The health and finance ministries are planning to assume responsibility for hundreds of Israeli medical students who are studying abroad and planning to practice medicine in Israel. As it stands, Israelis studying medicine abroad face rising tuition costs and a sometimes dubious quality of education.
The new plan calls for screening and selection of students who will be studying at one of a number of foreign medical schools to be vetted by the Health Ministry. The government will fund all or part of the students’ tuition up to about 400,000 shekels ($120,000). It will offer two tracks, one providing interest-free loans and the other where loans can be converted to full or partial grants. The plans call for 300 to 400 students a year to participate in the program.
The grants will be made available to students who commit to doing residencies at certain Israeli hospitals, health maintenance organizations and departments that are having trouble filling positions with qualified applicants – primarily in outlying areas of Israel. Students who have already begun medical school abroad will also be able to apply for the program, subject to their academic achievement and other, undetermined criteria.
The plan is based on a successful model that has existed in Norway since the 1990s, one that other countries have adopted. The program is not meant to replace plans to increase the number of medical students in Israel from 880 to 1,200 within five years. Instead, the new plan aims to ensure the quality of medical education given Israeli students abroad.
Currently, about 60 percent of newly licensed doctors in Israel are graduates of foreign medical schools, with the remaining 40 percent graduating from Israeli schools. The goal is to reverse that ratio and have 60 percent of 2,000 newly licensed doctors per year come from Israel, and the other 40 percent from high-quality medical schools abroad.
Getting an education at a high-quality medical school abroad can cost an Israeli hundreds of thousands of shekels. At the University of Debrecen in Hungary, for example, tuition is about $17,000 per year, in addition to the thousands of dollars needed for six years of housing and living expenses.
At Charles University in Prague, tuition is about $15,000 per year, and in Jordan it’s roughly $21,000. By contrast, tuition in Israel is almost entirely subsidized by the government, beyond the standard annual university tuition of 10,300 shekels ($3,100). So the government is already subsidizing Israelis’ medical school tuition – just not those studying abroad.
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The plan being developed by the Health Ministry calls for subsidies for the stronger students among the thousands who are not accepted by Israeli medical schools yearly. The criteria would include college-admission psychometric test scores and high school matriculation scores, along with results from a yet undetermined exams.
One funding option would give up to 400,000 shekels, interest-free, for the entire period of medical studies. The loan would be repayable after the student gets an Israeli medical license. Another option would convert all or part of the loan to a grant if the student returns to the country and works as a resident at one of the designated, hard-to-fill positions.
Students who receive loans but don’t complete their studies would be required to pay interest on the loans. Also under consideration is a plan to give scholarships for living expenses to underprivileged students who would commit to work after graduation in Israel’s outlying areas.
Behind Western countries
Israel lags behind Western countries in educating physicians, with nearly 60 percent of newly licensed doctors in 2020 graduating from foreign medical schools. That’s three times the average among countries in the Organization for Economic Cooperation and Development, the grouping of the world’s developed countries. The limited number of slots at Israeli medical schools – which also leads to the toughest admissions criteria – prompts thousands of Israelis a year to go abroad to study medicine, at their own expense and that of their parents.
There is a reservoir of thousands of potential medical students with high psychometric and matriculation scores who could study medicine abroad through the program. In 2021, 979 Israelis who studied medicine abroad received medical licenses in Israel compared to 770 who studied in Israel.
There is currently no country in the Western world as dependent on foreign medical graduates as Israel, yet it has no control or even basic information about who they are or what their abilities are. In practice, the first time the Israeli government learns that someone studied abroad and will be practicing medicine in Israel is when they take the medical licensing exams at the end of their studies.
The situation also makes it difficult to plan for future staffing levels in the profession and to an extent means that the government forfeits control over the quality of the doctors getting licensed. According to Health Ministry data, there is a major disparity in medical education in various countries and among medical schools there.
In addition, many Israeli families shoulder a heavy burden in financing foreign medical school educations, which can be particularly expensive at good universities. Because many families cannot afford it, the situation favors students from well-to-do families.
In the next several years, the number of medical licenses issued in Israel is expected to plummet, following a Health Ministry reform plan that disqualified low-quality foreign medical schools where thousands of Israelis were studying. It is expected to become increasingly difficult to fill positions in Israel’s outlying areas, as many of the residents working there studied at foreign schools that have now been disqualified.
Help wanted in the periphery
The problem in the outlying areas is particularly severe due to a program that will cut the length of residents’ shifts on duty. Furthermore, plans for new hospitals in the Negev and suburban Haifa will also require a substantial increase in the number of doctors. The new plan is designed to address all of these problems as well as to narrow inequalities and the difficulties faced by medical school applicants from poor families and even middle-class ones.
In Norway, which has a population of 5.5 million compared to Israel’s 9 million, there are five medical schools and five doctors per 1,000 people (compared to an OECD average of 3.6). The proportion of doctors working in Norway who went to medical school there is 60 percent – the level that the Israeli government is hoping to attain with the new program.