Upon completing his studies, the physician finds himself at a critical junction: he must decide upon which career path to embark. Clinical practice ought to be the obvious choice, being the direct and natural culmination of his many years of training. In practice, however, this is not so. Many doctors opt for other lines of work, or alternatively, to practice medicine abroad.
A survey conducted by the Technion and published in 2003, sampled 602 male and female medical school graduates in Israel in the years 1981–2000. The findings indicate that in retrospect, 12% of the graduates would not have chosen to study medicine. An additional 23% were not sure whether they would have chosen medicine. The survey also showed that 4.2% of the physicians left medicine in favor of other professions, such as industry and startup companies.1 Another recently published study shows an increase in the number of young doctors leaving the profession. The study, which included 733 doctors, graduates of medical faculties in Israel who received their license in the last decade, shows that in the graduating classes surveyed, the average percentage of graduates leaving the field of medicine was 5.5%.2
In addition to those who actually left, another 9% (still practicing medicine) have already turned to placement agencies or work interviews looking for other employment options. If even some of these active steps towards an alternative occupation materialize, then we can expect an even higher rate of physicians leaving medicine in the near future. It was also found that 13% of the physicians reported that they often contemplate the prospect of leaving the field, and only 65% of the sampled population of physicians never contemplate leaving, or do so very infrequently.3 The study's authors maintain that the intention to leave the medical practice and the actual withdrawal from it, are symptomatic of a regression in the level of physician motivation and work satisfaction. This may severely impact on medical services in general, and the quality of medical treatment in particular. Moreover, the study showed that an additional 51 doctors, outside the sample population surveyed, are currently abroad (6.5%). When this number is coupled with the number of those who left the profession, it emerges that approximately 12% of physicians do not practice medicine in Israel. 4 These findings correspond with, and are reinforced by new data held by the Ministry of Health, according to which, one out of seven medical graduates in Israel leaves the profession.5
These data come as no surprise, since they are consistent with the discrepancy observed between the number of licensed physicians under 65 and the number of physicians who actually practice medicine, as shown. These data correspond with the situation in other countries. According to OECD data, although the majority of graduates still choose to practice clinical medicine, there are now many more career opportunities in areas such as research, teaching and business. Although the majority of those diverting to these fields are doctors in the midst of their career, young doctors are also showing interest in these areas.6
As previously mentioned, recent years have also seen an increase in the number of women practicing medicine, and they are more inclined than men to opt for part-time practice. For example, 60% of female pediatrics residents intend to work part time, compared to just 15% of the male residents. It goes without saying that the difference in the number of work hours, coupled with absence due to childbirth and earlier retirement, strongly impacts on the number of physicians required.7
The reduced number of work hours resulting from the rise in the number of women in the field, increases demand for practitioners. When this demand is not met, there is an increase in the shortage of medical manpower as well as the individual physician’s workload, which in turn further lowers the medical profession’s stature.
While opportunities for work in other rewarding fields increase, the physicians who remain in the medical profession are subjected to burnout, excessive workload, pressure, violence, and other negative phenomena which will be discussed later. These phenomena diminish the appeal of the field of medicine, and should be viewed as major causes of the physician shortage.
1 N. Biterman and A. Shalev, "Survey of Medical Schools Graduates in Israel 1981-2000" the Technion, June 2003: 88.
2 D. Van Dyke, K. Holzman Shweid, G Ben Nun, and T. Kushnir, "Satisfaction at Work, Abandonment Intentions and Abandonment of the Medical Profession among Doctors in Israel: Survey of Licensed Doctors in the Years 2000, 2002, 2004, 2006", Harefuah 150 (4): 311. "Abandoning Doctors" were defined in the study as doctors who do not practice medicine, but have another occupation such as working in a technology company, pharmaceutics company, and business.
3 Page 312-313
4 Page 311
5 S. Rozenblum, "Medicine Complementary" Yediot Acharonot Newspaper, 5 April 2011
6 OECD, The US physician workforce: Where do we stand? OECD health working paper no. 37, October, 2008.
7 Ibid