Israel needs US-trained physicians. If this does not happen rapidly and in sufficient numbers, the quality of medicine in Israel will suffer.

The average Israeli physician is smarter and more mature than their US counterpart. It is considerably more difficult to be accepted to an Israeli medical school than in the US. Israeli trained doctors have been ultra-selected from their highly competitive peers.

Many Israeli doctors are older, with more life experience due to years of military service or pre-medicine pursuits. When I became a father during medical school in the US, I was an extreme anomaly. Not so with Israeli medical students.

While Israeli doctors are smarter and more mature, the average US trainee is a better physician. Why?

First, doctors in Israel are mostly not Israeli-trained doctors. Astonishingly, 60-65% of new doctors in Israel did not attend medical school in Israel. Jewish Israeli and Arab Israeli physicians each comprise 50% of new doctors in Israel, and many if not most study in medical schools outside of Israel. Statistically, your physician in Israel is not the super smart, mature individual who gets accepted to an Israeli medical school.

Second, U.S.-trained physicians have a major inherent advantage. The language of medicine and medical literature is English. Medical information progresses at a dizzying pace, and any excellent physician has to be continuously reading. And reading critically to distinguish medically relevant information from the chaff.  I am able to converse and write quite easily in Hebrew at this point. And most Israeli physicians can do the reverse in English. But if roles were reversed, and I had to continuously and critically learn highly technical medicine in Hebrew? Forget it. The amount of time and effort required would be so insurmountable as to be near impossible. Rare is the native Israeli Hebrew-speaking physician who continuously learns at the level of a native English speaker.

Third, the average Israeli physician is more mature and has accrued more life experience. Wonderful. But here’s the catch. There are no shortcuts in medicine, and especially fields that require finely honed manual skills. Our fighter pilots and special operators spend an inordinate amount of time in training. This is so they can experience every conceivable tactical scenario and practice it ad nauseam until it becomes automatic when the stakes are high. An experienced physician knows that every single patient, and every single clinical scenario is different. I have had innumerable cases where the experience gained from patient 100 critically influenced the care of patient 101.

When older and more mature physicians come late and leave early because of family responsibilities, they miss out on valuable experience. Their training suffers. When the trainee physician is older and further along in life, they are much more parallel with their attending physician. The mentor-mentee hierarchy gets blunted.

The result is a culture where losing critical time during training becomes acceptable and normalized. This may be positive for personal relationships and work-life balance, but it is damaging to the production of excellent physicians. Don’t you want your physician to have attended an academic conference that morning, to enhance their understanding of your disease? Don’t you want them to have done that operation 50 times before yours, instead of 20, because they left early to pick up their child from gan every day?

Finally, Israeli-trained physicians may be smarter and more mature, but Israel is a small country. The typical US trainee’s experience includes a much larger and more diverse patient population, a larger staff to learn from, and increased clinical and academic resources at their disposal. This translates into a richer training experience.

Israel desperately needs US-trained specialists. My specialty is Interventional Radiology (IR). IR is defined by minimally invasive procedures using imaging guidance. Image guided surgery in various organ systems using thin catheters and tiny incisions is another way to think about IR. IR is the future of surgery and has already replaced many traditional operations. Take internal bleeding, whether from trauma, spontaneous, or from medical error. An expertly trained and adequately staffed IR unit can treat the vast majority of these hemorrhages using local anesthetic only and a 2mm incision in the wrist or groin. The traditional surgical alternative typically requires increased risks and prolonged hospital and recovery times. Which would you prefer for your loved one?

Amazingly, there are an estimated 30 IR physicians in the entire country of Israel. In the US, there is also a profound shortage of IR doctors, and Israel has per capita six times fewer than the US! Other notable fields in Israel in desperate need of quality physicians include vascular surgery, anesthesiology, and intensive care medicine. Jerusalem, along with the northern and southern ‘peripheries’, is even harder hit, as most young physicians prefer to live and work in Israel’s coastal plain. Many of the Soviet-era aliyah physicians are now reaching retirement age. The above means frequent sub-optimal, if not flat-out inappropriate care to Israel’s citizens. Not to mention the personal and family toll borne by the too few physicians carrying impossible work burdens.

US physicians, Israel needs you and wants you. Make the brave and noble decision to join us. You are special by virtue of your professional background alone. You have the potential to make a major impact on medicine in Israel, because the pond is so incredibly small. Do not wait for life to get in the way. Come after your training. And do not listen to the naysayers. You can earn a respectable living for your family. You will find professional life here immensely rewarding, and you will immediately and profoundly impact Israel’s medical future.

Adam Farkas, MD is the Director of Interventional Radiology at Shaare Zedek Medical Center

www.jerusalemvascular.com

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