In Israel, it's not just Jewish mothers who want their kids to pursue a career in medicine.
"Like a Jewish mother who wants her kids to be doctor, an Arab mother in Israel dreams that her son will become a doctor, or if not that then a pharmacist," says Riad Agbaria, director of the School of Pharmacy at Ben Gurion University of the Negev.
The dream seems to be coming true. In 2011, Israel had 6,400 pharmacists, of whom 55 percent were Jews and 45 percent Arabs.
Among Israeli pharmacists under age of 35, Arabs already constitute the majority.
Pharmacist Nimar Ghazawi says that the Israeli Arab young flock to the profession because they lack decent alternatives.
"It's not like every Arab woke up one morning and decided to become a pharmacist," he says. "In engineering and finance, the chance of finding work is close to zero." Despite making up 20 percent of the Israeli population, he says, Arabs in high tech are “few and far between."
The fact that pharmacy has become a booming profession in the Arab sector wouldn’t cause most people to think twice if the influx of new students into the field didn’t stretch the boundaries of demand, with negative effects on established pharmacists.
How has the field drawn such a massive oversupply of applicants?
In Israel it is only possible to study pharmacy at the Hebrew University in Jerusalem and Ben Gurion University in Be'er Sheva, both of which have high admission standards – nearly 200 points higher than the average on the standardized psychometric exam. BGU applications must also attend an admissions interview, just like applicants to medical school.
Approximately 150 pharmacists graduate annually between the two schools– enough to meet market demand. But the many aspiring applicants rejected by both universities find alternatives for pursuing a career in pharmacy and then crowd the market with competition.
The 1994 peace treaty between Israel and Jordan provided the opportunity for Israeli Arabs, which has become a particularly popular option since 2004 because admission standards are lower. Even though Jordanian universities are significantly more expensive - $10,000 per year, not including living costs – hundreds of Arab Israelis are choosing to enroll.
Based on Health Ministry data, 207 new pharmacist licenses were issued in 2010. Of those, 44 percent went to graduates of Israeli educational institutions, 35 percent to graduates of Jordanian schools and the remaining 21 percent to applicants educated in Europe or the United States.
Agbaria estimates that today hundreds of pharmacists educated in Jordan are practicing their profession in Israel. Within the next three years he believes another approximately 2,000 pharmacists trained in Jordan, Germany and Eastern Europe will join them.
"The market needs between 150 and 200 new pharmacists per year," Agbaria says. "Already there are many more than that. We’re talking about a real national problem. These are educated people who can't find work in their field. Some of them are already taking retraining courses to become chemistry teachers, competing with Arab teachers for job openings, creating a problem in another profession."
Sending out resumes without a response
Maha Badran, 25, from the northern Arab Israeli town of Deir al-Asad has dreamt of becoming a pharmacist since she was 12 years old. Today she is experiencing all the hard knocks the field has to offer. She graduated from Hebrew University about a year ago, but still hasn't found a permanent position. For the time being she moves between clinics as a temporary employee in pharmacies belonging to the Israeli health maintenance organization, Clalit.
"Compared to my friends who studied pharmacy with me, I'm the lucky one," Badran says. "Job opportunities up North, where most Arab students return after graduation, are very limited because the market is flooded with pharmacists coming from abroad. Those of us from Israeli universities find ourselves sending out resumes without any response."
According to Badran, the problems already start at the internship stage. "At the Israeli HMOs, they prefer graduates of Israeli universities, but it is still very difficult to find an internship. There are even those willing to intern without salary, which just makes things worse for all of us."
Badran advised her 18-year-old brother not to pursue the profession she chose for herself. "Our mentality is that if you don't become a physician than you should become a pharmacist – like these are the only two professions," she says.
"People think that I earn a lot of money, but that isn't true." Badran refuses to divulge how much she earns, but a brief, unscientific survey among Israeli HMOs shows that a starting pharmacist usually earns between NIS 24 and NIS 28 per hour, sometimes less.
Shadi Khouri, a Haifa pharmacist who works for the Leumit HMO, graduated from the Hebrew University pharmacy program 12 years ago and earns NIS 65 an hour.
Khouri says that it is easier for Jewish pharmacists to find jobs at the major drug companies. "Even though they don't say so openly, the drug companies prefer hiring people with military backgrounds," he says. "Something like 80 percent of Arab pharmacists work behind the counter, while 80 percent of Jewish pharmacists work for the drug companies. It's unfortunate. Whoever in the pharma industry would give Arab pharmacists a chance would gain some diligent and professional workers."
Heartwarming incidents at the pharmacy counter
Ghazawi, 30, completed his studies in Jordan five years ago and today lives with his wife, also a pharmacist, in the Arab village of Kalansua. Beyond the difficulty of finding a job, he has first-hand experience with racism in the field.
"Sometimes, when I don't give people medication because they don't have a prescription or their prescription has expired, they make racist comments," says Ghazawi. "Right now I work at a pharmacy in Pardesiya, and I don't have to deal with racist incidents there. But when I worked in other places, I had to deal with these types of comments. In one case, a customer said, ‘they should toss you into Gaza.' That really hurt me. I almost cried. I said to myself, 'I studied and invested so much for this, so that someone could come into a pharmacy, insult me and leave?"
Ghazawi reports that other customers present at the incident told him not to pay attention to the man or yelled at him that he should be ashamed of himself. "Unfortunately,” he says, “a lot of people kept quiet. These types of incidents are more common when there are tensions between Arabs and Jews".
"On the flip side," Ghazawi continues, "there heartwarming incidents at the pharmacy counter as well. For example, when I advise people about medications or side effects and they rely on me – that gives me a lot of satisfaction. The pharmacy where I work is Arab-owned, and some of my co-workers are really wonderful Jews from all different ethnic backgrounds. I feel like I belong.”
Ghazawi admits that coming from a Jordanian university puts him at an initial disadvantage. "The first question people ask during job interviews is, 'where did you study?' They prefer people who studied at Israeli universities. Employers think there must be some sort of reason why you studied abroad, even if you received an academic scholarship, like I did.”
Ghazawi too says that he wouldn’t advise anyone to study pharmacy today, on account of the crowded market. "It’s difficult to get your foot in the door,” he says. “Pharmacists from the North are forced to head to the center of the country if they want to find work.” Those that graduated five years ago, like him, are doing ok. Those who graduated ten years ago are faring even better. But the future? “The future looks cloudy," he says.
"We recognize the difficulties in finding internship and job opportunities, particularly in the North,” says Ariel Orbach, chairman of the Pharmaceutical Society of Israel. “But these problems don't exist in other areas [of the country], Orbach says. "I wouldn't use the term ‘glut’ to describe the situation."
Orbach says that, starting in January 2013, there will be one comprehensive licensing exam, administered by the Pharmaceutical Society, for all graduates from around the world who want to practice in Israel, similar to a bar exam for law students.
“The goal is to create a high, unified standard among pharmacists, regardless of where they studied,” he says. “We believe that a professional pharmacist who provides appropriate advice is a lifesaving and life extending figure."
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