This is my first post...
I was hoping someone could help me. I'm a first year medical student, in the UK, and have been encountering all sorts of problems trying to explain why I could not attend lectures on the chagim, and why I need to leave early on shabbat. Now, being that I'm in the middle of nowhere in terms of a Jewish community, they have never had any experiences with this, and did not take kindly to my requests. Now, I am having a meeting with the dean, to explain this strange behaviour of mine, and I want to be perfectly clear about something first. I will be asked about shabbat in relation to my clinical years. As far as I understand it (I have indeed spoken to a few rabbi's about this, but I'm still not 100% sure), I cannot break shabbat, even during the clinical portion of my training, because it still falls under the umbrella of medical education. That is, until I am a junior doctor (resident) I am not solely responsible for patient care, and therefore I am not the one saving a life (pikuach nefesh), and therefore am not permitted to break shabbat (or yom tov) for this... Is that totally correct? I would like to ask more questions about what happens after, however would appreciate answers that relate to medical studies only right now.
Many thanks for your help!

I know a frum girl who recently qualified as a doctor; she may be able to help. Is there a way I can contact you?

Hello Bat Israel

Welcome to the Global Yeshiva!

A coworker of mine is actually also going through medical training right now, and as a very chasidishe lady she asked a sheila of a rav about her training which takes place on Shabbos in which she would be required to do things not typically done by a shabbos observant jew- (such as writing medical reports etc).

The answer that she recieved because of her INDIVIDUAL situation (i do stress individual) was that because it is for the purpose of saving lives it would permissable to her in certain manners- even though it is only the training aspect. I dont know all the details- but i do know this- when in doubt- ask a rav to poskin on your individual situation.

Each individual requires a unique answer specific to their situation.

Take care.

BatIsrael,

I'd suggest you contact the office of the Chief Rabbi; I'd be very surprised if Rabbi Sacks had not dealt with this issue before, possibly in an article you could take with you. Start with his website at http://www.chiefrabbi.org.
Kol tuv,

Steve Albert

quote:

Originally posted by batisrael:
This is my first post...
I was hoping someone could help me. I'm a first year medical student, in the UK, and have been encountering all sorts of problems trying to explain why I could not attend lectures on the chagim, and why I need to leave early on shabbat. Now, being that I'm in the middle of nowhere in terms of a Jewish community, they have never had any experiences with this, and did not take kindly to my requests. Now, I am having a meeting with the dean, to explain this strange behaviour of mine, and I want to be perfectly clear about something first. I will be asked about shabbat in relation to my clinical years. As far as I understand it (I have indeed spoken to a few rabbi's about this, but I'm still not 100% sure), I cannot break shabbat, even during the clinical portion of my training, because it still falls under the umbrella of medical education. That is, until I am a junior doctor (resident) I am not solely responsible for patient care, and therefore I am not the one saving a life (pikuach nefesh), and therefore am not permitted to break shabbat (or yom tov) for this... Is that totally correct? I would like to ask more questions about what happens after, however would appreciate answers that relate to medical studies only right now.
Many thanks for your help!

Batisrael;
I am sure your situation can be easily resolved. I'm surprised that your school is not familiar with this. Jews have been to just about every medical school on the planet. I'm not only a doctor but I have been professor in 3 different medical schools in the US and abroad and I've never heard of a situation where a Jewish student could be observant and not be able to complete a medical curriculum. I even know of cohanim, who cannot be close to dead bodies, getting through the medical program without any problem. So if the issues are not resolved with your dean, talk to your rav. If things are still not resolved contact me privately.

quote:

Originally posted by MosheYisraeli:
I even know of cohanim, who cannot be close to dead bodies, getting through the medical program without any problem.

REALLY?!?!

What school?

Michael

Thank you all so much for your suggestions. Tomorrow I am meeting with the dean and the Jewish chaplain, we'll see what happens...

I originally started this post in order to gain further insight as to the halacha surrounding what one is or is not permitted on shabbat or yom tov for a medical student. Does anyone have any comments, or is it an obvious answer? Perhaps I'm actually making much more out of this than should be, due to my constant battle in maintaining that this is what I am meant to do... Are there times when one can break shabbat to say, learn a new medical procedure, or just to stam shadow a doctor? Are there leniencies?

Thank you for your comments.

The questions you ask are difficult. They really need your own posek. At Shaare Zedek, for example, we cannot write into the patient's charts. They have Arabs who perform that function as Shabbat Goyim. At Hadassah they don't have such a requirement. In Israel some doctors have Shabbat telephones but others would never touch one....etc. So it depends on what your posek says regarding pechuk nefesh. Some are more machmir than others.

