Training programs conducted at Israeli hospitals for Israeli medical students enrolled in Hungarian universities are illegal, the Council for Higher Education says.
The programs were launched in 2006, and hundreds Israelis studying medicine in Hungary participate in them every year. But a few days ago, CHE Director General Moshe Vigdor informed the hospitals owners - the Health Ministry and the Clalit health maintenance organization - that the programs are not legal.
The CHE's new policy was formulated in response to a Haaretz report six months ago.
The programs are extremely lucrative for the hospitals, which not only get paid for each student's training, but also benefit from a permanent pool of extra medical staff. Consequently, Israeli hospitals have been vying for students who study medicine in Hungary.
Clalit operates training programs for sixth-year medical students from Hungary at its hospitals, including Soroka Medical Center in Be'er Sheva and the Rabin Medical Center in Petah Tikva. Similar programs also opened in recent years at most state-owned hospitals, including Sheba Medical Center in Tel Hashomer and Rambam Medical Center in Haifa. Some hospitals even offer the students medical insurance, meals and housing assistance to encourage them to register for the training programs.
Of the roughly 600 Israeli students studying medicine in Hungary, an estimated 200 are registered in training programs at Israeli hospitals.
But Vigdor said that since the training programs are conducted in Israel and are part of an academic degree program, they require the CHE's authorization, under Article 25 of the 1958 CHE law. This clause stipulates that the CHE must authorize any study program that leads to the conferral of a degree or that provides academic credits toward obtaining a degree.
"These medical studies, featuring clinical training in hospital departments, constitute a significant portion of the students' medical education," Vigdor wrote.
Since the clinical training conducted for Israel students at Israeli hospitals is under CHE jurisdiction, training programs for students from foreign universities conducted at these same hospitals should also be authorized and supervised by the CHE, Vigdor's letter argued.
"In view of these facts," he concluded, "clinical training undertaken in Israel by students who are enrolled in institutions of higher learning in Hungary, without CHE authorization, is illegal." The letter was sent to both Health Ministry Director General Prof. Roni Gamzu and Clalit Director General Eli Depes, and Vigdor invited them to meet "in order to examine the steps that must be taken to straighten out this matter without further delay."
The CHE is not actually authorized to stop training programs for overseas students in the country's hospitals. But it is authorized to decide that medical degrees conferred by Hungarian universities won't be recognized in Israel if training programs at Israeli hospitals continue without proper authorization and supervision, a source familiar with the issue said.
Until now, the CHE has recognized medical degrees obtained by Israeli students in Hungary, and the Health Ministry has conferred licenses to practice medicine on graduates of Hungarian programs who passed professional exams administered in Israel.
"This is a serious complication, and the CHE has a problem," a senior health system official said. "If the training programs for students from Hungary are illegal, it will have to file criminal suits against all the doctors who take part in the training."
"So far, the CHE has refrained from setting standards for clinical training," he added. "It is time for it to do so, and to regulate these important programs."
Sheba Medical Center director Prof. Zeev Rotstein said that "clinical training in Israel for Israeli students from Hungary enables them to connect with patients who understand their language. Such training makes them better health-care workers, and as a result of this training, the percentage of Israeli physicians who studied in Hungary and then returned to Israel to work has grown, and the quality of these physicians' training has improved.
"These are Israeli veterans of the Israel Defense Forces, and the state needs them to work as doctors here," he added. "The CHE is supposed to serve the State of Israel, and it should find a way to authorize these training programs."
The Haaretz report that sparked the uproar described the objections raised by the heads of Israeli universities to an international medical studies program run by Sheba Medical Center in conjunction with St. George's University of London Medical School at the University of Nicosia. This year, 30 students are enrolled in the program, which offers a medical degree after four years of study, and are now studying in Cyprus.
Questions about that program raised the issue of the legality of the training programs for students enrolled in Hungarian institutions. Ironically, however, the Nicosia program is on its way to winning CHE approval.
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