Women Leaders at MSK: Monika Shah

Monika Shah, MD, infectious disease specialist, Vice Chair of Education in the Department of Medicine, and Chair of Memorial Sloan Kettering’s Graduate Medical Education Committee, is everything you’d want in a good friend. She’s warm, compassionate, and easy to talk to — someone who’s quick to smile and always gets the joke. She’s also an exceptional physician and mentor — and one of the powerhouse leaders of MSK’s response to the COVID-19 pandemic.

Her childhood in suburban Chicago was the American dream realized: Her parents immigrated from India and worked hard to build a good life for their two children, who grew up in a welcoming middle-class neighborhood among a vibrant network of close family friends.

“There weren’t many Indians or immigrants in my neighborhood, but it didn’t matter,” remembers Dr. Shah. “We were a typical family, but with a slightly different background.”

Her father, trained as a chemical engineer, worked for a car parts manufacturer and her mother, who had a degree in sociology, worked the night shift on a factory floor. It was understood that hard work was part of life — for parents and kids.

Although they had few relatives living in the United States, they had a huge extended family in India — Dr. Shah counts 54 first cousins — with whom they were very close. But as she points out, “When your family is somewhere else, you find a new family.” The Shahs did exactly that, building a strong circle of friends that served as a surrogate family and ensured busy weekends and frequent celebrations. When Dr. Shah thinks about her childhood, she remembers laughter.

Growing up, she was an “introverted extrovert” who enjoyed gatherings with friends but was happiest holed up at the library. Yet, she went on to join the debate team in high school and become the editor of the school newspaper.

“I still prefer to be behind the scenes,” says Dr. Shah. “But I want to have a voice.”

A Great Desire to Help

Dr. Shah not only found her voice in high school, she also found purpose. She volunteered to be a hugger for the Special Olympics — one of the people who joyfully embraces the young athletes after an event — and felt herself connecting with the kids in an unexpected way. “I wanted to take care of them,” she remembers. “Some of them had serious medical issues that I learned about while volunteering. It started me on my path to medical school.”

She attended the University of Illinois as a pre-med major and continued to find ways to take care of people. She led the local chapter of a national nonprofit dedicated to helping the homeless and served on the organization’s board. She also volunteered to help the director, who was a paraplegic, by cooking meals and running errands for him. 

“My interest in medicine was always about helping people, finding those compassionate connections,” Dr. Shah says. “Caring for patients is what motivates me.”

She studied medicine at Washington University in St. Louis, Missouri. She liked everything and found it difficult to decide which medical specialty to pursue. In her final year, she did an elective in infectious diseases at a community hospital about 30 minutes from her parents’ home and was inspired by the doctors’ clinical and diagnostic skills, and the way they related to patients. Suddenly, her path was clear.

A Path to the Future

While in the second year of her residency at New York-Presbyterian/Weill Cornell Medical Center, she received a message on her pager that asked simply: “Can you please call Dr. Kent Sepkowitz at MSK?”

Dr. Shah had rotated through MSK but didn’t know Dr. Sepkowitz. Kent Sepkowitz, MD, now MSK’s Deputy Physician-in-Chief for Quality and Safety, had reached out to offer Dr. Shah the role of Chief Resident in Medicine, after she completed her residency. She accepted the offer and, in this role, was responsible for the educational experience of a large group of residents. She also learned how infections, including HIV, impact cancer patients. Dr. Sepkowitz was an early, and important, mentor.

After completing a fellowship in infectious diseases at MSK, Dr. Shah moved to the Infectious Disease Service at Harlem Hospital.

There, she oversaw a clinic for mothers infected with and children exposed to HIV. She was the inaugural physician caring for adolescents who had been HIV-positive since birth and were aging out of Pediatrics. In addition to treating patients, Dr. Shah obtained funding to expand the clinic’s services, hiring a social worker and psychologist and working collaboratively with OB-GYN and Pediatrics.

“Sometimes the social issues were so profound you couldn’t get to the medical issues,” she says. “If people came to the clinic hungry, that needed to be addressed first.” She continues, “I was proud of my work there. I felt I really made a difference.”

The work was rewarding, but when opportunity called — again, in the form of Dr. Sepkowitz and George Bosl, MD, then the Chair of the Department of Medicine at MSK— Dr. Shah listened. Dr. Bosl offered her a new role overseeing the Department of Medicine’s training programs for students, interns, residents, and fellows. She rejoined MSK’s Department of Medicine and the Infectious Diseases Service in 2008 and became an Associate Program Director for the Weill Cornell Internal Medicine Residency Program.

