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The health system is bracing for the absence of about 200 medical residents at hospitals across the country, whose resignations go into effect today. The resignations of an additional 300 or so residents will take effect later this week.

The residents submitted letters of resignation last month to protest the new collective bargaining agreement between the state and the Israel Medical Association, which represents the country's physicians in wage negotiations. The residents claim they did not receive fair representation in the salary talks, and that their main contract demands were not met.

A number of efforts to avoid the mass walk-out are under way. The Tel Aviv district attorney's office yesterday submitted to the National Labor Court, in Jerusalem, an emergency request for restraining orders against the residents through the IMA and Mirsham, a nonprofit organization that serves as the residents' trade union.

Representatives from the IMA, the Histadrut labor federation and the Finance Ministry met at treasury offices in Jerusalem to review the main demands of the residents who gave in their resignation letters. Finance Ministry officials said they have no intentioning of reopening the contract they signed with the IMA and conducting new talks - but in fact discussions about possible amendments and clarifications to the wage agreement have been taking place for several days in an effort to appease the residents.

The state is asking the court to issue injunctions that will prevent the resignations from going into effect on the grounds that they constitute a collective resignation. The district attorney's office wants the labor court to state in its injunction that any physician who does not report to work starting Wednesday after filing a letter of resignation "be considered a participant in an illegal and unprotected strike, with all that this entails."

As an alternative, lawyers are requesting injunctions that would require some of the residents who have handed in their letters to work until December 4, in order to lessen the shock of the immediate absence of so many residents at once. Lawyers in the Ministry of Health have begun contacting residents to ask whether they would consider postponing their resignations.

The National Labor Court is expected to discuss the state's request today.

According to Health Ministry officials, 73 percent of the 734 resignation letters will go into effect starting tomorrow. They say that 30 of the physicians who submitted their resignations were specialists, not residents.

The ministry said the hospitals that will be most affected by the resignations are Tel Aviv's Ichilov, Sheba at Tel Hashomer, Meir in Kfar Sava, Beilinson and Schneider Children's Medical Center in Petah Tikva, Assaf Harofeh in Tzrifin, Wolfson in Holon, and Rambam and Bnei Zion in Haifa. The gynecology, maternity, orthopedic, pediatric and surgical wards are expected to be the hardest hit by the absences.

"This is a complex matter, and we don't know what its results will be, but it is necessary to prevent damage to one of the state's most vital systems," Health Ministry director general Dr. Ronni Gamzu said yesterday about the state's efforts to manage the situation.

"We are at the start of a critical, complex and fateful week in terms of the public inpatient system. We must guarantee that alongside dialogue with the residents, we avoid significant damage to the hospitals. There is a risk that human lives will be affected," Gamzu added.

A number of hospital department heads have said they will have trouble operating their departments if their residents leave.

Meanwhile, the Health Ministry and the affected hospitals are gearing up for the possible walk-out. Hospitals will be on an emergency footing. Each department will have its own work plan, based on the number of doctors available. Elective and non-emergency surgery will be canceled, outpatient clinic services will be cut back, midwives will be added to maternity wards and specialists will be required to do on-call night shifts. The ministry is examining the possibility of closing some internal medicine wards and combining certain wards.