The rate of new doctors graduating from Israeli universities is the lowest in the OECD

The problem of overcrowding and the rate of population growth in Israel is one of the fundamental problems discussed in recent years and is a real challenge for education, transportation, housing, and other systems. Another significant challenge of the increase in the population and its accelerated aging is imposed on the health system - which must continue to provide the public with medical services of a high level, with reasonable availability and accessibility at the very least.
A new OECD report illustrates the magnitude of the challenge or, in less subtle words, the major crisis that Israel is likely to encounter if it does not act quickly. According to the data, Israel is in the middle of a pincer movement. ) is one of the highest in the organization and much higher than the average, and on the other hand - the rate of new doctors graduating from Israel is the lowest in the organization.
In 2020, about seven Israelis per 100,000 citizens received a license to practice medicine from a medical school in Israel, compared to an average that is almost twice as high in OECD countries - a rate of 13.5 new doctors per 100,000 citizens. In some countries the numbers of "locally produced" doctors are much higher - up to three times more than in Israel. In Ireland, more than 25 doctors per 100,000 people graduated in 2020, in Denmark 21 graduates, and in Sweden 19.
To fill the gap, Israel has traditionally relied for decades on doctors who studied medicine outside the country, and is the leader in the Western world in "foreign-made" doctors, with about 60% of the license holders who studied abroad - three times the average in the OECD. In the past, this was the largest immigration from the former Soviet Union, during which thousands of doctors came to the health system in the 1990s. In recent years, these are mainly Israelis who study medicine abroad, and then return to Israel.
However, this source of doctors is going to dry up to a large extent already in the coming years, following the "Stable Reform", in the framework of which the Ministry of Health shut down various medical schools, mainly in Eastern Europe, after it became clear that the level of studies in them is too low and does not meet the standard appropriate for the health care system in Israel.
Starting in 2025, university graduates, who were disqualified in the reform, will no longer be able to obtain a medical license in Israel. Because in the last decade these universities that were disqualified in the reform were a major source of medical license recipients - a significant shortage of new doctors is expected to arise.
The OECD report warns that Israel is facing a shortage of male and female doctors, and that "the large number of Israelis studying medicine abroad does reduce the national expenditure on medical studies in Israel, but it raises at least two concerns: it complicates the long-term planning of manpower Medical because it is not clear how many doctors will come to Israel each year. It exposes the health system to heterogeneity (differences) at the professional level of medical schools abroad."
Israel is already dealing with the consequences of the shortage of doctors, including the lengthening of queues and the great difficulty of implementing the policy of shortening shifts for interns announced by the government. This, even before the expected drop in the number of female and male doctors in 2025.
The minority of Israeli graduates also has consequences for the deepening of inequality in the health system and in Israeli society, from different directions.
First, according to the data of the Ministry of Health, most medical graduates in Israel live and work in the central region and Tel Aviv, and only a minority in the periphery. In addition, the paucity of places in medical schools causes a thin layer of students to be admitted to medical schools in Israel, most of them from a high socio-economic cross-section. At a later stage, they are more easily accepted into sought-after specializations.
In recent years, various attempts have been made to deal with the complex problem. Various committees, appointed by the state and the Council for Higher Education, indicated the need to increase the number of places in the medical schools to 1,200 per cycle, a number that would turn the tide so that 60% of the license recipients would be Israeli graduates (a rate that is still lower than the OECD average). . In recent years, several dozen places have been added every year in the faculties of medicine, but the growth is slow in relation to the expected shortage.
After years of delay, it was recently decided to cancel the American medical programs in which North American students study in Israel, who after their studies return to their countries of origin - and to replace them with Israelis. This, against significant financial compensation from the state to the universities for which the students from abroad were a significant source of income.
This step is expected to increase the number of medical students in Israel by 130 per year starting in 2023 and bring it to 1,100 students per year. By the way, although there is no debate about the urgent need to increase the number of medical students in Israel - the decision to cancel the programs was met with strong opposition from organizations associated with American Jewry, who tried to cancel it on the grounds of harming Israel's relations with American Jewry, as well as on the claim that it is possible to increase The number of students in Israel easily even without canceling these programs. However, it appears that the decision is final and will not be changed.
In the past year, a private initiative led by Prof. Uriel Reichman to establish a private faculty of medicine at Reichman University has also been progressing. The initiative provokes a heated debate within the health system between the supporters, who claim that increasing the number of students in any way is the order of the hour, and that the current situation of a paucity of places in faculties in Israel and the departure of Israelis abroad is the great generator of inequality, and those who oppose the establishment of the first private faculty of medicine.
Another initiative, which is promoted by the Ministry of Health, is to take responsibility for Israeli students who go to study medicine abroad in the form of subsidizing the financing of their studies and accompanying them - in exchange for a commitment to return to Israel at the end of their studies, with an emphasis on work in the periphery and in professions in need. This model is based on models that exist in Norway, Sweden , Denmark, Singapore and other countries. It will allow the state much greater control compared to today in terms of the level of those going to study abroad, the quality of the places where they will study and the ability to plan the future of the system.