On video: Announcement of a basket of medicines for 2024 22.02.24/per
At the end of February, the Ministry of Health announced that the number of new doctors in Israel will decrease in 2022 and compared to the OECD countries, the number of doctors in Israel per thousand people remains low and stands at 3.4 in Israel compared to 3.7.
Alongside this, just this week the Director General of the Ministry of Health, Moshe Bar Siman Tov, pointed out the problematic nature of the gap in medical care between the center and the periphery. Together with several doctors, we asked why there is a shortage of doctors in Israel, whether the situation will improve or if we are expected to get worse. Opinions differ, but on One thing everyone agreed - the country saw the wave coming and woke up too late.
Number of new licenses in medicine/official website, Ministry of Health
According to the report published at the end of last month, the number of new doctors in Israel in 2022 was 1,946. At the same time, in 2023 there was an increase with 2,486 new medical licenses. 55 and a paucity of places for students in the faculties of medicine in Israel brings many of the Israeli students to study abroad," explained Lavala!
Dr. Eil Braun, Director of Internal Medicine 8 at the Rambam Hospital in Haifa, a member of the hospital's board and an infectious disease specialist.
In addition, as of 2019, medical studies in Ukraine, Romania, and Moldova are not acceptable in Israel according to the decision of the Ministry of Health, which was based on a report by Shaul Naziv, which showed that the level of education is not sufficient for the high standards in Israel. Those who are already studying there are now finishing their sixth year, and the expectation is that in 2026 About 500 fewer doctors will enter the market than now, which means we will go down to 3 doctors per thousand people in Israel, which will create an even greater shortage of doctors, especially in the periphery."
According to Dr. Brown, we have not produced enough doctors and only in recent years has the state begun to make moves to produce them, but it takes time. It must be remembered that medical studies range from 4 to 7 years. "Training a medical student is an expensive thing, the most expensive there is in Israel
It is not similar to any other profession found in academia," emphasized Brown. "The main problem is where the clinical studies are studied in the universities.
We need more doctors to work full time to look after the students.
Even so ,
there is a shortage of doctors in the internal medicine departments in the hospitals and in surgery, so to 'separate' a doctor who will be with students for such a long time is very significant."
Additional faculties at the University of Haifa or Reichman, but Dr. Brown warns that this is not a quick solution. According to him, it will take years to narrow the gap and close it and he points out that the doctors are also looking at the economic aspect.
"People want a profession with a large income such as plastic surgery and ophthalmology. Professions such as anesthesiology, surgery and internal medicine include very difficult internship periods. This is not a matter of marketing, doctors are not hungry for bread, but living conditions are important to them. As for example in the profession of surgery, which used to be the pinnacle of medicine , but the doctors now have considerations not to call them in the middle of the night," he explained.
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Dr. Eil Brown/Official website, Rambam Spokesperson
Small steps, but almost no practical solutions
Prof. Ido Wolff, head of the oncology department at the Ichilov Medical Center in Tel Aviv, floats a theory that the state used in reality and failed.
"There were several theories and one of them was that the fewer doctors there are, then the spending on health in the country will decrease and they won't need so many doctors," explained Prof. Wolff, who is also the head of the medical school at Tel Aviv University and the head of the National Council for the Prevention and Diagnosis of Malignant Diseases.
"The training of doctors in Israel is historically determined by the ministries of finance and health and they limited the amount. We reached 700-800 medical students per year and they stopped us, they did not give money for growth. At the same time, many students studied medicine abroad, the state saved and we reached a distorted situation All of which is supported by the State of Israel, which has led thousands of doctors who study medicine abroad instead of in Israel."
Prof. Wolff explains that the result was that the universities began to screen students through matriculation and psychometrics.
"I hear the claims to lower the high psychometric score, above 730, but the problem is not there but the number of places that exist today for medical students. There are 5,000 people who want to study in Israel, but there are only 700-800 places each year."
Prof. Ido Wolff/Official website, Miri Gatniu, Ichilov Spokesperson
Like Dr. Brown, Prof. Wolf also points to the Ministry of Health as being to blame for the current situation and making the decision not to allow students to study medicine in Eastern Europe without any alternative.
After all, the great mass went to study in Eastern Europe because it is much cheaper and it was much easier to get accepted than to study medicine in the West.
Almost everyone passed and it was a kind of 'Israel Bluff'.
Israel should have done the calculations and opened more places, but we know Israel.
When do you realize there is a shortage?
in 2022.
What happened?
Realize that we are facing a huge crisis and that the gates of heaven will open upon us in 2025. The country is waking up, but slowly."
Prof. Wolf claims that there is an organized plan by the ministry and the state to increase the number of doctors by Israeli students who will study medicine here to 2,000 doctors each year, but According to him, this will happen, perhaps, only in 2030. "We all know that in the next three years there will be a big crisis here," stated Prof. Wolff.
