[Medical training in Israel--can we realize the comments of Pazi's Committee and at what cost?].

In spite of the growth of Israel's population, the number of graduates from the four Israeli Schools of Medicine has changed very little in the last 30 years. Nevertheless, the annual number of new practitioners grew from about 300 to 900, due to Israeli graduates of European Schools and the large number of physicians among the new immigrants from the former USSR states in the early nineties. A committee, nominated by the National Board of Higher Education (MALAG), headed by the late Prof. Pazi, concluded that under steady state conditions we must train 800 medical students per year. MALAG adopted this recommendation. As a first step, MALAG approved two new programs: a special program for Academic Reserve candidates (Atudaim) and a new (5th) medical school in the Galilee. These two new programs, together with the new 4-year MD program in Tel Aviv, will add about 200 graduates to the list of medical students. Yet, the question of whether we can realize the recommendation of Pazi's Committee (to train 800 MDs annually) and at what cost, remains open. This preliminary review is devoted to the relevant factors that must be considered before the latter questions can be answered. First, we note that the limiting factor of the number of medical students is the ratio between the number of teaching departments in each of the medical disciplines and the number of weeks of Clerkships required in the given disciplines. Our main conclusion is that realization of the recommendation of Pazi's committee requires an increase in the number of teaching departments, preferably by upgrading the academic level of those departments that do not teach students, and increasing the teaching load of other departments. We may also have to reduce the number of weeks of 'bedside teaching' but should beware of reducing it to a minimum lower than about 70 weeks, as in North America. Regardless of the need to train more physicians, we must increase teaching in the community. Only a combination of all these measures will reduce our dependence on the education of Israeli physicians abroad.