As for being able to complete your medical education; it's relatively easy in a society that has religious and civil freedoms. I'm sure your Jewish chaplain should be able to handle it for you without any problem.

I don't think civil liberties have come this far north. The things people think they can say and get away with over here is totally jaw dropping!

Anyway, I'm allowed to keep shabbat while a preclinical student, but no promises for my last 2 years. I was also warned that I should expect more "clashes" with other senior doctors, who don't appreciate students doing anything different. At the end of the first term, I'm feeling very beat, and ready to pack my bags and leave. I'm going to look into transferring elsewhere, or finding a new profession.

Thanks for everyone's help,
Shabbat shalom.

Batisrael;
Please, don't get discouraged. If I can be of any help contact me privately. The most difficult thing about medical school is getting admitted. Once you are in, it's just a matter or perserverence. In many ways medical school is a hazing or an initiation, with very little to do with the subject matter.

The situation has changed radically since the 1950's. At that time the idea of shomer shabat students was new but the schools got use to it reasonably quickly as they were impressed with the quality of the students. This was primarily because they only just then starting accepting any jews. I think I was the first person at my medical school to request taking exams scheduled for shabbat on the preceding Friday but they went along with it. (Yeshiva students had a lot less problem adjusting to a fourty hour week of studies than most college students.) One solution for cohanim was optometry or podiatry school which were so happy to see such highly qualified students that they were more than willing to accomadate them.

Aryeh Shore

BatIsrael,

Please allow some tips from one doctor's son who studies |rabbanut| topics:

(a)Rav Moshe Tendler (in |Practical Medical Halakha|) discriminates, when discussing medical training, between violating |shabbat|'s spirit-- which is dispensable for proper instruction-- and actually doing |melakha|; latter should, with no patient at risk, remain |verboten|. Be sure what you're asking.
(b)A |teshuva| called |Melamed Le-Hoiyl| (vol. 2-- |Yoreh Deah|, 52) brings his rabbis' oral tradition saying that |mehallel shabbat be-farhesiya| (public sabbath desecration) only applies if transgression occurs before ten sabbath-observing Jews. Always weigh this against the |safek| of |piykuah nefesh|-- and think twice when complaing about, "being in the middle of nowhere in terms of a Jewish community."
(c)My father's advice on these matters: "If you really want to get through, shut up. If not, pack out right away."

|Be-hatzlaha|.

Shalom Pollack

P.S. Collectively doing something permitted presents no difference to individual transgression-- where allowed. Why fret upon not being,"solely responsible for patient care"?

quote:

Originally posted by batisrael:
This is my first post...
I was hoping someone could help me. I'm a first year medical student, in the UK, and have been encountering all sorts of problems trying to explain why I could not attend lectures on the chagim, and why I need to leave early on shabbat. Now, being that I'm in the middle of nowhere in terms of a Jewish community, they have never had any experiences with this, and did not take kindly to my requests. Now, I am having a meeting with the dean, to explain this strange behaviour of mine, and I want to be perfectly clear about something first. I will be asked about shabbat in relation to my clinical years. As far as I understand it (I have indeed spoken to a few rabbi's about this, but I'm still not 100% sure), I cannot break shabbat, even during the clinical portion of my training, because it still falls under the umbrella of medical education. That is, until I am a junior doctor (resident) I am not solely responsible for patient care, and therefore I am not the one saving a life (pikuach nefesh), and therefore am not permitted to break shabbat (or yom tov) for this... Is that totally correct? I would like to ask more questions about what happens after, however would appreciate answers that relate to medical studies only right now.
Many thanks for your help!

“b)A |teshuva| called |Melamed Le-Hoiyl| (vol. 2-- |Yoreh Deah|, 52) brings his rabbis' oral tradition saying that |mehallel shabbat be-farhesiya| (public sabbath desecration) only applies if transgression occurs before ten sabbath-observing Jews. “

I don’t understand how this pertains to our question.

If there is a Sufaik Pikuach Nefesh to a Yisrael, you can do any Malacha in front of anyone to save him

If there is no Pikuach Nefesh to a Yisrael, then it is Ussur to do any Malacha unless..

Someone is sticking a gun to your head and he wants you to do a Melacha for his benifit or...

Someone is sticking a gun to your head and he wants you to do a Melacha in order to push you off Judaism (like to cut unripened wheat and throw it in the sea) if there is not a Minyan of 10 Jews (this is the only case that 10 Jews are required to give up your life than to Over the Issur.) See Sanhedrin 74 and YD 157 for the Sugya.

