Cover Story:Is there a doctor in the house

In a subterranean research lab on the Stanford campus, medical student Matt Kirschen has pored over enough MRI brain scans to know — there’s no neurological connection that programs Jewish kids to become doctors.

And despite clichés about “my son the doctor” and a common perception that the medical world is brimming with Jewish M.D.s, Kirschen is among those who agree that many young Jews are steering clear of the profession these days.

Scanning the ranks of his 469-student medical school, “I definitely think that’s an accurate trend,” said the 26-year-old Kirschen, who is halfway through an M.D./Ph.D. program and is president of Stanford’s 30-member Jewish medical students’ association.

“At least half of my friends going out of college go into consulting,” observed Kirschen, who graduated from Brandeis University in 2000.

No statistics are kept on religious affiliation of students at Stanford or other medical schools. But there are plenty of signs that far fewer Jews are pursuing an M.D. than back in the 1930s, when more than half the applicants to American medical schools were Jewish, according to Dr. Michael Nevins, author of “Jewish Medical Roots.”

“I see it as a bittersweet phenomenon,” said the New Jersey internist. While Nevins considers the declining number of Jewish doctors a reflection of wider opportunities and less intolerance, on the other hand, it saddens him. “Jews have contributed phenomenally to medicine in history.”

At UCSF School of Medicine, Dr. Robert Stern, a professor of pathology, estimates that Jewish enrollment has dropped from roughly 20 percent when he started teaching there 27 years ago to 10 percent to 15 percent now.

At Stanford, where the student body is about 40 percent Asian, 40 percent white and 20 percent under-represented minorities, first-year medical student Ben Berk estimates that four or five of his 87 classmates are Jewish. Overall, “it’s really a very diverse group of people,” he said.

A 2002 survey of more than 300,000 college freshmen revealed a waning interest in pursuing a medical career among all students, but “the decline has been a bit sharper among the Jews,” according to UCLA education Professor Linda J. Sax.

Her study, “America’s Jewish Freshman,” found that young Jews expressed a “growing interest in becoming artists, musicians and writers.” Aspirations to become a doctor or dentist, meanwhile, dropped from more than 14 percent of Jewish freshmen in 1971 to less than 10 percent in 1999.

What’s going on? Theories abound.

Nevins said the trend appears unrelated to the kind of quotas imposed in the 1940s and 1950s that severely restricted Jewish admissions to medical schools.

Instead, “many seem to be choosing of their own volition not to pursue a medical career,” he wrote in an article titled “The Vanishing Jewish Doctor.”

At UCSF, Stern is among those who view the trend as a measure of success, and becoming a doctor no longer represents the pinnacle of accomplishment: A once-struggling immigrant population now has wide access to other professional and social circles of American life.

“Jewish kids are no longer overachievers. They’ve arrived,” said the 67-year-old Stern, who regularly hosts Shabbat meals and other celebrations in his San Francisco home for Jewish med students.

He himself arrived in the United States as a toddler from Germany and became an “overachieving Jewish immigrant kid” who graduated from Harvard and went on to medical school at the University of Washington.

Today, many Asians and other immigrant groups have supplanted Jews in their pursuit of a medical career, he asserted. Women also are flooding into medicine, accounting for 57 percent of the 2002 entering class at UCSF.

Nationwide, about a third of some 66,000 medical students are non-white minorities, according to Nevins, with Asians making up about 20 percent of that total.

“These are the kids gunning it,” Stern maintained. “Jewish kids don’t have to gun it anymore.”

Dr. Robert Brody, a 58-year-old internist at San Francisco General Hospital, said when he was growing up, “We went into medicine because it was expected of us.”

Today, the oldest of his three sons, David, is applying to medical school, not because of expectations but because, the 26-year-old said, “I knew I wanted to be in a service-oriented profession.”

When Kirschen was growing up in what he describes as a “liberal yet traditional” Jewish household in Los Angeles, he never felt parental pressure to become a doctor.

“They told me I could do whatever I wanted,” said Kirschen, who was at one point weighing careers as either a rabbi or a physician. Though his parents were pleased with both choices, “they did not nudge me in any direction.”

Four years into his seven- or eight-year training and research program, Kirschen said he doesn’t get any “my son the doctor” comments from his folks.

“The only comments I hear is ‘my son who is going to be a student forever,'” he cracked.

Kirschen said he wouldn’t have it any other way.

Following what he said was his family’s example of service to the community — his father is an optometrist and his mother a school psychologist — Kirschen is now conducting research on the role of the cerebellum in human memory in healthy patients along with those suffering tumors and concussions. He eventually hopes to practice and teach at a large medical center.

“I just had to follow my passions,” said Kirschen, who occasionally does that by working in his lab until 2 or 3 in the morning as part of the dual M.D./Ph.D. training program.

But a 1997 article in the Journal of the American Medical Association theorized that loss of professional autonomy, malpractice issues, high education costs and “increased opportunities for more lucrative and less strenuous occupations” may be scaring some potential doctors away.

At Stanford, Dr. Gabriel Garcia, associate dean of admissions, said Jews aren’t the only students shying away from medical school these days. “There’s been a huge drop in applications to medical schools by everyone, particularly white males,” he said.

He speculated that some have been lured to careers in high-tech and biotechnology. “I see the last decade as a decade of immense opportunity for smart graduates,” said Garcia.

Rachel Sobel, a 26-year-old second-year UCSF student, grew up in a Reform household in Florida, where she was free to navigate her own path. Her father is a physician and her mother is a teacher and state legislator, so “service is just part and parcel to the outlook of the people in my family,” she said.

As for any parental pressure? No way. “I think they’d be proud of me whatever I do,” said Sobel, who first worked as a medical writer after college and currently writes dispatches from medical school for U.S. News and World Report.

Though not pushed, 22-year-old Jonathan Davis said he was influenced by his family’s medical legacy.

His now-deceased grandfather, Dr. Julian Davis, graduated from UCSF; his father, Jim, practices medicine in San Francisco; and he’s now a first-year student at his grandpa’s alma mater.

“He was one of the first, if not the first, Jewish men to be trained at UCSF,” Jonathan Davis said. “Walking through the halls here, I get a sense of awe and tradition following something my grandfather did.”