Medical students prefer not to intern in Israel's periphery
Some paid large sums for spots at 'better' hospitals in central Israel in the past; northern, southern hospitals desperate for interns.
By Yuval AzoulayMedical school students consider Tel Aviv's Ichilov Hospital to be the most desirable location for internships during their seventh year of study, a Health Ministry report has discovered.
Beilinson Hospital in Petah Tikva and Kfar Sava's Meir Hospital were also close to the top of the list, while hospitals in Afula, Nahariya and Ashkelon came in last, out of 19 state hospitals.
In the past, students used to "swap" internships at the more sought-after hospitals for money, but the Health Ministry says it has put a stop to this practice.
The report says that last year some 139 medical school students asked for internships at Ichilov and 123 requested Beilinson. "The best hospitals are always in the center [of the country]," says Miki Cinori, 28, of Tel Aviv University, who is interning at Ichilov. "Working in the South or North is like working overseas.
"As a future doctor, I won't find the services Ichilov offers at other hospitals. As a new doctor, I want to be exposed to the maximum amount of knowledge, instruments and advanced technologies. Most of my friends prefer to do their internships at one of the hospitals in the center. Ichilov is good for both patients and doctors, as far as the conditions and work environment are concerned."
The smaller hospitals farther away from the Tel Aviv area are desperate for interns. "It's a problem for the entire periphery," says Dr. Shimon Scharf, director of Ashkelon's Barzilai Medical Center. "There is a shortage of doctors, and here it's most acute. Interns could do a hell of a job here."
He's furious, but not surprised by the report's findings. "The fact that they're releasing these figures now is like adding insult to injury," says Scharf. "The state doesn't distribute personnel in a logical manner. The hospitals in the periphery are harmed, and now they're rushing to advertise it. It gives periphery hospitals a negative image, as though they are less popular, and therefore not as good."
Dr. Michael Dor, executive head of the Health Ministry's medical administration, says many students consider their chances of finding work following their internships, and whether it will likely be a well-paid position, before choosing a hospital at which to intern. "They look at the prospects of private practice after their hospital work," says Dor. "If a doctor works in a hospital and doesn't make a lot of money, he will want to complement his [hospital salary] with private work. In the periphery, there is not a lot of that, so they would prefer to come to the center from the beginning."
A medical official in the South illustrates the situation for the outlying hospitals. "We hardly have the money to buy medical equipment, and we can't even consider building a new building in the next few years [like better-funded hospitals can]," says the official. "We can't tempt medical students to do their internships here, although we want to. Meanwhile, central region hospitals have various funds full of money and give interns perks and benefits, such as pay increments, grants, rent assistance, etc. We're not attractive."
Scharf suggests changing the system. "The internship is considered a study year, and the students can be forced or told where to go, then given some incentive or scholarship," he says. "I interned at Sheba [Medical Center in Tel Hashomer], and when they asked me to go to Wolfson [Medical Center in Holon], I didn't hesitate, because of my love for medicine. It all begins and ends with leadership."
The students are allotted internships in a lottery supervised by the Health Ministry. The most desirable places ¬ the hospitals in the Tel Aviv area ¬ are given out first in the raffle.
In some cases, students have "sold" their internships at a more desirable popular hospital to those whose names did not come up in the lottery. "Students charged as much as NIS 50,000 to swap an internship," says a Health Ministry official. "Students who got a place in a popular hospital could sell it to another who found a place in a peripheral one. We put a stop to this practice."
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CAN YOU DIRECT ME TO A HOSPITAL IN THE NORTH -ITS A GOVERNMENT HOSPITAL CALLED REBBECCA ZIV IN SFAT -SAFED " THE CAPITAL CITY OF THE GALILL IT DOES EXIST -BUT HOW LOW ON THE SCALE - WHERE ARE THE MINISTERS FOR THE DEVELOPEMENT OF THE FAR FAR NORTH -NOT AFULA HADERA BUT NORTH IN ZEFAT SAFAD SFAT YOU NAME IT ITS THERE NO ROADS NO RAIL NO FLIGHTS -GREAT COUNTRY UPPER GALILEE JACK. [any interns ]
First-off, I don't know of any doctors who are guilty of "money-grubbing." Here in the US, the challenges to doctors in terms of long hours and over-regulation by money-grubbing insurance companies are major issues. God bless their dedication! The problem is the Health Ministry and the system for choosing internships. They should look at the Internship Matching system employed here, wherein the hospitals - all of them - match applicants to their needs and standards. The students should be required to apply to hospitals in all three areas of the country, since not all will be selected for the Center. This would enhance the quality of medical care and training throughout the country.
"The doctor simply prescribed some banana-flavoured penicillin and he was as right as rain within days." Glad to hear it A sick kid is no joke
"Anyway Hope your kid got through it alright" He did indeed, WWACD - thanks for the kind thought. In the old days he would have had to stay in an isolation ward for weeks on end. The doctor simply prescribed some banana-flavoured penicillin and he was as right as rain within days. I offered a grateful prayer for Sir Alexander Fleming.
As a physician in Israel, I can attest that the desire to be paid for my investment in learning as well as the day to day difficulties is not "moneygrubbing". It is no wonder that there is a nationwide "braindrain" of people being pulled by more attractive salaries and arguably less rigid educational requirements to get into the high tech sector. It is not an embarrasment to want to provide for your family.
Clickfool, doctors in Israel aren't paid as they are abroad. Most work for what the Americans call HMOs and are paid an average salary in Israel's socialised medicine structure. They still have to do the many years of study and places at medical schools are limited and competed for. Israeli medicine is known to be of the highest standard.
"The finest doctors are those who are called to the profession to help their fellow man. Money-grubbing should be way, way down their list of priorities" Doctors are amongst the smartest, busiest, most highly trained professionals with better than 7 years of intense studies and many sleepless nights thereafter. Money-Grubbing may not rank high with these amazing men and women but you don't want someone that frittered away his/her youth studying and provides this most important of services to barely be able to make ends meet with a two child family. Before my daughter was born, we had the most amazing pre-natal doctor I could imagine. I once got into a conversation with him about cars during which he expressed amazement at the amount of people able to buy a BMW in Israel. WTF!? The man was at the top of his profession!? Anyway Hope your kid got through it alright God Bless
"If a doctor works in a hospital and doesn't make a lot of money, he will want to complement his [hospital salary] with private work." The finest doctors are those who are called to the profession to help their fellow man. Money-grubbing should be way, way down their list of priorities. Medical colleges also produce far too many doctors without a true aptitude for the work. Medicine requires unusual qualities - great empathy, a yearning love of humanity and a quality of intuition which is close to shamanism. Not every person possesses these qualities, and not every person who'd like to be a doctor should be trained to be a doctor. On a personal note, about five years ago my son developed a very high temperature and I took him along to our doctor. He immediately diagnosed scarlet fever - without the usual symptoms being present, and though scarlet fever is now incredibly rare. A day later the typical symptoms arrived. I was amazed by this doctor's talent and shamanic abilities.