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Israel ends lucrative American medical training programs to focus on local doctors

Universities to lose major source of income, and country to lose boost to Diaspora ties; move meant to tackle shortage of spots for Israeli students

Judah Ari Gross is The Times of Israel's religions and Diaspora affairs correspondent.

Student getting hands-on experience in Emergency Medicine Course at the Medical School for International Health (MSIH) at Soroka Medical Center. (Courtesy MSIH)
Student getting hands-on experience in Emergency Medicine Course at the Medical School for International Health (MSIH) at Soroka Medical Center. (Courtesy MSIH)

Israel has announced that it is closing three lucrative American medical training programs at Israeli universities, in order to free up space for local students, as the country faces a doctor shortage.

Through these programs, foreign nationals — mostly Americans and Canadians — study medicine in English while living in Israel, and then sign on for their residencies in the United States.

The move, which was approved by the Council for Higher Education, the Education Ministry, and the Health Ministry, is expected to increase the number of Israeli medical students by 130 each year, beginning in 2023. It comes amid an impending shortage in the number of doctors in Israel, one that was recently further exacerbated by a recent Health Ministry decision to stop recognizing medical degrees from a number of countries, mostly in eastern Europe, due to quality concerns.

“The State of Israel is in the midst of a real, deep crisis in terms of medicine as a result of a number of factors, and this requires fundamental treatment in order to sure that Israel’s population continues to receive good health care in the future as well. There is already a shortage of doctors, which is expected to get worse in the coming years in light of the rise in life expectancy (and with it a rise in the elderly population), many doctors retiring, the revocation of recognition for medical degrees from several institutions in Europe, and the demands of residents to shorten their shifts, which will require more residents,” a spokesperson for the Council for Higher Education said.

“This will help tackle the growing and expanding needs of the State of Israel, as part of our comprehensive program to significantly expand the number of medical students,” Education Minister Yifat Shasha-Biton said in a statement.

Three universities currently offer American-accredited programs: Tel Aviv University, Ben Gurion University in Beersheba, and the Technion: Israel Institute of Technology in Haifa.

Through these programs, foreign nationals study medicine in English while living in Israel and then sign on for residencies in the United States. In a small number of cases, after completing their residencies, some students return to Israel to practice medicine, but the majority remain in the US or Canada.

The closure will go into effect at the beginning of the fall of 2023, and currently enrolled students will be allowed to complete their studies.

Though Shasha-Biton’s ministry and the Council for Higher Education touted the closure of the American programs as a major step forward in addressing the looming dearth of doctors, they neglected to mention the costs — literal and figurative — of shuttering these programs, some of which have been operating for decades.

In fact, these foreign medical study program currently represent a major source of income for the three Israeli universities that offer them. The tuition for the American programs — roughly $40,000 a year — is more than 10 times higher than that of Israeli medical programs, at approximately NIS 11,000 ($3,400) a year.

The spokesperson for the council said it was indeed aware of the financial aspect of this move.

“These issues were considered seriously and were reviewed by committees in Israel and abroad, alongside the Finance and Health Ministries,” the spokesperson said.

To compensate for this loss, the government will subsidize the universities to the tune of NIS 58,000 ($18,000) per year for every additional Israeli student gained, though this is still far less than they would receive from the canceled programs.

The Sackler Health and Sciences complex at Tel Aviv University. (screen capture: Google Street View)

In less quantifiable terms, the shuttering of these programs also closes an important conduit for Israel-Diaspora relations. Through these programs, thousands of American doctors — mostly Jewish, but not only — have spent considerable time in Israel, learning about it and developing deep ties to the country and its population.

Though it was not immediately clear if his office was consulted about the matter in advance, Diaspora Affairs Minister Nachman Shai said he supported the move.

“I believe that the right decision was made in this case. Today, we have many ways to promote relations between Israel and Diaspora Jewry, including for example the multiple educational programs of Masa and Taglit,” Shai said through a spokesperson, referring to short, vacation-oriented trips.

“I believe that in this case, it is appropriate to increase the amount of seats available for Israeli citizens in medical schools, instead of giving them no choice but to study abroad and perhaps not returning back home,” he said.

The Council for Higher Education said it took the connection between Israel and the Diaspora seriously and maintained a number of programs to maintain it, including sending Israeli doctors abroad for fellowships.

“The Council for Higher Education [also] develops programs, research fellowships and new areas for post-doctorates who want to come to Israel to study for different lengths of time and works to expand its international connections,” it said.

A number of domestic and international studies over the years have warned of an impending shortage of doctors in Israel, as those reaching retirement age are not being replaced quickly enough.

According to a 2019 OECD report, close to 60 percent of Israel’s doctors have trained abroad, well above the OECD average of 18%. This has further been constrained as Israel has limited the number of countries whose medical programs are recognized by the Council of Higher Education.

“The human resource shortage in the healthcare system is a national problem that was neglected for years, and today, most medical students study abroad. These spaces are needed for Israeli students instead of foreign students who are not expected to work one day in the Israeli healthcare system,” Health Minister Nitzan Horowitz said in a statement.

The closure of the American programs will not come close to fully addressing the looming doctor shortage in Israel or dramatically reduce the number of Israeli medical students in programs abroad. However, Horowitz said plans were underway to increase the number of slots available in Israeli medical programs in other ways as well.

“This is part of a wider effort we are making to address the root of the problem,” the health minister said.

The shortage has generally been attributed to an inability to accommodate medical students in laboratories and hospitals, not in classrooms. A spokesperson for the Council for Higher Education said finding cadavers for study alone represents a major challenge.

“It’s not like the humanities where you can just add a classroom. If it were as easy as that, we would just add another few hundred spots in medical programs without closing anything,” the spokesperson said.

In the coming year, Israeli medical schools will have spots available for just shy of 1,000 new students — 70 more than the previous year.

The spokesperson said these 70 students were being sent to three existing medical programs, with 31 going to Tel Aviv University, 15 going to the Technion and 24 going to Ben-Gurion University.

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