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The Very Model of a Modern Major Doctor—By Wendy Elliman (as appeared in Hadassah Magazine, April/May 2010, Vol. 91 No. 5)

4-May-2010

 

They come from towns, villages and kibbutzim across Israel (four of them are Druze). They are from the religious and secular communities; the youngest have just finished high school and the oldest is 25.

 

These young men and women comprise not only the first students in Israel’s first military-medical school, but also, believes school dean Dr. Shmuel C. Shapira, the future leadership of Israeli medicine.

 

“They have been selected for an excellence program, which teaches leadership and teamwork as well as advanced clinical and medical research skills,” says Dr. Shapira, who is deputy director-general of the Hadassah Medical Organization and director of the military-medicine track at the Hadassah–Hebrew University Faculty of Medicine in Jerusalem. “With eight candidates applying for every available place, we were able to choose the best.”

 

This volume of applicants is expected to mushroom as the track, which gives graduates a medical degree with a military specialty, becomes more widely known. 

 

“We had only six months in which to plan and recruit for this inaugural year,” says coordinator Ilanit Tobby-Alimi. “All of Israel’s medical schools competed fiercely for the privilege of teaching it. Hadassah won the Defense Ministry tender last April, and we opened in October. Our academic reputation, our medical and physical facilities and the syllabus we proposed made our bid their clear choice.”

 

Building a curriculum and recruiting students were fast-tracked into a quarter of the time a new academic institution usually takes because the Israel Defense Forces could not afford to wait. Each year it needs 70 new military doctors: In 2006, only 46 candidates applied for IDF military-medical courses. Two years later, that number was down to 30. So Hadassah scrambled planning teams, looked at (the very few) international models, created shortcuts where possible and adapted and improvised in classic Israeli style—and opened on schedule.

 

“What we have created is, in very many ways, a new model of military-medical education,” says Dr. Shapira, who has been involved for decades in training physicians, both at Hadassah and as a 17-year Israel Navy veteran. A former head of the IDF medical corps trauma unit, he is today, at 54, an active reserve lieutenant colonel and an expert in terror medicine and nonconventional weapons threats. He also advises the IDF about prevention and response to potential biological, chemical and nuclear attack.

 

Military medicine is a distinct academic discipline, notes Dr. Shapira, a body of knowledge particular to the medical needs and problems of military units, differing from that required in ordinary medical practice. 

 

The military doctor must manage military trauma, injuries inflicted by unconventional weapons, exertion, environmental medicine (exposure to extreme cold and heat, high altitudes and undersea environments), search and rescue, military epidemiology, military-related psychological and stress disorders, primary-clinic management and mass casualty and disaster. He or she must move comfortably between fixed and field medical facilities and confidently make medical recommendations about the health of a platoon or commander. 

 

“The medical corps has given excellent service, but now gaps will be closed and we will operate from a stronger academic base,” said Chief Medical Officer Brig. Gen. Nahman Ash at the formal ceremony for the track’s opening.

 

Until now, military physicians have been medical school graduates, their skills bolstered by short IDF medics’ and medical officers’ courses and self-education. The curriculum designed for the six-year military-medicine track by Hadassah, the Hebrew University of Jerusalem, the Defense Ministry and the IDF will not only graduate skilled doctors, but also teach these future officers courses in Zionism, Jewish studies and leadership.

 

Forty-one of the 50 students in the program are post-high school. Ilanit (full names are not printed at the request of the IDF), a gifted basketball player, was recruited into the IDF’s sports-training unit but applied for the military-medicine track instead. “I feel I can contribute more as a physician, both during my Army service and afterward,” she says. “And I can continue as a basketball coach in my spare time.” She is already working with one of several Jerusalem teams that clamored for her when she moved to the city.

 

Nine of the students have completed their Army service but will spend another five years on a base or with a combat unit following their six-year medical training—a commitment required by the Defense Ministry, which picks up the tuition and housing costs. The oldest student, a religiously observant man, served in an IDF elite unit. “When I heard about the track, I realized this was what I really wanted to do,” he said.

 

The 50 students share many classes with the 100 regular first-year students at Hadassah–Hebrew University Medical School. Israel’s first medical school, the Faculty of Medicine was opened by Hadassah and the university 60 years ago, and its graduates have been at the forefront of Israel’s clinical and academic medicine ever since. As well as studying the regular medical school curriculum with the faculty students, the military-medicine track students will, like them, do rotations in medical facilities, although theirs will mainly be in military clinics and bases.

 

From here paths diverge. “Added to the track curriculum are specialized military-medicine courses and the selected nonmedical subjects,” says Dr. Shapira. “During the long summer vacations, the students will do basic IDF training and officers’ courses—both women and men. Women doctors don’t go into combat with infantry units, but other than that, there’s no difference in the IDF service of men and women physicians.”

 

Mitigating this demanding study schedule is the fact that the military-medicine students need not work their way through school. “Tuition is covered, and all students live together in the medical school dorms, whether they come from in or outside the city,” says Tobby-Alimi.

 

An important component of the program for these students from very different backgrounds is to bond with one another and to their teachers. Dr. Shapira and Tobby-Alimi keep in close touch with all 50. “We value each one of them,” he says, “and we hope their experience at Hadassah will bring many of them back here once their military careers are over.” 

 

To recruit students, Dr. Shapira travels the country, speaking to 10th-, 11th- and 12th-graders. “I tell them we’re looking for top candidates who want to combine medicine with the special contribution to Israel society that can be made in the IDF,” he says. “I put a lot into selling the track and seeking out the best and the brightest, but the most effective recruiters will be our own graduates.”

 

As the track fills up, it will have an increasing impact on the medical school. “There will be 300 military-medicine students on campus by the time the first 50 reach their final year, and considerably more if Hadassah and the university feel able to increase annual intake to 75, as the defense establishment wants,” says Dr. Shapira. “Track students are far more socioeconomically and demographically diverse than the faculty students. We are expecting to see an enriched campus, both academically...and socially.”

 

A military-medicine track has been the dream of many for years, explains Dr. Shapira. “Each of Israel’s surgeons general has wanted this. Hadassah, which launched medical, nursing and dental education in Israel, has long wanted it. 

 

“And it has been my own personal dream as well. I feel deeply privileged to direct this military-medicine track. It involves promoting three of the things closest to my heart: medical education, health care and the security of Israel.”