Batisrael;

As I mentioned before, you need a specific posek of your own to tell you what to do. Having said that, let me share with you what I did in medical school when I was in very much the same situation as yours. This was in keeping with my posek but it doesn't mean that's what you should do. I'm not a posek.
In the US, during the first two years we learn basic sciences. They are just classroom work like any other college. So unless exams are scheduled on Shabbat there is no problem. I could have requested to take my exams erev Shabbat but I didn't need to.

Years 3 and 4 are clinical years. Where you go to different hospitals and basically learn on patients..."see one, do one and teach one". These are real patients who are sick and you are basically assisting your precepting doctor. My posek told me it was taking care of sick patients and it was pekuach nefesh so I could do it on Shabbat. Except I could not write my patient charts until motze Shabbat.

During years 5 to 7 you are a resident doctor and you are taking care of sick patients. I lived within walking distance to the hospital.
Your posek may be more machmir than mine so don't use me as an example. Don't forget there are thousands of Jews in your situation around the world and they are getting through their medical education programs without compromising their observance. So it's possible.

Thank you all once again for your comments. Let me first respond to Shalom Pollack's comments. Although I must admit that I didn't quite understand or agree with all you had to say, your comment "(c)My father's advice on these matters: "If you really want to get through, shut up. If not, pack out right away."" is quite a harsh one. That being said, this is basically what I have been told by the medical school, so it does represent the overall mentality of those involved in medical education. I had no idea medical school was reserved for secular students alone, or those willing to put their religious observance on hold... quite a pity and a loss for the profession.
My particular program has a clinical component from year one, so sitting quietly in a lecture theatre on shabbat is not the problem. It is really about learning procedures on models, then on each other, and finally using them on patients is what I was specifically referring to.
I am looking for a rav to poskin on these issues for me, as well as trying to further understand the nuances of the halacha. I have found an expert on the subject Dr. Avraham Avraham, author of Nishmat Avraham and one of the world experts on Jewish medical ethics. He wrote a booklet called "Halachot for the physician on the Sabbath and Festivals", which I will be ordering. I included that information for anyone else in a similar situation who might be interested.
Thank you so much Moshe Yisraeli for your inspiring comments. Please let me know how I can contact you privately.

Kol tuv,
batisrael.

BatYisrael,

Glad time was not wasted; comments come only out of complete sympathy. Let me remind you: I am a doctor's son; add also-- one uncle as well as two brothers follow, professionally, dad's footsteps. So maybe some qualifications could be claimed.
Interesting that your first-year medical school curriculum includes patient examinations. My elder brother made Harvard; such was their system. He thought it unique.
What |halakhic| issue can "early introduction" (to clinical medicine) pose? Are you afraid of |issur refuah|?
Please note: when something is not real curing-- like, for example, removing warts or even chewing tobacco-- then no transgression occurs. There are different levels of sickness--|holeh sheyaish bo sakanh|, |holeh she-aiyn bo sakanah|, etc.-- for which different guidelines, how to treat, exist. You're saying |training| might be barred if patient health rests on someone else's shoulders. That does not sound right; truth might, actually, prove reverse-- in my humble opinion.
About |Nishmat Avraham|: writer has said book gathering dust. Its author is named as Avraham-Sofer Avraham, Bayit Vegan 86, Jerusalem; publication data: |Machon Falk-Schlesinger Le-Hayker Ha-Refuah Al-Piy Ha-Torah| (Jerusalem: Falk-Schlesinger Institute for Research of Medicine according to Torah, 5751). Must thank you for reminding me about it; English title mentioned sounds familiar too.
Regarding Rav Chaim's criticism: not everything is always black and white-- someone mentioned inscribing medical records; your viewing treatment as "exercise" also, we'll concede, falls into a gray area. Many |heteyrim| are based upon |sefayk sefayka le-hatiyr|-- double doubts to permit outweigh single doubts to prohibit.
Some |poskiym| hold: |Melakha shelo be-farhesiya| violates |shabbat| just |mi-de-rabanan||. There might be, if this complements our positive commandment |me-deorayta| of saving lives, substantial balance towards |kula|!
That certainly does not put an observant student at disadvantage while undergoing training, such way, only with non-Jews. My advice is, therefore, not to try another medical school-- assuming others require, perhaps before more fellow Jews, similar acts. We will then have the issue of |mumar le-hakhiys|-- desecration looks like it's done antagonizing Jewish law (rather than resulting from ignorance or pressing circumstances).
Please consider. |Be-hatzlaha| again. And |kol ha-kavod| for speaking up.

