When the University of Pennsylvania’s president Liz Magill was forced to resign her position due to her equivocal stance regarding antisemitic harassment on Penn’s campus, J. Larry Jameson, MD, PhD, was soon announced as her interim successor. Jameson had served as executive vice president of Penn’s health system and dean of the Perelman School of Medicine since 2011.

Jameson is a prominent molecular endocrinologist, author of over 350 scientific articles and chapters, and an editor of the venerable Harrison’s Principles of Internal Medicine. He has garnered a reputation as a strong, thoughtful leader, criticizing U.S. News & World Report’s medical school methodology rankings and joining Harvard, Stanford, and Columbia in refusing to participate in the rankings process. (After ending its participation, Penn rose from No. 6 to No. 2 on the 2023-2024 U.S. News Best Medicine School Rankings.)

In addition, under Jameson’s leadership, Penn’s medical school last year entered a partnership with historically Black colleges and universities in an effort to attract students from racial groups that are underrepresented in the medical field.

Jameson has been lauded by senior faculty and seems to have all the right stuff to assume interim and perhaps permanent leadership. He has denounced calls for genocide as a form of hate, writing, “I want to reiterate that every person at Penn should feel safe and be secure in the knowledge that hate has no home here.” But Jameson faces three significant challenges in the days and months ahead.

The first is to keep Penn academically free from external forces and undue influence by wealthy donors and graduates of Penn’s prestigious Wharton School of business. Already, billionaire Marc Rowan, who co-leads Wharton’s board of advisors, is probing Penn’s operations, asking questions about their teaching methods, faculty hiring practices, free speech, and political orientation.

The deep-pocketed donor who started the successful effort to remove Liz Magill and board chair Scott L Bok submitted a list of 18 questions in an email to Penn’s trustees titled “Moving Forward.” There is fear among Penn’s faculty that Rowan and other philanthropists will attempt to wrest control of Penn’s direction and turn it into something other than a university, or at least force the university to be more responsive to pressures from donors. Likewise, there is a congressional movement to hold private schools like Penn accountable for their actions across the board.

One of the questions Rowan is seeking to answer is: “What is the University’s policy on direct and indirect foreign donations from countries/individuals and, specifically, what is the policy on publicly identifying any such contributions? Similarly, what is the University’s policy on direct and indirect foreign donations to student organizations?”

This is similar to a question posed to Magill at the Congressional hearing. But whether Penn is deeply financially entangled with countries openly hostile to Jews, or beholden to wealthy Jewish individuals stateside, makes little difference. Jameson will have to disentangle this nebulous web of influence as one of his first orders of business.

The second tall order is to immediately restore safety for Jewish students – indeed, for all who feel threatened on campus – and take a firm stand against mounting antisemitism on college campuses. Here is where medical leaders like Jameson can shine, contributing to the reversal of antisemitism not only at his university but also in the medical profession and U.S. medical schools, which has a deplorable history, particularly in the early and mid-20th century.

Antisemitism did not begin to fade until the end of World War II, as the horrors of the Holocaust led to a broader societal acceptance of Jews. In New York State, the Education Practices Act (1948) set a precedent for other states to pass legislation to eliminate discriminatory admissions practices. As the wave of antisemitism began to lessen and the need for physicians grew, medical schools and graduate medical education programs started to remove the quota systems, and most were eliminated by 1970, according to medical historian Edward C. Halperin, MD, MA, who is also Chancellor and CEO of New York Medical College.

But the legacy of these quotas had long-lasting effects on the medical profession and on the Jewish community. Traces of antisemitism persisted in medicine into the late 20th century and beyond. Shocking antisemitism at the University of Toronto’s medical school was recently uncovered by Jewish-Canadian physician Ayelet Kuper, MD, DPhil. Her account was published in Canadian Medical Education Journal. Just imagine how doctors and doctors-in-training holding these vile beliefs treat or intend to treat Jewish patients in their practice.

Although antisemitism in the medical profession is widely condemned, and diversity and inclusion are key priorities for many medical schools and organizations, the history of antisemitism serves as a reminder of the need for vigilance against discrimination in all its forms.

This leads to the third challenge for Penn, which essentially encapsulates the first two concerns: can the new administration self-govern itself and ease tensions over antisemitism? This may be difficult to accomplish given that the abolition of the Jewish quota in U.S. medical school admissions policies was largely driven by forces external to academic medicine, such as governmental and societal interventions rather than proactive changes within universities themselves.

In comparing the existence of medical school quotas for Jews to the present alleged discrimination against Asian-Americans – that is, viewing Asians as the “new Jews” insofar as both groups have been targeted as “over-represented” at elite institutions – Halperin said, “It is unlikely that the system will reform itself from within. It is far more likely that higher education will circle the wagons to defend itself against allegations of bias. If change is to occur, it will need to come from outside the higher education system.”

Perhaps a highly-touted physician like Jameson, with demonstrated leadership skills and moral clarity, as opposed to his predecessor – an attorney who tried to legislate morality and whiffed badly when asked to address the evil of genocide – will have much better success quelling campus protest at Penn while preserving the freedom of academic thought and discourse that can serve as a model for all universities to follow.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of Every Story Counts: Exploring Contemporary Practice Through Narrative Medicine.