Planting a ‘Tree’ of health in the Galilee

Establishing a medical faculty is a once-in-a-lifetime opportunity: An interview with Prof. Ran Tur-Kaspa, dean of Bar-Ilan University’s new school in Safed.

By JUDY SIEGEL-ITZKOVICH
bar ilan medical school 311 (photo credit: BIU)
bar ilan medical school 311
(photo credit: BIU)
Establishing a new medical school is one of the closest things to the act of creation by man, as doctors’ minds will be forged there, and success will benefit life and health for decades. Few people have such an opportunity, since founding such a faculty is a rare act – even in the US, only about a dozen medical faculties are opened every five years. In little Israel, the physician who last had the privilege was the late Prof. Moshe Prywes, who established Ben-Gurion University’s Faculty of Health Sciences and its Goldman Medical School in Beersheba in 1973.
Now Prof. Ran Tur-Kaspa, a senior internal medicine and liver disease specialist who combines medical practice, research and administration skills, has been given his chance. He is dean of Bar-Ilan University’s Faculty of Medicine in the Galilee (called “Ilan – Tree – of the Galilee,”) which will open in October in temporary rented premises in a former geriatric hospital in Safed. Five years later, it will move into a permanent campus in Safed’s Kinneret quarter, with a breathtaking view of Rosh Pina and the Kinneret. Bar- Ilan, located in Ramat Gan, is the country’s largest university; it jumped at the chance to have a medical faculty of its own.
Tur-Kaspa, who studied medicine at the Hebrew University-Hadassah Medical School in Jerusalem’s Ein Kerem and worked for years in Hadassah University Medical Center’s internal medicine department in Ein Kerem, is currently chairman of the internal medicine department and liver institute at the Rabin Medical Center-Beilinson Campus in Petah Tikva. He also runs his busy molecular hepatology research lab investigating viruses of the liver, and was for four years the vice dean and head of Tel Aviv University’s Sackler Medical Faculty.
IN AN interview with The Jerusalem Post before the official opening, the 61-year-old professor describes how his new challenges came about. Bar-Ilan University president Prof. Moshe Kaveh offered him the job, which he did not seek. “I couldn’t say say no to such a once-in-a-lifetime opportunity,” he said.
Tur-Kaspa, a fourth-generation Israeli whose great-grandparents arrived during the First Aliya in 1882 and were among the founders of both Zichron Yaakov and Binyamina (where the dean grew up), was a Fullbright Fellow at Yeshiva University’s Albert Einstein College of Medicine in New York and a visiting scientist at the US National Institutes of Health in Bethesda, Maryland.
Now that he has been made dean, he has no immediate plans to leave the clinical and research facilities in the center of the country where he works.
He will get the use of a home in Rosh Pina, says the married father of three daughters who all live in Mevaseret Zion. “It will be gradual, as I am not ready to leave all these duties now. But I have three associate deans and four vice deans, so I will have a lot of help running the faculty.”
He uses the official title “faculty” rather than “medical school” because he sees it as a cental facility that not only teaches medicine but also pursues research to benefit patients. “Schools need only blackboards and marking pens. For research, one needs more.”
Although he now has cooperation from the other medical faculties, that doesn’t mean the project faced no opposition. When Prywes’s fourth medical faculty opened 38 years ago, heads of the three pre-existing schools voiced opposition. Prior to the establishment of the Technion’s Rappaport Medical School in 1969, the two pre-existing schools voiced their opposition.
Before TAU’s faculty was founded in 1964, heads of the country’s only medical school objected. Only when plans for Israel’s first medical school by the Hebrew University and Hadassah women from the US were released in 1949 did no one protest.
Shaare Zedek Medical Center director-general Prof.
Jonathan Halevy headed a public committee in 2007 that after much deliberation recommended the establishment of a fifth school. Before the government approved the opening of a new faculty, the existing four insisted that to graduate more doctors, they needed only to expand their own classes. Even in 2009, heads of the four faculties voiced skepticism about the possibility of a fifth at a symposium in Safed to prepare for the school’s opening in 2011.
But the state could not turn back, and in May 2010 the powerful Council of Higher Education (headed by Prof. Manuel Trajtenberg) formally approved a fifth faculty and agreed to help fund it. President Shimon Peres and Vice Premier and Regional Development Minister Silvan Shalom gave strong backing to the project.
HALEVY CALLED the government decision for a fifth faculty “the fulfillment of a dream,” noting that it would create more competition among the medical schools, boost the Galilee region and its health services and, at least initially, bring home Israeli students who due to the limitations on admissions to the others had to study abroad.
Now, deans and staffers of the first four schools, especially the Technion-Israel Institute of Technology in Haifa, have warmed up to the idea and offered cooperation. BIU decided to develop something unique rather than clone an existing faculty. Real estate values have risen in Safed as staffers are hired. Indeed, land prices have quadrupled. All the frenzy is creating many new jobs, among academics as well as among auxiliary support staff such as lab technicians and service personnel.