Sincerely,

Shalom Pollack

quote:

Originally posted by batisrael:
Thank you all once again for your comments. Let me first respond to Shalom Pollack's comments. Although I must admit that I didn't quite understand or agree with all you had to say, your comment "(c)My father's advice on these matters: "If you really want to get through, shut up. If not, pack out right away."" is quite a harsh one. That being said, this is basically what I have been told by the medical school, so it does represent the overall mentality of those involved in medical education. I had no idea medical school was reserved for secular students alone, or those willing to put their religious observance on hold... quite a pity and a loss for the profession.
My particular program has a clinical component from year one, so sitting quietly in a lecture theatre on shabbat is not the problem. It is really about learning procedures on models, then on each other, and finally using them on patients is what I was specifically referring to.
I am looking for a rav to poskin on these issues for me, as well as trying to further understand the nuances of the halacha. I have found an expert on the subject Dr. Avraham Avraham, author of Nishmat Avraham and one of the world experts on Jewish medical ethics. He wrote a booklet called "Halachot for the physician on the Sabbath and Festivals", which I will be ordering. I included that information for anyone else in a similar situation who might be interested.
Thank you so much Moshe Yisraeli for your inspiring comments. Please let me know how I can contact you privately.

Kol tuv,
batisrael.

Quote “Some |poskiym| hold: |Melakha shelo be-farhesiya| violates |shabbat| just |mi-de-rabanan||.”

Are you saying,according to these Poskim, from the Torah, I’m allowed to light a fire on Shabbos, as long as 10 jews don’t see? Who are these Poskim that hold this way?

Quote “There might be, if this complements our positive commandment |me-deorayta| of saving lives, substantial balance towards |kula|!”

If it’s of a Yisrael, then your allowed to save his life against all the Mitzvos besides 3. If not, where is the Mitzvah Asay? (We even have a rule, without Ayvah, then “Ain Maalin V’Ain Moridin, even B’Chol.)

batisrael
it's mosheyisraeli@yahoo.com

Moshe,

My source which states we only class transgressions |be-farhesiya| when done before ten Jews (|Melameyd Le-Hoiyl|, II-|Yoreh Deah|, 52) was given.
That responsa also cites |Hagahot Rabbi Akiba Eger|, |Yoreh Deah| 264, as having been noticed "afterwards" ("|ahar kakh matzati|"). Current |Shulhan Arukh| editions do not include a direct statement, there, on this matter; discussion does, however, concern |mumar le-hakhiys|-- our Scripture's intent relates, his understanding being, to, primarily, |public| violation. Other sources deal with |mehallel shabbat be-seyter| and whether it's considered |me-dioratya| or |de-rabbanan|. Further research required.

Your assumption incidents remain, "without |Ayvah|," allows much. This writer once argued privately regarding Israeli hospitals, in all cases, accepting Arabs.
"|Ayvah|" implies an individual doctor's life found imperiled. |Igrot Moshe| ruled such might be, where physicians are liable (for sums near "hatzi rekhusho") should one refuse treatment, considered |pikuah nefesh|; saving one's self then supersedes sabbath.
Just training worried BatYisrael; don't obfuscate.
Replies from anyone appreciated.

Shalom Pollack

quote:

Originally posted by Rav Chaim:
Quote “Some |poskiym| hold: |Melakha shelo be-farhesiya| violates |shabbat| just |mi-de-rabanan||.”

Are you saying,according to these Poskim, from the Torah, I’m allowed to light a fire on Shabbos, as long as 10 jews don’t see? Who are these Poskim that hold this way?

Quote “There might be, if this complements our positive commandment |me-deorayta| of saving lives, substantial balance towards |kula|!”

If it’s of a Yisrael, then your allowed to save his life against all the Mitzvos besides 3. If not, where is the Mitzvah Asay? (We even have a rule, without Ayvah, then “Ain Maalin V’Ain Moridin, even B’Chol.)

Of course that Farhesiah is 10 Jews. That is brought in the Gemarah in Sanhedrin I brought down. The NAfka Minah for that I already wrote, or if he's considerd a Mumar.What I can't figure out why it would be a D'rabanan only.

I never said that there is no cases of Ayvah, I just said that there is no mITZVAS ASay to save a life. If there is Ayvah, then you can save yourself even in front of a million Jews.

I also can't understand why losing half your money is a right to be Michalel Shabbos? don't you need to give up all your money not to be Oiver a LAv?