Israelis Studying Medicine Abroad to Face Tougher Licensing Tests

Health Ministry says graduates of foreign medical schools, who make up 60 percent of doctors in Israel, might lack clinical experience

Ido Efrati
Ido Efrati
File photo: Operating room at Tel Hashomer (Sheba) hospital in central Israel, July 2003.
File photo: Operating room at Tel Hashomer (Sheba) hospital in central Israel, July 2003.Credit: Moti Milrod
Ido Efrati
Ido Efrati

Graduates of foreign medical schools will be required to pass much tougher government licensing exams possibly by November. “This will be a much higher quality exam and a much greater reflection of the required level,” Prof. Shaul Yatziv, head of the Health Ministry’s medical licensing department, said.

Yatziv said that new measures instituted to prevent cheating would include testing for the first time in front of a computer rather than in a hall full of students. The authorities will add a practical section in addition to the current theoretical exam. Those who pass the theoretical part will face questions about the diagnosis and treatment of case studies presented on the computer, with the use of visual aids such as EKG results.

Yatziv said the newer test would be more difficult for graduates lacking in clinical experience to pass.

>> Read more: Thousands of doctors study abroad - and they're threatening Israeli health care

Overseas graduates will be able to sign up for a preparatory course for the licensing exam, but the authorities will restrict the number of bonus points earned for completing these courses. The courses, run privately, take five months and cost anywhere from 7,000 to 10,000 shekels ($1,900-2,720). In the past, students completing these courses earned 10 bonus points which sometimes meant the difference between failing or passing the exam.

Yatziv said that under the new system, medical school deans would be made responsible for the courses, and bonus points would be awarded on a more monitored basis.

“To me quality is more important than quantity. In Israel 60 percent of the doctors are graduates of foreign medical schools and 40 percent from Israeli institutions. In other Western countries it is the opposite ratio. I don’t think we have to restrict someone who wants to study abroad, but let them study at good schools or at least reasonable ones,” Yatziv said.

Many members of the medical system support Yatziv's proposals and feel the requirements should be tightened further.

Prof. Arnon Afek, deputy director of Sheba Medical Center, Tel Hashomer and a former Heath Ministry director general said internships - which take place after medical school training - should be more standardized. “It’s inconceivable that each hospital should decide who finishes their internship and who doesn’t without standard criteria. Internship is the entry gate to the medical profession,” he says.

Afek would also like to see a standardized exam for students finishing medical school in Israel and abroad. At present, there is only one licensing exam for graduates from abroad, while Israeli graduates are required to pass a series of five tests. According to Afek, a single exam would create a greater sense of equality among graduates.

Yatziv argues that a standardized exam is not necessary, and that expanding licensing exams to Israeli graduates would increase logistical problems for the tests, which are taken by 1,300 graduates at a time. He believes internship programs will also be reformed “and we will begin to see much better students.”

According to Yatziv, a national internship committee has determined stricter rules for clinical training, “which will make possible better monitoring and teaching during internship.”

Yatziv says that in some cases, wards are “flooded with interns,” which makes good teaching difficult. “The new rules will also include teaching by department heads, who will be required to monitor interns and give more detailed evaluations,” he added.

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