Ariel Roguin: Israel needs more medical schools

Ariel Roguin (Interventional Cardiology, Rambam Medical Center, Haifa, Israel) reports that because of a lack medical schools in Israel, many medical students choose to study abroad which “is inconvenient for them and their family”. In this commentary, he reviews the challenges of medical education in Israel but also explores what is working well in the country.

In Israel, we only have fi ve medical schools and only 700–800 medical students graduate from these schools each year. A similar number of students choose to study abroad, but this is inconvenient for them and their family. Therefore, because of this shortage of medical schools, our schools do not produce enough doctors to meet the needs of our population of eight million. 

Those who go to a medical school in Israel have to complete a six-year programme that includes three years of preclinical studies and three years of clinical studies. After fi nal exams and MD thesis, all students have to pass the national exams – students who have completed their medical studies abroad have to pass the Ministry of Health exam. After these exams, in order to obtain a license to practice medicine, an additional year of internship is required. Thus, the total time from student to qualifi ed doctor is seven years. However to specialise in cardiology, a physician must fi rst fi nish a three-year residency in internal medicine and pass the exams. It then takes another three years to specialise in cardiology. As part of this programme, an additional six months are dedicated to research. In my view, the three years spent in internal medicine does not contribute signifi cantly to the cardiologist’s professional education. However, the purpose of this part of the training is to provide staff for the medical wards that suffer from a severe shortage of manpower. All of this training is on top of Israel’s compulsory military service (two years). Thus, the average cardiologist completes his/her training at the age of 35–40.

Medical students in Israel do receive a thorough education during their studies and residency. On top of the routine work, there is a focus on clinical education, journal clubs, research, and tutoring of the younger students/residents. Therefore, most physicians are involved in all aspects related to being a doctor, including caring for the patients, tutoring younger colleagues, clinical and basic research activity, and journal club preparation. Furthermore, during the fellowship period, there is a great programme that includes educational sessions with the top country leaders and experts in each fi eld once every two weeks on various topics in the fi elds of internal medicine and of cardiology.

All Israeli hospitals are affi liated with universities. Therefore, any physician can easily access most online databases and all the literature in the fi eld. As part of the fellowship, the Israeli Heart Association has periodic conferences with updates in the different areas of sub specialisation which are at the highest level and are attended by a relatively large audience.

EuroPCR has provided excellent opportunities to improve knowledge in the fi eld of interventional cardiology and allows a friendly atmosphere to hold meetings at the highest level. For example, for the last few years, we have facilitated several EuroPCR seminars to interventional cardiology fellows and young practitioners. These seminars have been a great success
and we have received excellent feedback. Also, most of the senior operators in Israel participate regularly and actively in European meetings held by the European Society of Cardiology and PCR.