Preventive Medicine

Israel holds the dubious world record for having the highest percentage of doctors who studied medicine abroad: Only four out of every 10 new doctors studied medicine in Israel. The exceedingly small number of available places in Israeli medical schools given the demand among young people who wish to go into the profession has turned the medical schools here into a very exclusive club.

To get admitted to this club, one needs marks on the psychometric exam and matriculation exams that are virtually beyond reach. Many highly motivated candidates with excellent grades are compelled to study medicine abroad, at their family’s expense, to the tune of hundreds of thousands of shekels, or else to give up on the profession altogether. This situation also perpetuates the socioeconomic gaps: The chances of getting accepted to medical school in Israel are much higher for someone from an affluent background (more than half of the medical students in Israel are from families in the top decile), and not every family can afford the expense of medical studies abroad.

Haaretz correspondent Ronny Linder reported that the government plans to learn from the successful model that began in Norway in the 1990s, in which the country selects which students will study abroad and aids them with an interest-free loan or a grant if they work in underserved regions after graduating. This will be the first time the state takes any responsibility in identifying and supporting these students, but it is no substitute for the necessary solution: significantly increasing the number of places in Israeli medical schools, so that at least 60 percent of new doctors study in Israel. This would still be substantially lower than the average in developed countries, which stands at 80 percent.

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For too many years, the government relied on the aliyah of doctors from the former Soviet Union, and then on doctors who earned their medical degrees abroad, and was unable or unwilling to increase the number of medical students in Israel. This is a fundamental problem that affects all aspects of the system: the ability to reduce the number of hours for medical residents’ shifts, to shorten the wait for appointments with specialists, as well as the ability to build a new hospital. And if that weren’t enough, at present about 15 percent of all medical students in Israel are foreign students who will return to their countries of origins once they complete their studies. No one is trying to change this either.

The official explanation for why the number of spots in medical schools in Israel is not being increased is the shortage of “clinical fields” – placements in hospitals and health funds for clinical training. But the past two years have shown that when funds are made available and the desire is there, it is possible to significantly increase the number of clinical fields, and with them, the number of medical students. There is no reason why Israel should be last in the world in the “production” of local doctors who studied in the language and in the system in which they will work in the future.