“All of these varied experiences as an MSK faculty member were so formative to my growth as a physician educator and leader,” she says. “I learned as much as I taught.”

In 2016, she was tapped to chair the Graduate Medical Education (GME) Committee and now oversees all GME programs. In addition to her work in education, Dr. Shah is an active member of the Infectious Diseases Service, providing inpatient consultations and maintaining a large outpatient continuity practice, which includes several HIV-positive patients that she’s treated for years.

A Year-Long Blur

When COVID-19 first struck New York City, Dr. Shah was brought into the Hospital Incident Command System (HICS) to help lead and support a wide variety of efforts, including those of Mini Kamboj, MD, Chief Medical Epidemiologist.

An immediate and pressing concern was COVID-19 testing and determining which patients should be tested first with the limited supplies available. Testing was only the beginning of hundreds of new protocols that had to be written and then shared with staff in a matter of days — an enormous project that was overseen by Dr. Shah and Elizabeth Robilotti, MD, Associate Chief Medical Epidemiologist.

“I worked with Marketing & Communications to conceive of and quickly build the Clinical Guidance section on OneMSK, where we housed all the COVID-related protocols,” says Dr. Shah, who learned how to update OneMSK so she could post many of the protocols herself. “Our clinicians needed timely material that they could easily retrieve in the moment. Sometimes, I edited and reposted documents five times a day because the protocols were changing so quickly.”

Once COVID-19 vaccines became available, Dr. Shah was tapped again by Dr. Kamboj, who was also Co-Chair of the Vaccine Task Force, to help implement a prioritization framework for vaccinating employees. It was a grueling job.  

“[While] working in ambiguous circumstances, with little actual data, we made the best decisions we could to keep things moving, with constant re-assessment,” she explains. “That principle has defined our work throughout the pandemic.”

She also developed the COVID-19 Vaccine Care Team, recruiting and overseeing chief medical residents and medical oncology fellows to support employees who experienced side effects from the vaccine. Staff reached out to the team via pager with their questions and concerns. 

Dr. Shah was and is a tireless champion of the COVID-19 vaccines. She spoke at numerous information sessions for staff, gave interviews, recorded videos about the safety and efficacy of the vaccines, conducted informal “walkabouts” on units where she answered employees’ questions one-on-one, and responded to thousands of emails from staff.

“It was a year of little moments that ended up making a huge difference,” she says.

She continued leading the Graduate Medical Education program throughout the pandemic. “Our educational programs had to reorganize how we incorporated trainees into care and how we recruited and educated them — a lot had to go virtual seemingly overnight,” she recalls.

At the same time, there were various immigration and travel bans resulting from the pandemic that directly impacted MSK’s trainee workforce and recruitment. “My team had to understand the issues, communicate the issues, and help to mitigate them,” she explains. “I am so proud of the resilience of our entire GME community, our trainees especially.”

Looking Beyond COVID-19

The lessons of COVID-19 were harsh, but there were important takeaways.

“One thing we’ve learned is that we can be nimble,” says Dr. Shah, remembering weeks of work that were condensed into days. She also saw the benefits of “leading with kindness,” particularly during such an emotional time. And she is grateful for the “incredible partners” she had every step of the way, including Dr. Kamboj, Deborah Korenstein, Marcia Levine and Elizabeth Rodriguez, who were key partners in her HICS-related implementation work, as well as her colleagues on the Infectious Diseases Service, and many others. She appreciates the “small moments of levity” they shared that made her job easier.

At the beginning of March 2020, her husband, also a physician who worked on the frontlines, told their three sons, who are now 20, 16, and 13 years old, “We’re not going to see mom for the next six months and that’s okay.” She appreciates how well her family adapted — it reminded her of her childhood, with her own hardworking parents and their independent children.

“My boys really stepped up,” she says. “My oldest son is a gourmet cook now — we’re sad that he’s back at college. He did a lot of cooking for us!”

Women Who Changed the World

“My initial connection to medicine was sparked by a deep desire to give back,” says Dr. Shah. There are few more celebrated examples of “giving back” than Mother Theresa, the Albanian-born nun who dedicated her life to serving the poor of India. Her humanitarianism left a great impression on Dr. Shah.

Dr. Shah is also an admirer of Rosa Parks, who helped initiate the civil rights movement in the United States when she refused to give up her seat to a white man on a Montgomery, Alabama, bus in 1955. Dr. Shah appreciates her demeanor as much as her actions. “Rosa Parks was a quiet introvert,” she says. “She proved you don’t have to be the loudest voice in the room to be effective.” It’s a realization that resonates with Dr. Shah.

“I am never the loudest, but I’m still effective. And I make my voice heard.”