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Specialists at government hospitals around the country worked on-call night shifts on Monday, in some cases for the first time in many years, after medical residents finally put their resignations into effect. Some senior physicians did half shifts of "just" 12 hours, while others put in full shifts of 24 hours each, the norm for residents.

Internist and hematologist Dr. Moshe Mittelman, who is director of the Internal Medicine A ward at Ichilov Hospital in Tel Aviv, spent Monday evening and last night doing his first on-call shift since the late 1980s. "I feel very badly about the situation we're in. It's a black day for our health system," Mittelman said on Monday.

"The situation should light up a big question mark for everyone connected to medicine, and the political leaders should ask themselves, 'Where did we go wrong?' The residents are good, dedicated people who went into medicine because they wanted to engage in medicine, and when they say they've had it, they need to be heard," Mittelman added.

Of the seven residents in Mittelman's department, four resigned. Of the three left, one is pregnant and a second cannot do night shifts due to illness. That leaves one resident and four specialists to care for the 41 patients in the ward's rooms and corridors - more than 100 percent capacity, even before the winter when inpatient rates soar.

Mittelman believes that having senior physicians filling in for the absent residents is only a stopgap measure. "I personally love being with people and caring for patients, but it's only a temporary solution, for around three days," he said. "After that, the hospital administration will have to come up with a solution, to close or combine departments or to bring in reinforcements.

"Besides that, for me, too, the on-call shifts come at the expense of other things," Mittelman continued. "This morning, for example, I cancelled a research meeting as well as another meeting on academic issues."

Dr. Moshe Salai, director of Ichilov's orthopedics division, helped fill in for absent resident in the emergency room on Monday, among other places. "I did all sorts of things, like replacing plaster casts, which I haven't done regularly for a very long time," Salai said.

On Monday, he convened a meeting of his remaining staff and asked them to be prepared to share the burden. "At present I don't have a lot of pressure but it's only a matter of time before it happens, and then we could run into problems," Salai said.

Kfar Sava's Meir Hospital decided to call in the troops: Hospital administrators asked the Israel Defense Forces to waive reserve duty for specialists and residents scheduled for imminent call-up. "The concern is of getting into chronic under-supply of inpatient services," hospital director Dr. Eitan Wertheim said.

"Hospitals aren't meant only for immediate lifesaving; they provide innumerable additional services such as operations, which will need to be rescheduled at other hospitals in the next few days, and this will also cause them to collapse. There'll be a domino effect," Wertheim warned.