"It is very difficult to correct the past, students who did not enter in time simply will not be there. Now there is a mad rush to train physician assistants, to expand powers in order to prepare for the coming crisis. The crisis is a fact, we just don't know how deep it will be. We are trying to incentivize the Israeli doctors who are studying Abroad, but it is not easy because they are being chased all over the world.
They receive a European-American medical license and the world is open to them."
Prof. Wolf emphasizes that "Hishrabloff" continues even in these years and claims that the opening of the Ariel University of Medicine did not add doctors. "Ultimately, what is needed here are clinical fields, or in other words to build hospitals.
All Ariel students study the practical work in the hospitals in Tel Aviv, therefore it is a zero sum game.
Now they are also talking about the Gemzo report (director general of Ichilov and the former Ministry of Health) which will oblige hospitals to give more teaching time to students in exchange for payment to doctors from the state.
This is the right step, all the rest are not practical solutions."
Dr. Vadim Bankowitz/Official website, Jonathan Center, Israeli Center for Joint and Back Health
Dr. Vadim Bankowitz, director of the orthopedic unit at Soroka Hospital in Be'er Sheva and a lecturer at the Faculty of Health Sciences at Ben Gurion University, raises another theory that led to a shortage of doctors according to him.
Those who are not accepted go abroad because they know in advance that it is a shame to waste time because the entrance threshold is very high, but some of the population in Israel receive affirmative action and enter medical studies at the age of 18, where is the fairness?" asked Dr. Bankowitz.
In his words, he refers to the figure that According to the report of the Ministry of Health, as of 2022, 46% of medical license recipients were from the Arab sector.
"Some of the students in Israel fail the personality tests on the way to admission to the schools. I ask myself: What personality test did an 18-year-old who just finished school pass compared to a 21-year-old combat soldier who did significant service that he didn't pass? It could be that something is wrong here. There is inequality here which is annoying".
"These people risk their lives and contribute to society, and they are the ones who have to prove it?" Dr. Bankowitz continued. on the outline of the military men, but it's all in wartime. Next year, these people will continue to trail behind."
Bankovich talks about the fact that if there is affirmative action, then the psychometric test is not really a measure to determine who can be a doctor and who cannot and claims that it is necessary to approach the future students who serve in the IDF. "I have had doctors who were absent from the department for 4 months and I support them and try to help them , but there may be department managers and managers who look at reservists as 'disappearing' and will hire someone who is not absent.
It really is a country that eats its inhabitants."
Doctors think about the conditions of their lives.
The profession of surgery is no longer in demand/ShutterStock
Bankowitz understands what is behind affirmative action and the desire to support disadvantaged populations and give them the chance and claims that his colleagues also think this way, but he claims that less is said about it.
"It is very difficult to improve matriculation and psychometrics after 3 years in the military service," he explained.
"There is a reverse selection here that removes the population that contributes the most and invests for the country and the security of the country, and we are hurting them. Unfortunately, no one wants to touch this hot potato and pass it on, because as it were, we are going against the conventions of years here. There is no equality here and we need to fix the It's nice one hour earlier."
In conclusion, Bankowitz also holds the opinion that the medical system in Israel will not be able to cope with the crisis.
"This will harm every medical service we will need. There will be more standards in the center than in the periphery in the north and south, the hospitals will be severely affected. According to estimates, due to the stable reform, there will be a 40% shortage of doctors in Israel, this is a deep and severe crisis, we need to open more medical studies in Israel, train doctors and to bring the Israeli doctors who are abroad to Israel, in order to minimize damage."
The Ministry of Health responded:
"As published in the Ministry's announcement on the health professions manpower report for 2022, and as widely published in the various media, including Walla, it is important to note that the report Refers to the data of 2022, however, in the data of 2023 there is an increasing trend in the number of new licenses in medicine, with 2,486 new licenses.
As published, with the aim of providing a long-term solution to the shortage of doctors and increasing the number of doctors in Israel, in 2023 the Minister of Health established a committee to deal with the shortage of medical personnel, headed by the Director General of the Ministry of Health, which will form, among other things, a national planning body for medical personnel that will determine the The number of specialists required in each field and actions to achieve these goals. In addition, the Ministry of Health is working to increase the number of specialist doctors in all fields and geographic areas, through financing community interns in the health insurance funds, as well as to increase the number of new medical students, which increased in recent years from approximately 730 in 2018 to over to 1,100 students in 2023, with the target being an increase to 2,000 students each year by the end of the decade, in addition to increasing the number of brothers and sisters. In addition, this year, the Ofakim program will be presented with the encouragement of the Minister of Health, a first of its kind program to finance medical studies at quality institutions in Europe , within which funding is expected to be given to about 100 medical students abroad per year, alongside increasing the number of doctors in Israel."
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