MDs in the Periphery

Scientific background

One basic condition for supplying available, accessible, and high-quality health services is a trained medical workforce in appropriate numbers. Israel has been struggling with a physician shortage in the periphery, posing a major challenge to medical-service delivery there.

One step taken in recent years to ease the shortage was the provision of financial incentives to interns in the periphery. A study we conducted on the impact of the incentives showed an increase in the number of internship starts in peripheral hospitals, due to several factors, including the incentives. However, the number of physicians remaining in the periphery after their internship remains unknown.


  1. To examine the extent to which physicians who received the incentive have remained in the periphery
  2. To map the career route of physicians in the transition from interns to specialists
  3. To understand the process of choosing a post-internship workplace

Working hypotheses

  1. A large portion of physicians interning in the periphery will remain to work there, especially if they come from there originally
  2. Satisfaction with internship will play a large role in the decision on subsequent workplaces
  3. Factors influencing the post-internship choice of hospital will include its ability to offer sub-specialization and organize a fellowship abroad

Type of research and methods of data collection

  1. Cross sectional study based on a physicians’ survey
  2. 10-15 preliminary interviews with directors and young specialists to understand the transition process between internship and specialization
  3. Internet survey supported by telephone calls to some 650 post-internship physicians

Methods of data analysis

The data will be weighted by the sampling rates of the various layers. Distributions will be examined, and bi- and multi-variate analyses conducted.

Uniqueness and Relevance to the National Health Insurance Law

Important data will be collected as an input to medical workforce planning and interventions impacting physicians distribution – topics vital to the supply of equitable, high-quality, appropriately available medical services. The research questions have not been investigated in Israel so that this study will provide new data. Some of data will also be pioneering on an international scale.

Possible policy recommendations

Recommendations on the use of financial incentives and on other steps to attract physicians to various districts, specialties, and frameworks of care.