English Version of an article that was published in TheMarker
The article written by Ronnie Linder-Gantz was published in TheMarker on June 10, 2017. Below is the English version. Click here to view it in Hebrew.
The sweet victory of Dr. Ray Bitton who became a doctor against all odds
Ray Bitton did not allow hindrances to stop her on the path of realizing her dream to become a doctor. She completed her internship cum laude and is soon commencing her specialization at the new Assuta Ashdod Hospital. "The state of medical standards in the periphery is shameful. The number of standards is stuck at standardization from the 70s"
Ronnie Linder-Gantz – TheMarker
We first came to know Dr. Ray Bitton, 34, on November 2014 when she was in her sixth year of medical studies at Bar Ilan University's Faculty of Medicine in Safed. Already at that time, the story of the manner by which she was accepted to medical studies against all odds was highly extraordinary and inspiring: Bitton relayed how she studied at a school which offered no possibility of obtaining five unit matriculation in English or Math, and how she was the only student who applied to five units Math after the matriculation exam was ordered especially for her.
Bitton relayed how following high-school she took five units in Biology, Literature and Oral Torah so as to improve her marks, registered to pre-academic studies and also did a matriculation exam in Physics, and how she took the Psychometric Test five times to improve her mark in the attempt to be accepted to medical studies. When this was also not enough to be accepted, she registered to BA studies in Emergency Medicine with the aim of moving on to medicine. Although she graduated cum laude, she was still short of nine points to be admitted to medicine studies.
At this stage, where most people commonly give up, Bitton decided to travel to Hungary and study medicine there, studies that cost 14.5 thousand dollars per year. She received a special scholarship of $10,000 from ISEF Fund, and individually collected the rest aided by her family and with great difficulty. Only in her fourth year, upon the opening of Bar-Ilan's Medicine Faculty in Safed in a tri-annual course, did return to become a medical student in Israel.
We met her this week, following completion of her internship cum laude, and after the status she had written about her success against all odds and despite the persons who tried to stop her on her way to become a doctor became viral.
Bitton, who has since become a mother of two daughters, is currently waiting for the opening of the new Assuta Ashdod Hospital where she will commence her specialization in Internal Medicine and Cardiology. "I always oriented myself towards Cardiology," she says.
Alike her life's course, the path to this specialization was also rough: on her first year of studies in Safed she resided in the city while her husband, who was at the time a dental student in Tel Aviv, resided in Ashdod. "We used to meet on the weekends," she recalls. After that they moved to Haifa. The family continued to support her and her dream throughout: "My first daughter was born a month before the final exam in Gynecology, and then my mother came to live with us in Haifa for three months so that I will be able to study. She used to bring my daughter to me every three hours and I would breastfeed her with my books on me."
Israel is still situated above OECD average
Her internship (seventh year of medical studies, practical work in hospitals; R.L.G) was conducted at Soroka Medical Center in Be'er Sheva. Upon completion cum laude, she received a specialization offer from the manager of Halev (Cardiology) Institute. However, despite the best intentions of all parties, the specialization at Soroka did not materialize: "We came to the meeting with the hospital's management and they told me that it will take at least half a year, without a commitment on a definite period of time. I was told that currently it is customary to wait for a standard at home and that there is no certain prediction when this awaiting will end. I was told that if I so desire, I can commence working in external shifts (a doctor who does night shifts but is not a hospital employee nor considered an intern; R.L.G), and that there are five persons listed before me for specialization in Internal Medicine."
Two opposing trends are evident in Israel in recent years: on one hand, a significant increase in the number of medical students via expansion of existing study frameworks and the opening of the medical faculty in Safed alongside the increase of the number of licenses for Israelis who studied medicine abroad – a state that coincides with the system's rising demands for doctors. These needs spring from the increase and aging of the population and the retirement of doctors who made aliya to Israel from the USSR in the 90s.
Israel above average
The number of doctors per 1,000 capita in OECD in 2015*
Austria ---------------------------------------------------------------------- 5.1
Spain ------------------------------------------- 3.8
Israel ------------------------------------ 3.4
OECD Average ----------------------------------3.3
USA --------------------------- 2.6
*Last available year Source: C.S.B
Israel is still situated a little over OECD average in the number of doctors (approx. 3.4 doctors per 1,000 capita in Israel in view of 3.1 doctors per 1,000 capita in OECD), yet the rate of doctors aged under 65 has dropped by 9% in the last decade and there is a need to prepare for the aging population.
On the other hand, despite the shortage in doctors there is also a shortage in standards for specializing doctors: the number of new doctors has increased however it is not accompanied by adequate standardization. Following the Doctors' Protest in 2011, 650 standards for specializing doctors were allocated and spread across a period of nine years, but it is not enough; if a decade ago there was a state where standards, particularly in the periphery, "waited" for specializing doctors, currently the situation is reversed, where doctors who have completed their internship wait for an available specialization standard for extensive periods of time.
Bitton explains that "the state of standards in the periphery is shameful: the number of clients increasingly grows while the number of standards is stuck at standardization from the 70s. Hence, multiple excellent medical graduates sit at home, sign unemployment, sometimes for a year or more – waiting for a standard to be available. This is not only the case in the most sought after specializations such as Plastics and Otolaryngology, but also in the least considered specializations such as Internal Medicine, Pediatrics, Chirology – all of the professions defined as lacking, where previously persons were accepted to specialize in them even before they officially completed their studies."
Eventually, Bitton decided to decline the offer: "It's a belittlement of the profession," she says. And then, she claims, "an amazing offer arrived from Assuta Ashdod. I submitted my resume and was summoned for an interview. Looking back, I am glad that this is the way things turned out, because it gives me a chance to take part in a Zionist pioneering act of establishing a new hospital. It attracts young interns to take action and go there."
Israel at the lowest place
Number of medical studies graduates per 100 thousand capita in OECD in 2015
Australia ------------------------------------------------------------------------------ 15.8
Spain -------------------------------------------------------------- 13
OECD Average ---------------------------------------------------- 12
USA --------------------------------- 7.5
Israel -------------------- 5.5
"Vanity is the first sin in Medicine"
Bitton adds that "there is a risk since it is new and the level of expertise is unknown, but everyone shares the interest of proving that the hospital is good. The true indication will be the percentage of those who pass Stage A (Certification Test during internship; R.L.G) in the internship."
Do you think that you and your peers - who are graduates of the tri-annual course in Safed, are older than "regular" medicine studies graduates, and some of which underwent an arduous path in order to be accepted to medical studies – have an advantage or a disadvantage over the rest of the new doctors?
"Yes, I do think that having to work hard in order to be accepted carries significance in view of someone who was easily accepted. It makes us appreciate the goal we have attained. This is also projected upon the clients. I think it makes me become more sympathetic towards them and speak to them at eye level. The sin of vanity is the primary sin in the field of medicine, and it is important for me not to commit it."
What is your message to a girl, like you, who is now reading this article?
"For and foremost, to dream - so that you will have something to realize. Then, to strive towards the goal without looking sideways, to believe in yourself and let no one tell you that you can't. To remember that sometimes the path is long and tiresome but there is nothing like the feeling of getting up in the morning and feeling that you have won."
