The Israeli anesthesiology workforce crisis: a reassessment survey

Abstract

Background: Anesthesiologists provide crucial anesthesiology services in the operating room and non-operating room locations. Combined with an aging and growing Israeli population, there is an increasing demand for anesthesiology services. A previous study performed in 2005 showed that most anesthesiologists are immigrant physicians with few Israeli medical school graduates. Since then, physician immigration decreased, many have retired and demand for anesthesia services has increased while insufficient numbers of new anesthesiologists were trained, leading to a shortage, limiting surgeries and other procedures in many hospitals. The present study examined the composition of the Israeli anesthesiology workforce in 2021and compared it to the 2005 workforce.

Methods: A cross-sectional survey of demographic and professional information about each Israeli hospital anesthesiologists was solicited from 34 anesthesiology department chairs responsible for 36 Israeli acute care hospitals.

Results: There are 1313 anesthesiologists in the 36 hospitals, resulting in a ratio of 14.2 anesthesiologists per 100,000 population. 22.6% of anesthesiologists will reach retirement age over the next ten years. The proportion of female anesthesiologists was 28.7%. While Israeli medical school graduates increased to 18.1% from 12.2% in 2005, non-Israeli citizens and non-permanent residents comprised 8.5% of the workforce.

Conclusions: Despite growth in the ratio of anesthesiologists per population, a workforce shortage is expected to worsen over the next ten years due to retirements, shortened call hours, and the Yatziv reform which bans graduates of certain overseas medical schools from obtaining Israeli Medical Licenses. The current workforce has compensated for the existing shortage of anesthesiologists by enlisting non-Israeli trainees from overseas. Yet, it is crucial to maintain and enlarge the local Israeli workforce to forestall a worsening shortage.

Keywords: Anesthesiology; Israel; Physician workforce; Residency; Workforce shortage.

Fig. 1

Age distribution of the 1313 hospital department anesthesiologists. The black bar represents the graduates of Israeli medical schools. The hatched bar represents graduates of former USSR medical schools who are Israeli citizens or permanent residents. The white bar represents graduates of other medical schools who are Israeli citizens or permanent residents. The gray bar represents non-Israeli citizens or permanent residents. The graph shows a U-shaped distribution with a higher prevalence of anesthesiologists between the ages of 55–65 years and 30–40 years, with a dip between the ages of 40–55 years