strictly kosher food to the hospital or plan group outings to restaurants Lehrer could go to, even though she was the only Jewish physician assistant on the service.

Smaller challenges did arise, however, including taking off her sheitel — a wig worn by some observant women who cover their hair after marriage — before scrubbing into surgery.

“It would take me 15 seconds. I had someone time it,” she said.

Knoll told The Times of Israel that antisemitism, too, has become a “strong and visible” challenge for Jewish medical workers. Her organization recently hosted a webinar on the topic to “bring awareness of this issue for all healthcare professionals, and discuss ways to speak up against antisemitism during medical school, training, and in hospitals.”

Giving back

For Milikowsky, Lehrer, Knoll and Weinstock Neuberger, serving their home communities and giving back is of utmost importance. Their respective organizations are constantly engaged in public health outreach and education. They also use their professional networks to help other Orthodox Jews find jobs in the field, or provide doctor referrals and appointments for those in need.

With a little concern and a few minutes of dedication helping a new student or unemployed colleague, you can change the trajectory of someone’s life in a powerful way

“Everything that we do is run by volunteers,” Knoll said, adding that her organization runs a weekly podcast along with regular symposiums and events. “They are taking care of their families, they are taking care of their patients and they are also giving back to the community.”

Dr. Miriam A. Knoll (right), with student Tamar Itzkowitz (left), were paired through the JOWMA Mentoring program. Itzkowitz is a first-year medical student at Hackensack Meridian School of Medicine. (Courtesy JOWMA)

“With a little concern and a few minutes of dedication helping a new student or unemployed colleague, you can change the trajectory of someone’s life in a powerful way,” Lehrer added.

In March 2020, the global health crisis hit particularly close to home. Shortly after celebrations of the Jewish holiday of Purim early that month, coronavirus infections peaked in Orthodox communities across the United States. The community was also the subject of much criticism from authorities in New York and suffered soaring antisemitism: Despite overwhelming compliance, some crowded weddings and funerals made headlines locally and nationally.

As a physician assistant in neurosurgery, Lehrer is used to dealing with trauma. Many of her patients come in for gunshot wounds or brain blood clots. During the height of the coronavirus pandemic, she saw patients who had suffered strokes as a result of getting infected with COVID-19. During that time, her phone wouldn’t stop ringing — she would receive almost 30 calls a day from neighbors and community members in Monsey begging her for help.

“I remember receiving a call from someone saying, ‘Could you please just find out if my wife is alive or dead?’” she recalls. “I decided that night that no matter what, I would help all these families out and do whatever I can.”

Lehrer quickly found herself updating families, facilitating communication with their hospitalized loved ones, and comforting them. She also helped sneak in homemade kosher food to patients during Passover.

I remember receiving a call from someone saying, ‘Could you please just find out if my wife is alive or dead?’ I decided that night that no matter what, I would help all these families out and do whatever I can

“One patient was comatose for over four months,” she said. “I will never forget when I was driving to Cleveland a few months ago, a man called me and asked, ‘Is this PA Lehrer?’ He said he wanted to thank me for being on the phone with his wife daily and giving her chizuk [support].”

“I was crying for the next hour and thanking God for the miracle that He performed for this young man,” Lehrer added.

As an ICU nurse, Milikowski was on the front lines when the COVID-19 crisis first struck. Beyond caring for her patients, Milikowski and the Orthodox Jewish Nurses Association helped provide information on the coronavirus to their communities, distributed pulse oximeters and eased fears of going to the hospital.

ICU nurse Chaya Milikowski is a board member of the Orthodox Jewish Nurses Association. (Courtesy)

In her hospital’s break room, she and her fellow nurses displayed a painting of a single tree and a blue sky. Every time one of their patients died from COVID the medical staff would add a star in the sky, and every time a patient had recovered they would paint a colorful flower beside the tree. By the time vaccinations began in early 2021, they had filled the first painting and started a second. Recently, Milikowsky’s coworkers decided to get matching tattoos with flowers and stars as a reminder of what they went through over the past year.

“As an Orthodox Jew, I wasn’t going to get a tattoo,” she said, referring to the biblical prohibition against getting inked. “But my husband, for my birthday, had a necklace charm made with stars and flowers. So I don’t have a tattoo, but I wear a pendant with stars and flowers against my heart.”

Working in the ICU can take a toll on one’s mental health, admits Milikowsky, but as a nurse, she believes, “You have to pick up on the positive outcomes and hold onto those.”

“I can go home at the end of a 12-hour shift and say I alleviated somebody’s pain or I noticed someone’s down-trending vitals and alerted the rest of the team to a complication before it got worse, or I helped a patient die with dignity,” she said.

“It doesn’t have to be all negative,” Milikowsky added. “To me, helping a patient die with dignity, surrounded by family, pain-free, that’s a success.”

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