Matan Uriel from Moshav Carmei Yosef did everything he could to prepare himself for medical school in Israel. When he finished his army service at 23, he received an excellent score of 729 on the psychometric exam and worked hard to improve his matriculation exam scores.
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“I got an average of 107, but I was still several points from what I needed to be accepted,” he recalls. “I wrote letters to the universities, but it didn’t help.”
Uriel took the exams needed to apply to European medical schools. He did well on those, winning acceptance to three universities and choosing to attend Semmelweis University in Budapest.
At 26, he is now in his second year, but doubts he will be returning to Israel to practice medicine. Uriel’s education is costing him and his family $7,875 a semester, even after a reduction he received for good grades.
“I want to return home, but after I get my degree I want to try to repay my parents, who invested half a million shekels [$130,000] in my training,” he said. “I can’t come back to Israel if I have to continue depending on them.”
But while Uriel can’t afford to return to Israel, Israel can’t afford to keep losing medical students like him.
Matan Uriel is one of approximately 500 Israelis who leave the country every year to study medicine abroad. The Health Ministry estimates that close to half of them do not return after they get their degrees.
Israel is turning out fewer doctors per capita every year than most other Western countries, and a shortage of physicians is gradually building up as the population ages and older doctors retire.
The number of doctors for every 1,000 people was just 3.1 in 2013, down from 3.36 in 2003. A Health Ministry report published five years ago estimated that by 2020, the rate would fall to 2.83, below the generally accepted minimum of 2.9.
Israel has been training fewer physicians than it needs for the past three decades, but the shortfall had been made up by doctors who got their education abroad. In 2013, 57 percent of all those who received a license to practice had studied abroad.
Israel is losing its future medical professionals like Uriel because it doesn’t offer them aid to pursue their studies abroad, says Moshe Cohen, a cardiologist for the Clalit health maintenance organization and founder of a preparatory program for Israelis who want to study abroad.
The Swedish government, for instance, offers Swedes studying abroad a grant that covers a quarter of their living costs and a low-interest loan for the rest — as long as the students commit to return home to practice. Israel does nothing.
“Even though the government is reliant on students studying abroad by every calculation it has made concerning future manpower needs, it doesn’t keep any registry of students overseas, doesn’t maintain any connection with them while they’re studying, and doesn’t provide any way for them to easily enter the health care system” if they return to Israel, says Cohen.
To the contrary, the government demands money from them.
In order to improve their chances of getting specialist training, Israeli medical students studying abroad often prefer to do their clinical rotations at Israeli hospitals rather than at medical centers in the country in which they are studying. Each rotation lasts 10-12 weeks in the fourth and fifth years of school and 20 weeks in the sixth year. Unlike students at Israeli medical schools, who don’t pay extra to do their rotations, Israelis studying overseas have to pay about 430 shekels a week to do their rotations at Israeli hospitals.
Israeli students are in demand by European universities because they are regarded as outstanding, motivated students. The University of Zagreb in Croatia, for instance, accepted 20 of its 24 Israeli applicants, or 83 percent. By comparison, only 18 percent of the German students who applied were accepted.
In spite of the lack of incentives and the fact that close to half of Israeli medical students studying abroad receive offers to remain in the country where they are studying, most would like to come back home, according to a survey conducted by Cohen. Of the 267 students asked, 70 percent said they would like to finish their training in Israel if they could.
A month ago, 480 Israelis studying medicine abroad petitioned the Health Ministry for help.
One of their key requests is that they be formally recognized as students, which would entitle them to lower National Insurance Institute payments in school and make it easier to get student loans from banks.
But Arnon Afek, the ministry’s direct general, isn’t enthusiastic about encouraging Israelis to study medicine abroad. “In the final analysis, the solution isn’t to help those abroad but to increase the number of places for study in Israel,” he said. “And that’s what we’re trying to do.”