Although the government decided unanimously on Sunday to approve the establishment of a fifth medical school in the Galilee - the country's first since Ben-Gurion University of the Negev in Beersheba was founded in 1973 - there are many financial, organizational, academic and other problems that could leave it only a dream on paper. The school, and an accompanying research institute, will be based in Safed, with some of the clinical studies to be offered in the city's Ziv Hospital, according to the decision. Health Minister Ya'acov Ben-Yizri voted for the proposal, which is based on the conclusions of a public committee headed by Shaare Zedek Medical Center director-general Prof. Jonathan Halevy two years ago. However, numerous senior ministry officials have long opposed such a move, saying it would have been much cheaper to expand the programs of the four existing medical schools (Hebrew University-Hadassah in Jerusalem, Tel Aviv University, Technion in Haifa and BGU). And in the Madoff era, when potential donors are scarce, finding donations of many hundreds of millions of dollars would be difficult. It would also be a significant problem, they argue, to find highly qualified professors and lecturers willing to spend time in the Galilee and teach medical students during the four clinical years of their seven-year curriculum. But Halevy told The Jerusalem Post that the government decision was "the fulfillment of a dream. There will be more competition among the medical schools, and some of the Israelis who were previously not accepted and went to study in Eastern Europe and elsewhere will come home to study - today, there are 1,000 of them studying medicine in Hungary alone." Halevy added that he hoped the Galilee medical school would eventually grow to 150 students; the four existing schools currently produce only about 300 graduates a year due to Treasury limitations via the Council for Higher Education, as teaching medicine is a very expensive process. Halevy, a liver specialist, said he was sure an adequate number of lecturers and professors could be found among senior medical school teachers in other faculties who were soon to or had recently retired. "Even some professors who are older than that are suited to teach clinical work," he said, and the new school would certainly attract younger qualified teachers from Israel and abroad. He added that the extension of the Trans-Israel Highway (Highway 6) to the north would make Safed and the north much more accessible. Although planning and building a campus in Safed would be expensive and would take years, the first class could begin as soon as autumn, 2010, Halevy suggested, because medical students spend the first three years in non-clinical, theoretical studies that do not require major facilities or hospitals. All agree, however, that Israel will very soon need more doctors, as the masses of physicians who arrived in the 1990s from the former Soviet Union will soon retire, and the current crop of 300 graduates will not be enough to take their places. Better-paying and more convenient jobs in computers and engineering, the brain-drain, the increase in the percentage of women doctors (who tend to work part-time) and other influences have worked to destroy the axiom that Israel has more doctors per 1,000 residents than any country in the world. The number of licensed physicians under 65 is around 25,000, or 3.53 per 1,000 residents. Since 1999, this rate has been dropping as the population has aged, and without intervention, the rate will reach 2.72 per 1,000 in 2020. Experts in medical manpower have said that the annual number of medical graduates must immediately be increased to 600. According to the expected conditions for a public tender, the new medical school will have to be under the aegis of a research university that doesn't currently have a medical faculty. The only such institutions that have shown interest in being affiliated with a new school are Bar-Ilan University in Ramat Gan and the University of Haifa. The Post learned that University of Haifa plans to join forces with the Technion-Israel Institute of Technology in Haifa to present a joint bid, competing with Bar-Ilan, which has spent years in preparation for launching a medical school of its own. President Shimon Peres, who has for years lobbied informally for the establishment of a medical school in the Galilee, issued a formal statement on Sunday saying he was sure establishing a medical faculty in the Galilee "will strengthen and develop Kiryat Shmona, Safed and the whole Galilee, just as BGU contributed to the strengthening and development of Beersheba and the Negev. "The government's decision was reached very late, which will make it difficult to raise funds in the current economic crisis, but all of us are bound to join the effort and bring resources so that this welcome project will come about." Peres was deputy prime minister and minister for development of the Galilee and Negev during the government of Ariel Sharon when he first raised the idea of an advanced university-based medical school in the Galilee. Outgoing Prime Minister Ehud Olmert said after the cabinet meeting that marked International Women's Day that half of all medical graduates were women. The decision to establish a fifth medical school, Olmert said, would bolster the north and add vitality to the country. "It will bring medical students to one of the most beautiful and impressive areas in the country." Dr. Oscar Embon, director-general of Ziv Hospital, welcomed the cabinet decision and said it was a "significant achievement that will have a positive effect on all fields of life in the region. The northern hospitals will especially benefit." "It will be possible for them to absorb many more students beyond those who study at the Technion's medical school, and help the hospitals upgrade their medical infrastructures and services," he added. It would also provide many needed places of employment, said Embon, and improve the quality of life in the north. The Israel Medical Association also welcomed the cabinet decision but said its implementation depended on the allocation of significant financial sources and immediate activity to expand infrastructures in the northern general and psychiatric hospitals, which includes those in Safed, Nahariya, Tiberias, Nazareth and Afula, as clinical departments must be added now to hospitals in the Galilee in order for the new medical school to teach on a high level. The research capabilities of the general hospitals in the region must also be upgraded, said Blachar. Prof. Shaul Sofer, dean of BGU's health services faculty, said that he was "not very sorry" about the cabinet's "populistic" decision, even though he had long been against it. His main reason for opposing the establishment of a fifth school was "the fear that in our country, with its limited resources, a fifth school could come at the expense of the existing schools and that priorities may be set improperly." He was also concerned that there wouldn't be enough hospital departments that could offer high-level teaching on a clinical level. "But to be honest," said Sofer," the same thing was said when our own medical school was proposed, and even before that, they said this at the Hebrew University when it was proposed that Tel Aviv University would open its medical school." But the BGU medical faculty dean said that the number of medical graduates could much more easily have been boosted by expanding the number of students at the four medical schools and dividing up the number of students more equally among all the hospitals in the country. One benefit of the decision, however, was that potential faculty could be created partly from returning Israelis who went to the US and elsewhere and developed into high-level professors and clinicians there. Health Ministry associate director-general Dr. Boaz Lev said that implementing the decision "will not be a simple thing. It won't be easy to raise money, but the decision is not a tragedy. If it works, and good relations develop with neighboring countries, a medical school in the Galilee would be a bridge to peace." Asked why Ben-Yizri voted for the decision when many in the ministry were opposed, Lev said it was "not ssolely a medical decision; it also involves national infrastructure. He didn't consult with me, but he must have spoken to others."