Holocaust Survivors Program Alters Community and Curriculum

In the bustling postdoctoral clinic, Carmen Ramirez Sosa ’22 would often have brief conversations with her patients. But with her first Holocaust Survivors Program (HSP) patient, it was different.

A group photo of HSP faculty and students Clinical Associate Professor John Moran (left), prosthodontics resident Carmen Ramirez Sosa, Periodontics Professor and the creator of RSDM's Holocaust Survivors Program Howard Drew ’82, and fourth-year DMD candidate Rafi Anapolle.

“I spent one hour just talking, and he asked so many questions about what I was planning to do,” recalled Ramirez Sosa, who just completed her prosthodontics residency. “I think it was after three or four appointments that he felt comfortable [starting the treatment].”

For survivors, medical treatments can evoke trauma from the Holocaust. A white coat, for instance, could remind them of forced medical experiments. A loud noise, a crowded clinic, or a small examination room can also be triggers. That’s why RSDM began implementing a special training program called person-centered, trauma informed (PCTI) care to prepare students in delivering the best care for Holocaust survivors and all patients who might have experienced trauma.

The PCTI training provides background on the Holocaust and its impact on the survivors; it also equips participants to recognize trauma and treat patients accordingly. As part of their mandatory selective/electives, all third- and fourth-year DMD candidates take an online certificate course offered by The Blue Card, a nonprofit organization dedicated to caring for Holocaust survivors. Postdoctoral candidates and residents as well as faculty and staff members partaking in HSP can also take the online course, obtain a certificate, and receive continuing education (CEU) credits.

“With HSP patients, we focus on the PCTI care principles,” said Ramirez Sosa. “We provide a safe environment and make them feel comfortable; we explain all the procedures to get their consent before performing anything inside their mouth, and that makes them feel empowered about their treatments.”

Patient-centered, trauma informed care emerged in the past decade, explained Michael Conte, senior associate dean for clinical affairs. And incorporating it into the RSDM curriculum was an important step that grew out of a special partnership formed between RSDM and the Jewish Federation of Greater MetroWest NJ aimed at making PCTI care the gold standard.

“We thought it'd be very beneficial for our students to have this training because they're going to be dealing with patients who are very, very different than they are,” said Conte. Although the training focuses on caring for Holocaust survivors, its basic principles are widely applicable to all patients.

Rafi Anapolle, a predoctoral candidate in the Class of 2023, not only draws from his PCTI training when he’s treating HSP patients, but also other patients.

For instance, when he had a patient with significant teeth erosion—which hints at either a nutritional deficiency or an eating disorder—he remembered to take a step back. “The whole thing about PCTI is building a connection and making patients feel empowered,” Anapolle said. “By building that connection, they eventually start opening up to you in giving their full histories. … For this patient, that applied, too.” He was then able to successfully help his patient.

He has also helped with the treatment of three HSP patients so far.

“As a Jew, being able to give back to your people, who are the reason you are who you are today—that's the most important thing you could possibly do,” he said. “I think most of us who do the program—at least the Jewish students—do it because that's what we need to do. It's a requirement for us to give back to a generation that has gone through hell.”

The program has been one of the highlights of his time at RSDM. “I'm so happy I go here for dental school because I’m able to have this opportunity; not every school offers that,” said Anapolle. “The program made my experience at Rutgers worthwhile and unique.”