*The text below was written by Joseph Sofaer, a recent graduate. NBN is extrmely thankful for his time and efforts in putting this article together.
Medical Licensing Exam for Physicians Who Just Graduated Medical School
Note: If you graduated from a U.S., Canadian or U.K. medical school, and completed a residency or internship prior to moving to Israel, you will NOT be required to take an exam.
If you completed medical school but did not start a residency or perform an internship, you are required to do a one-year intership (‘Staj’) before entering residency. In order to qualify for an internship spot, you must pass a specific licensing exam. The following is one person’s impressions of the exam:
I graduated from the University of Ben Gurion’s International Program (MSIH) in May 2019 and took the licensing exam in October 2019. I thankfully passed after going through an appeal process (which I’ll explain later). Since then I was placed at Shaare Zedek for Staj. The following advice is based on what I went through and will hopefully help prospective doctors.
Registering for the Exam:
The exam is given twice per year: once in the summer/autumn and once in the winter/spring. You must pass the exam before being eligible for Staj. The exact date of the exams varies and registration had to be completed by approximately two months before the date of the exam.
The exam is administered by an office called the Israel Medical Association. Phone: 03-610-0444. You cannot, however, register directly with this office.
Registration was done via the Agaf Rishui Mikzaot Refuah department of the Health Ministry, who have a number of offices to serve the various regions of Israel – Jerusalem, Tel-Aviv, etc. They deal with a wide variety of issues pertaining to licensing MDs, including stajers from abroad.
I was told that in order to register, I had to provide the following:
- MD diploma or certification from your university stating that you have completed your studies and have fulfilled all requirements to be eligible for a degree in medicine, which will be awarded at a certain time
- Official transcripts
- Official certification of the date that you commenced and completed your studies
- Syllabus of the program of study at your school of medicine: subjects studied, courses and examination grades – divided into years (preferably divided into semesters) during the years of study, including starting and finishing dates
- Teudat Zehut or photocopy of your passport with a valid visa
- Two passport photos
- A healthcare worker questionnaire
- An application to take the exam
Original documents are not to be sent, only notarized copies that were certified by a licensed notary in Israel. The original notarized certification (with the red ribbon) should be sent, as well as an additional copy of it (a total of two copies).
Documents in languages other than Hebrew and Arabic must be translated into Hebrew by a qualified translator in Israel. A copy of the original document and its translation must be submitted.
After submitting my documents in person and confirming with the office that they had received them, all I had to do was wait for my confirmation to come through. However, as the weeks passed and I still hadn’t received said confirmation I started to worry a little and emailed the office (as I was overseas at the time) to see what was going on. Much to my astonishment, the office emailed me back saying they hadn’t gotten to my application yet (this being already past the deadline for applying for the exam). After a few back-and-forth emails, I received the confirmation – and saw I was registered to take the April 2020 exam instead of the October 2019 exam. Several nervous weeks later and a huge amount of help from Nefesh b’Nefesh’s Head of Government Advocacy and Employment Division, I was confirmed for the October exam!
I later received an email with confirmation of registration and providing the details of the exam (date, time, seat location etc.).
Preparing for and Taking the Exam:
The exam is computerised and is multiple choice, divided into two sections of 110 questions, with 2.5 hours per section and a ~30 minute break in between. You can take the exam in English, Hebrew, Arabic, Russian and other assorted languages. The pass mark is 60%. It is a mentally draining exam, much like the USMLE Step 1 and 2 CK and you need to be prepared for this.
I used the UWorld question bank for three months, first learning by fields (internal, pediatrics, surgery etc.) before putting them together. I also used Online Med Ed for their reviews. I’m sure review books could help, but throughout medical school learning through practice questions always worked for me so this is how I did it.
When I took the exam, I found the first session to be much more difficult than expected, but the second section was perhaps a little easier but I’m sure it all depends on the exam and the random question number allotment you receive. Questions were difficult and were often highly specialised (eg. asking an oncologist a question versus a family doctor). It was obvious in the exam that questions are directly taken from random paragraphs in the recommended textbooks and a lot of the time are not clinically based at all. Some questions were definitions of words, some asked about extremely specialised things I hadn’t even learned in medical school and some had mistakes in the question and/or answers. So be prepared for anything that they can throw at you. I don’t recommend reading textbooks back to front, but to learn as much clinical knowledge as you can, which should pull you through.
Approximately 6 weeks after writing the exam I checked my profile on the IMA website and it showed that I had failed the exam, but I had an appeal in a few days because I had received a mark between 55 and 59. I did not get an email! So make sure to check yourself everyday after about a month in case the results were released. The appeal consisted of me going to a specified location where hundreds of other ‘nearly passed’ examinees and I sat in front of computers that showed every question in the exam, the correct answer and the answer I had marked in the exam. If I disagreed with anything to do with a question or answer, I wrote it down on a sheet of paper. After the appeal, I had to look up every question I had written down in the corresponding textbook (ie. surgery questions were looked up in the surgery textbook). I had to find proof that my answer that I had marked was correct, or that the answer shown as correct in the appeal was incorrect. I had to write a separate ‘appeal’ (in Hebrew) for each question, stating proofs from the recommended textbook and a photocopy of said proof. After handing in the appeal in person to the IMA office in Tel Aviv, I had to wait another 6 weeks or so to receive confirmation of my passing the exam (late January by now).
However, another problem came up. The Health Ministry had gone ahead with the lottery (Hagralah) to place Staj doctors before the results of the appeals were finalised, so I had to wait until the next lottery which may not be until June/July. However, Coronavirus put paid to that because the Health Ministry decided to rush through waiting Staj doctors in March 2020 to help with the pandemic and assigned us to hospitals as close to our place of residence as possible. And because the Health Ministry had my wrong address (I had previously lived in Beer Sheva), I was placed in Soroka instead of a Jerusalem hospital (sigh). But thankfully, after a few days of wrangling with the Health Ministry, I received confirmation of my Staj at Shaarei Tzedek in Jerusalem. And that’s where I am now, sending in a bunch of forms and waiting to start life as a working doctor here in Israel!
Note about the USMLE Exams:
It is possible to not have to take the Israeli licencing exam if you have passed the USMLE Step 1 and Step 2 CK. It may be a little more complicated, but will save you time and you will be able to start working earlier (if you’ve already taken and passed said exams before applying for Staj).
- It is important to know that Olim Chadashim are entitled to some degree of funding from the Misrad Haklitah. In general the Misrad Haklitah will fund you for 6-months.
- This can be very helpful in getting your foot in the door of a residency spot that would otherwise be unavailable.
- Of course, if you can find a residency that can start you on a regular teken immediately, you should do so (the salary from the Misrad Haklitah is lower).
- You must open a Pincas Hitmachut before you begin residency. Otherwise, any time you spend in residency may not be counted!
If you happen to have a research background (e.g. published 3 papers) then you may qualify for assistance from the Misrad L’Klitah B’Madah (02-675-2767). They will provide funding for up to 3 years, although the salary is fairly low. Once again, this is only an option you’d want if you couldn’t be accepted to your residency of choice with regular funding.