Although Safed Mayor Ilan Shochat predicted on Monday that the country's fifth medical school would open in his city in October 2011, most participants in the International Workshop in Medical Education in the 21st century suggest that the date is at least five years away. The decision to establish another medical school - the first new one in 35 years, since Ben-Gurion University of the Negev founded its faculty of health sciences - was approved recently by the Council for Higher Education and the cabinet to prepare for the looming shortage of physicians in the very near future. Bar-Ilan University in Ramat Gan and the Technion-Israel Institute of Technology in Haifa (which already has a medical school) have said they will apply to the public tender to establish such an educational institution. It takes seven years to produce an ordinary MD and more to create a specialist or sub-specialist. Despite disagreement on the timeline, participants in the workshop at the Canaan Spa on Mount Canaan, near Safed, were of the same opinion, that much must be done to prepare for a fifth school, and that while the government will provide some funding and construction of a campus will have to be financed by foreign and local philanthropists, a "visionary and charismatic leader" who knows how to push through such a massive project is needed to bring the fifth medical school into fruition, said Prof. Shimon Glick, a former dean of BGU's faculty of health sciences and a retired senior Health Ministry official. The school is envisioned as contributing as much to the growth and advancement of the Galilee as Ben-Gurion University did for Beersheba and the Negev in the past few decades. The two-day conference was organized by the Israel National Institute for Health Policy and Health Services research, which is chaired by Prof. Shlomo Mor-Yosef, director-general of the Hadassah Medical Organization. It is being attended by some 70 medical educators, hospital directors, university representatives and medical education experts from the US and Canada. The discussions are focused not on the technical details involved in establishing the Galilee medical school but on the massive changes required in medical education to produce capable physicians. They will have to cope with the changing patient/doctor relationship, the information and medical technology revolution, the explosion of new medical knowledge and the need for health promotion instead of just disease treatment and interdisciplinary teamwork. As most of the existing medical schools are fixed in their ways and very conservative about change, most speakers suggested it would be beneficial to "start from scratch" rather than just expand the graduating classes of four medical schools. President Shimon Peres, who has for decades been promoting the development of the Galilee and Negev and was the first to call for a fifth medical school in the North, flew to Safed by helicopter from a meeting with Prime Minister Binyamin Netanyahu to deliver an opening speech at the conference on Monday. Peres called for the establishment a "medical empire" in Israel to be an inspiration and a help to the rest of the world. The founders of the state, including David Ben-Gurion, allowed themselves "such small dreams" such as a million Israelis and economic independence. At this stage in its history, said Peres, "don't be stingy in your vision... We have to live from our brains and innovation." Deputy Health Minister Ya'acov Litzman disclosed that he had already discussed with Netanyahu the idea of an Israeli company that would develop and manufacture vaccines against diseases that threaten Israelis, including the flu, rather than be dependent on foreign companies to do so. He urged that the government do more to prevent the emigration of young Israeli scientists and doctors and to bring back Israeli emigrants who have had prominent careers abroad.