“We have already brought back 10 outstanding Israeli scientists from leading US institutions such as Harvard, Yale, Stanford and the University of Texas who will carry out research with us,” says Tur-Kaspa with excitement. “A total of 40 are expected to return.”
Long - underdeveloped hospitals in the north are finally attracting attention, as the Health Ministry’s Ziv Medical Center in Safed, Western Galilee Hospital in Nahariya and Poriya Medical Center in Tiberias; the English and Italian Hospitals in Nazareth; and the Mazra Mental Health Center in Acre are now all affiliated with the new faculty. Up to six students will accompany each senior doctor on rounds and examine patients – after getting their permission. Tur-Kaspa is sure there will be very few patients who will turn them down, as “they understand the need to learn. And as students have more time to listen than busy senior doctors, they can often discover relevant things that the MDs haven’t.” All the clinical teachers will be paid for their time and effort and get sabbatical privileges; this is not true at all the other medical faculties.
Medical schools must remain under the universities’ auspices and not be affiliated with private colleges, he insists, “so that what happens in law schools is not repeated.” There, almost anybody with the money to pay can become a lawyer. In medicine, it is of utmost importance to ensure the highest quality of teaching, says Tur-Kaspa, and the reputation of Israeli-trained physicians around the world proves the point. He also believes that the growing number of private hospitals are unable to provide clinical teaching, as they do only certain things and do not have the wide variety of know-how found in the public hospitals.
The level of clinical teaching of medical students, and the area’s medical services, will certainly be upgraded, benefiting the local population. Clalit Health Services, whose members constitute over 80 percent of Galilee residents, will participate, as while medical students will see patients and real illnesses in community health clinics.
The student body will be about equally divided among women and men. Some 60 to 70 first-year medical students will start their academic studies in October, but the clinical teaching will begin in these hospitals because Tur- Kaspa decided that Israeli medical students who have completed their academic work in Hungary and other European countries (plus some Israeli Arabs – who constitute 52% of the Galilee’s population – in places like Jordan) would be able to complete their degrees in the Safed school.
“Over 300 would-be returning Israeli students applied. We, of course, will close down this program when our first-year students reach their fourth year and need the clinical facilities,” says the new dean. A four-year program for would-be physicians who have completed their bachelor’s degrees will be available, along with a nine-year MD/PhD curriculum. The faculty expects to have 1,000 students on campus at all levels of study in six years’ time.
All Safed students will be Israelis only, as the new school is interesting in meeting the country’s urgent medical manpower needs. “We’re not planning to open a section for overseas students,” Tur-Kaspa says.
All accepted students were selected for their scholastic ability and also their personal suitability as physicians, thanks to interviews with psychologists, group dynamics and simulation exercises.
ALTHOUGH THE Bar-Ilan faculty would be very pleased if all graduates remain and work as physicians in the Galilee (where highly trained general practitioners and specialists are too few), Tur-Kaspa says they will not have to sign such a commitment.
“It is not logical. If a graduate wants to go on to become a gynecologist, for example, and there is no suitable teaching manpower in the Galilee, he or she will have to go elsewhere. And medical students who have decided to come home to finish their MD degrees instead of earning a European Union degree that allows them to work anywhere in Europe have proven their commitment to Israel.”
Besides being in the Galilee, the faculty will be very different from the first four because, instead of using the more traditional medical-school approach of separating studies by discipline such as biochemistry and microbiology, he and his staff have developed a cutting-edge curriculum that includes topics such as inflammation or metabolism, and focuses on creating “disease-oriented research centers.”
These centers will conduct research into cancer, heart disease, aging, infectious diseases, trauma and child development, and will feature a variety of teaching and research specializations including bioinformatics (determining gene sequences related to diseases), preventive medicine, medical ethics and law, sociology and even medical economics.
“The school will look at the quality of the environment, even air pollution – anything that has to do with medicine,” says Tur-Kaspa, who visited medical schools abroad to collect ideas that work. Classes on integrative medicine (complementary medicine) will be included if they are evidence based. He has already hired a senior physician from England who will come and work only on disease prevention. “The first course students will take will be Public Health and Disease Prevention,” he adds.
Students will not spend most of their time learning information by heart,”as I did way back in medical school in Jerusalem. It’s impossible,” he says, what with the doubling of information every 18 months.
Information believed to be fact and then memorized could be disproved and replaced by new facts.
Students have to learn how to access the latest proven information. “We are looking for donations for purchasing iPads that students could use.” A medical library that will have smaller rooms to collect information digitally will also be available. So far, tens of millions of shekels have been committed to the school, with matching funds coming from the Treasury and BIU donors.
The new faculty’s academic program will fulfill a crucial role in both training medical professionals to serve in different facilities in the north and bringing the most advanced medical equipment, techniques.
knowledge and expertise to a region severely lacking in medical care. The ultimate goal, Tur-Kaspa concludes, is for “Tree of the Galilee” graduates to “integrate a deep knowledge of the scientific basis of medicine with the best clinical skills, all while teaching doctors to be empathetic.” If Tur-Kaspa can achieve his vision, the country’s healthcare will be enriched far beyond the immediate need to train more physicians.