title: Policy issues related to educating the future Israeli medical workforce: an international perspective.
abstract: A 2014 external review of medical schools in Israel identified several issues of importance to the nation's health. This paper focuses on three inter-related policy-relevant topics: planning the physician and healthcare workforce to meet the needs of Israel's population in the 21(st) century; enhancing the coordination and efficiency of medical education across the continuum of education and training; and the financing of medical education. All three involve both education and health care delivery. The physician workforce is aging and will need to be replenished. Several physician specialties have been in short supply, and some are being addressed through incentive programs. Israel's needs for primary care clinicians are increasing due to growth and aging of the population and to the increasing prevalence of chronic conditions at all ages. Attention to the structure and content of both undergraduate and graduate medical education and to aligning incentives will be required to address current and projected workforce shortage areas. Effective workforce planning depends upon data that can inform the development of appropriate policies and on recognition of the time lag between developing such policies and seeing the results of their implementation. The preclinical and clinical phases of Israeli undergraduate medical education (medical school), the mandatory rotating internship (stáge), and graduate medical education (residency) are conducted as separate "silos" and not well coordinated. The content of basic science education should be relevant to clinical medicine and research. It should stimulate inquiry, scholarship, and lifelong learning. Clinical exposures should begin early and be as hands-on as possible. Medical students and residents should acquire specific competencies. With an increasing shift of medical care from hospitals to ambulatory settings, development of ambulatory teachers and learning environments is increasingly important. Objectives such as these will require development of new policies. Undergraduate medical education (UME) in Israel is financed primarily through universities, and they receive funds through VATAT, an education-related entity. The integration of basic science and clinical education, development of earlier, more hands-on clinical experiences, and increased ambulatory and community-based medical education will demand new funding and operating partnerships between the universities and the health care delivery system. Additional financing policies will be needed to ensure the appropriate infrastructure and support for both educators and learners. If Israel develops collaborations between various government agencies such as the Ministries of Education, Health, and Finance, the universities, hospitals, and the sick funds (HMOs), it should be able to address successfully the challenges of the 21st century for the health professions and meet its population's needs.
authors.affiliation: Josiah Macy Jr. Foundation, 44 East 64th Street, New York, NY USA.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Schoenbaum
authors.affiliation: University College London, Gower St, London, WC1E 6BT United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Crome
authors.affiliation: University of Illinois College of Medicine, 1853 West Polk Street, Chicago, IL 60612 USA.
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Curry
authors.affiliation: Department of Psychiatry and Behavioral Neuroscience University of Chicago Medicine, 5841 S. Maryland Ave., MC 3077, Rm M344A, Chicago, Illinois 60637 USA.
authors.forename: Elliot S
authors.initials: ES
authors.lastname: Gershon
authors.affiliation: Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, 8410501 Israel.
authors.forename: Shimon M
authors.initials: SM
authors.lastname: Glick
authors.affiliation: University College London, Gower St, London, WC1E 6BT United Kingdom.
authors.forename: David R
authors.initials: DR
authors.lastname: Katz
authors.affiliation: Faculty of Medicine Hebrew University Hadassah School of Medicine, Braun School of Public Health and Community Medicine, Ein Kerem Campus, Jerusalem, Israel.
authors.forename: Ora
authors.initials: O
authors.lastname: Paltiel
authors.affiliation: Division of Otolaryngology Department of Surgery, Brigham and Women's Hospital, 45 Francis St, Boston, MA 02115 USA.
authors.forename: Jo
authors.initials: J
authors.lastname: Shapiro
keywords: Financing medical education; Health professions workforce planning; Medical education; Physician workforce planning