May 2024

"Increase your wisdom and do not let it go, for it is your life and from it come the results of life" (from the "Hebrew Physician's Oath").

For ages, throughout today, physicians have considered medical education and teaching as integral parts of their role.

Medical education is a great privilege as it provides interest, continuity in the profession, and drives up-to-date practice and specialization. However, it also carries a significant responsibility toward medical students and society at large.

In the medical community, teaching residents is seen as the pinnacle of professionalism due to the advanced level of medical education involved.

The State of Israel, through the Scientific Council of the Israel Medical Association, is committed to maintaining high standards in residency programs, which is why substantial resources are invested in these programs.

The process of admitting physicians to residency programs is conducted by department heads in departments accredited for training. Naturally, some departments and specialties are more sought after than others, creating occasional pressure on department heads during the admission process.

The Ethics Office has received complaints about inappropriate conduct by managers in the health maintenance organizations (who are not physicians), who conditioned the admission of certain residents on "bringing new clients to the health fund."

These complaints are joined by the fact that even in hospitals, department heads in high-demand departments are under enormous pressure to admit "influential doctors" into their residency programs. These pressures come from both within and outside the healthcare system.

In response to these complaints, the Ethics Office, with the encouragement of the Scientific Council of the Israel Medical Association, convened to establish rules to strengthen the responsibility of the department heads regarding the admission of physicians to residency programs based solely on professional considerations.

Position Paper:

1. Every physician has an ethical obligation to contribute to teaching the next generation of doctors, to the best of their ability.
2. The department head is solely responsible for the admission of physicians to the residency program and has a heightened duty to ensure the quality of teaching in his department.
3. When admitting a resident to the residency program, the department head should base his decision solely on professional criteria, which includes the benefit to the profession and the quality of the future specialist, and without foreign considerations.
4. Physicians must not exert pressure on the department head, or anyone else, to admit a particular resident for non-professional reasons.
5. Admission to a residency program must not be conditioned on bringing, transferring, or recruiting insured patients to the health maintenance organization.