As women constitute about half of medical students, younger doctors and medical
residents, the Israel Medical Association’s Scientific Council and the Health
Ministry have just launched a pilot program to enable physicians to complete
their hospital residencies in part-time hospital work.
The program, which
will be assessed over five and even 10 years to determine whether it becomes
permanent, is meant to alleviate doctor shortages in growing numbers of
specialties. It will also enable young women to both have families and
specialize, and doctors of both sexes to conduct medical research in addition to
learning a specialty.
Six years in a full-time job are required to
complete a medical degree, followed by a year of hospital internship. It then
takes four to seven years to become a specialist in most fields, but
subspecialties like pediatric neurosurgery or obstetrical anesthesia take even
The program, similar to initiatives in the US, Britain,
Switzerland, Australia and other countries that began as long ago as the 1960s,
required a lot of thought, as it has long been the Israeli medical
establishment’s doctrine that one can become a good doctor and specialist only
through intensive, round-the-clock involvement and constant exposure to patients
under the tutelage of clinical teachers in hospitals.
But many women –
and doctors of both sexes who want more leisure time and involvement with their
families – have said they would not even study medicine or a specialty (beyond
being a general practitioner) if they did not have more time to accomplish it.
Five or 10 years ago, there was no shortage of physicians, but the growing
retirement of thousands of immigrant physicians from the former Soviet Union and
the dropping out of native Israeli doctors who seek more lucrative professions
have taken their toll.
Writing in August’s issue of the IMA’s Harefuah
journal, leaders of the Scientific Council presented the program for half-time
study of medical specialties that suffer serious shortages of medical
Studies of half-time resident programs abroad have shown that
not only are these doctors much more satisfied, but specialists who earn their
titles more slowly are also better at their job than those who took the standard
One British study of doctors in the field of
obstetrics/gynecology found that 84 percent of the residents were satisfied with
the part-time curriculum, while 81% said that the quality of study was just as
high as in the full-time course. The main problems were “a negative attitude” in
the medical establishment toward the part-time program and its “discrimination”
in favor of the full-timers.
Among the first Israeli medical societies
that asked to be included were anesthesiology, neonatology, emergency medicine,
family medicine, pathology and internal medicine – all of which suffer from
severe shortages in specialists because of the difficulty of finding new
residents. (This is because these fields offer little opportunity for
moonlighting at private practice and are very time consuming, involving a lot of
night work.) The IMA appointed a committee in 2009 to look into the matter and
decided to pursue it, but insisted that if the part-time option was found to
result in lower-quality residents, it would be discontinued.
assessing quality and comparing the results in full-time and part-time programs
are disputed – examination is one method, while judging whether graduates are
good, ethical and patient-friendly doctors is another.
According to the
IMA, regulations set to be prepared by the Health and Justice Ministries are
ready, making it possible to move ahead on the historic step of accepting
part-time residents in a number of specialties.
“Will the early
enthusiasm for the part-time program last?” the authors wrote. “Will
there be differences in their functioning as doctors? Time will
Since the Health Ministry had not announced that the part-time
program had begun, The Jerusalem Post
requested its comment on Wednesday. A
spokeswoman said that “the ministry was the initiator for the program on the
basis of a report on medical manpower, published by a committee headed by
ministry economic adviser Dr. Tuvia Horev. Now the regulations that were written
require only the signature of the health minister,” – that is, Prime Minister