Israeli Bureaucracy Keeps Immigrant Health Professionals Unemployed

Health professionals who trained and even worked abroad have a much lower pass rate on the state licensing exams than those who studied in Israel.

Emil Salman

Despite a government commitment last year to reduce the obstacles faced by immigrant health professionals seeking to work in Israel, they must still cope with bureaucratic tangles and often fail the licensing exams, leaving them frustrated and often unemployed for lengthy periods.

The cabinet resolution of November 2014 that dealt with the issue will be discussed on Tuesday at a joint hearing of the Knesset Immigration, Absorption and Diaspora Affairs Committee and the Labor, Welfare and Health Committee. The committees are expected the review the steps taken by the government to implement the resolution.

No solution could come too soon for Daniel, 31, a speech therapist who immigrated in 2012 from Spain. He has not been able to work in his profession in Israel because his credentials were not recognized and he failed the licensing exam. He intends taking it again soon.

“I submitted documents upon documents [to the Health Ministry] and between each submission I waited months for an answer. In the end they told me my degree would not be recognized, even though I worked in the profession in Spain,” Daniel said.

“After I took the test and failed, I worked at temporary jobs because I needed to earn some money, but my parents have had to support me,” Daniel said. “Now I’ve stopped working to prepare for the next exam. I hope I pass.”

Data from a new report by the Knesset Research and Information Center shows that health professionals who trained and even worked abroad have a much lower pass rate on the state licensing exams than those who studied in Israel.

In 2014, 68 percent of foreign-trained physicians failed the medical licensing exams. Among optometrists, 80 percent of those trained abroad failed the exams, compared to 40 percent of the Israeli-trained applicants.

Among speech therapists, 80 percent of the foreign-trained applicants failed, compared to only 2.6 percent of the Israelis. Among pharmacists 62 percent of the foreign-trained applicants failed, compared to only 5 percent of the Israelis. It should be noted that the statistics for “foreign-trained” professionals include Israelis who studied abroad and then sat for the local exams.

“The licensing exams constitute the primary obstacle for olim,” said Esther Blum, director of the Council of Immigrant Associations in Israel. “The statistics are horrifying. The difficulty is partly the language, since there are five languages in which the tests can be taken but there are professions that require Hebrew proficiency. But you have to understand that these people have already been practicing and the [academic] material isn’t as fresh in their minds as it is for students who just finished their studies, but they must go through it all again. People despair because they can’t pass the exams; they go into another field or they remain unemployed.”

Dr. Roni Gamzu, a former Health Ministry director-general and now the director of Ichilov Hospital in Tel Aviv, concurs. “When you’ve been a doctor for 10 years and you’re forced to go back to your basic knowledge from your studies, it’s very hard and explains the percentage of failures. We have a clear interest in integrating these immigrants into the field. There has to be someone regularly available to solve their problems.”

Some 1,600 self-declared health professionals arrived in Israel as immigrants between 2012 and 2015. Of those, 34 percent were doctors, 8 percent dentists, and 18 percent psychologists. The others included nurses, occupational therapists, physical therapists, and dieticians.

One of the government's commitments was to enable the submission of licensing requests over the Internet. The Health Ministry has set up a portal for doctors, but has yet to set one up for other professionals. Another commitment, not yet implemented, was to ease the licensing process for paramedical professionals like physical therapists and dieticians. The Health Ministry was supposed to promulgate new regulations by February 2015, but the committee established to draw up the regulations has yet to submit its conclusions.

One important step implemented by the Health Ministry is a website that describes all the procedures and lists all the documents required for licensing in several languages.

Immigrant association officials note that four bills aimed at easing the absorption process for health professionals were submitted in the past two years, but not one has come to a vote in the Knesset. These officials want the Health Ministry to translate licensing exams into additional languages and to set up a special unit in the ministry to deal with supplementary professional education for immigrants in these fields.

“One of the most common employment barriers among immigrants is the lack of congruence between the training abroad and that in Israel,” said one official. “That’s why many immigrants cannot simply exchange their professional license for an Israeli one, and find themselves unemployed.”