Sheba Hospital Archives
Sheba Hospital ArchivesFlash 90

Corona has accelerated many changes in the world and has highlighted the need to fortify our health care systems. Besides the corona pandemic, Israel is now facing a new crisis- a shortage of physicians. Among OECD countries, Israel was the only country in which the increase in the number of doctors did not meet the population increase – a worrying trend for Israeli society. Moreover, up to 60% of Israel's physicians pursue their education abroad, making Israel’s medical system reliant on medical education in various other countries, primarily in Europe.

These trends became even more troubling during Covid, when many med school programs shuttered their doors to students due to Covid restrictions. Sheba Medical Center stepped up to help, offering clinical training during the “second shift” to these Israeli students. Sheba created this special program also in partnership with med schools abroad, which also enabled medical students to continue their studies within Sheba so as not to fall behind. There is tremendous importance to securing the future of healthcare professionals in Israel, bringing Israel’s future doctors “home.”

Prof. Gadi Segal shares special insight into the program, the motivation for it, and how this endeavor could be the solution to the pressing concern of a lack in quantity and quality of physicians in Israel.

Dr. Segal is responsible for opening the first corona ward in Sheba Hospital, and as well implementing the Telemedicine initiative, which allows for long-distance treatment and even hospitalization. He has also served as head of internal medicine division in Sheba hospital until now. Dr.Segal is in charge of the Education in Sheba Hospital and is a professor for internal medicine in Tel Aviv University, among other prestigious achievements.

“Israel is suffering not only from a lack of physicians but perhaps more dire, a lack in quality of good physicians in Israel, while the best students leave to pursue studies in Europe,” Dr. Segal began in his interview with Israel National News.

“Medical school is divided up into two phases- the pre-clinical phase in university, and the clinical training phase which takes place bedside in hospitals. There is a lack of positions available for clinical training in the field, so that the universities will not even consider admitting more students,” Dr. Segal says, presenting the problem.

Dr Segal continues: “The issue is that because of this many of our best students are going to study in Europe. Approximately 700 students graduate from med school here in Israel whilst in Europe the numbers are in the thousands. The main problem is that there is no way to get good clinical education whilst in Europe. The culture, population and even epidemiology of sicknesses are different to Israel, and even though the pre-clinical level of education is up to standard, the clinical training is sub-par.”

“The initiative I undertook was to solve the nationwide problem- to increase the places for clinical training. The hospital runs at all hours. There is no reason not to also teach clinical studies also during the second hospital shift- 1 p.m. until 7 p.m.. I decided to first open the program to students returning from Europe, allowing them to continue their studies here in Israel. When Covid hit, there were 12 students trapped here and could not continue their studies in Italy, which was struck badly by the pandemic. The university there reached out to Sheba to try find a solution that would enable the students to continue studying and not have to lose a year of studies. They were joined by 3 other students from Slovakia and they started a 15-week program in the second shift, which was a huge success,” said Dr. Segal.

“This proved that the program was not only feasible but desirable. The second aspect of the innovation was to convince other physicians to teach. The fact that senior physicians are also being paid [by students’ tuition], to work and teach in the evening shifts, actually improves the quality of care for the patients,” Dr. Segal states.

“The level of teaching in several European countries is quite low. Many medical schools graduates are not eligible to enter the licensing exam in Israel. There are hundreds of Israeli students that need another year of clinical education in one of the five pillars within the clinical education phase. They then approached Sheba to join the second shift program.

“There are now 40 students in the program. I anticipate that at least 30 of them will receive their medical license. That is 30 more doctors than we would not otherwise have had in Israel,” explains Dr. Segal.

“Israel’s Ministry of Health wants to incentivize Israeli universities and hospitals to open more seats. They fund each spot opened. So, they send funding for each new position opened in the clinical phase. We are just waiting for the Council for Higher Education and universities to recognize the opportunity nationwide of the second shift program. Here in Sheba, we have proven that this model of the second shift program is not only possible but desirable and can open up many more places for clinical teaching.”

“The government should continue to incentivize universities and clinical training programs to continue to second shift program, and rapidly expand the program. Their resource here has doubled- they need only utilize it. I personally can guarantee that the quality of the teaching will only improve, and we can lead the way, as we did with the Covid,” Dr. Segal concludes.