geriatrics in Israel

 

Geriatric medicine – Israel (EUMS )
Israel’s total population is approximately 9,000,000 with a multi-variegated population made up of approximately 80% Jews and 20% Arabs (almost all Moslems). All Israelis enjoy very high life expectancies at every age (average at birth 84.4, higher than the OECD average). The percentage of people aged 65 and older in 2020  is 11.5  % making Israel a relatively young member of the EUMS. However the population is ageing and this figure is expected to reach 15 % in 2035. However, the absolute number of older persons is rising more rapidly that is suggested by the relative figures. Older persons in Israel come from many countries, with approximately 40% having been born in the country. Over one third are survivors of the Holocaust which presents special challenges to health and social services 
Nationwide health spending (public and private) in Israel totals only 7.5% of GDP, compared with the 8.8% OECD average, with only 60% of spending in Israel coming from public funds. 
In 2020 there are 330  practicing specialists in Geriatric Medicine in the country, 420 if one includes those retired, some of whom maintain some activity.  There are three routes to become  a specialist  the shortest at 4 ½  years after licensure (2 years Internal Medicine , 2 ½ in a geriatrics ward.) The other two routes are a 2 1/2 year fellowship following either Family Medicine or Internal Medicine (both are 5 year residency programmes).
 
Of the just over 40  major general hospitals in the country, almost  all have a geriatrics teaching programme  involving consultations, acute Geriatrics , subacute and rehabilitation units, dementia and psychogeriatric units, daycare-hospital, specialized memory clinics, and geriatric outpatient clinics. 
A curriculum in geriatric medicine is integrated into the undergraduate medical training in each of the country’s 5 medical schools although the time allotted is insufficient (1-2 weeks only). Unfortunately, geriatrics is not a mandatory rotation for residencies in either Family or Internal Medicine residencies, although it can be taken as an elective. Academic geriatrics is very active with a number of associate and full professors of Geriatric Medicine in Israel’s Faculties of Health Sciences.
A challenge to the health system in general and older persons in particular is that the population of the country’s   doctors themselves  are ageing, and is currently second only to Italy in the proportion of physicians over 55, with half of Israel's doctors being in this category. With their imminent retirement over the next decade there is increasing concern that there will be insufficient young doctors to take their places. 
 The Israel Geriatric Medicine Society (IGS) was founded in the 1980s  and has more than 400 members. Geriatric medicine have been a recognized medical specialty since the early 1980s.  The IGS has been a Full Board Member of the EuGMS since 200??  President  Tzvi Dwolatzky, EUMS representative:  A. Mark Clarfield (markclar@bgu.ac.il) 


For further details please see: 
1)    https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30789-4/fulltext
2)    Clarfield A. Mark , Paltiel A, Gindin Y, Morganstin B, Dwolatzky T. Country profile: Israel. J Amer Geriatr Soc 2000;48:980-4.

contacts in Israel

Prof., MD, FRCPC

Mark Clarfield

markclar@bgu.ac.il