Home Page in English Ben-Gurion University of the Negev עמוד הבית בעברית אוניברסיטת בן-גוריון בנגב
 
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OVERVIEW

Introduction

The Negev Desert comprises over 60% of the land of Israel. Its residents (numbering over 520,000) comprise one of the most unusual ethnic mixtures in the world. Who are the people of the Negev? They are immigrants from North Africa, Ethiopia, India, Europe, North and South America and the Republics of the former Soviet Union; they are Bedouin Arabs and Jews born in Israel.

In a small corner of this desert, the Joyce and Irving Goldman Medical School of Ben-Gurion University has become a beacon to countries throughout the world. Originally located in Beer-Sheva's Soroka Hospital (which serves the entire population of the Negev), the Joyce and Irving Goldman Medical School brought major changes to the world of medical education and substantially improved health care in the Negev.


The orientation of this school ... provides the rest of the world with an extraordinary model for research, education and service. [It] brings a realism into the health and education system that we sorely lack in the United States.

Philip R. Lee M.D.
U.S. Asst. Secretary for Health, 1994

 

 

The Beer-Sheva Experiment

This extraordinary development in Israel is without parallel. It is most unlikely that the events which have taken place there could occur in any other country. ... It is the history of Israel, the culture of the Jewish people, with its emphasis on health and admiration for the medical profession, and the nature of Israeli society that have created the Beer-Sheva experience. No two countries are the same but no country has any greater claim to uniqueness than Israel has.

Willoughby Lathem, Editor
"The Future of Academic Community Medicine in Developing Countries"
Rockefeller Foundation, New York, 1974



Ben-Gurion University set out in 1974 to create a unique medical institution - a Medical School which was to be the major component of the new Faculty of Health Sciences. Created under extremely adverse economic and psychological conditions, the Medical School accepted its first students immediately after the Yom Kippur War.

Its program marked a dramatic departure from conventional institutions for medical education. In order to counter the trend toward training specialists who tend to focus on only the "sick" part of the patient, and whose services are rendered in large central hospitals, the new medical school presented a so-called experimental program. Its goals were:

  • To train its students to be aware not only of their patients' medical problems, but of their psychological and social backgrounds as well. The patient is regarded as a human being - part of a family, a community and a culture - factors which must be taken into account when treating an illness.
  • To assume responsibility for the health care of the population of the Negev by delivering medical services of the highest standards both in the hospital and in the community.
  • To hire and train first-rate clinicians and health-care professionals and to support continuing medical education programs for practicing physicians and other health professionals.
  • To conduct clinical and basic biomedical research of the highest standards as well as to establish programs for health economics and policy, health promotion and disease prevention.

The result of this effort has become a model of medical education and the Joyce and Irving Goldman Medical School of Ben-Gurion University is now a world leader in the field of community medicine. The "experiment" in medical education is, in reality, a radical return to its roots wherein the physician cares for the patient as well as the illness.

It is clear at this still early stage of the experiment that your reforms have had a significant impact on your own student body at Ben-Gurion as well as on the three other medical schools in Israel. Moreover, your reforms have provided an important model for a number of third-world nations. You have had marked success in selecting and educating medical students who are interested more in treating individuals than diseases.

Eli Ginzburg
A. Barton Professor Emeritus of Economics, and Director, Conservation for Human Resources
Columbia University, NY

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Training the New Physician

Ben-Gurion University in Beer-Sheva, Israel remains the best example of a medical school methodically focusing on personal qualities. This small school, ... has from its beginning emphasized empathy, flexibility and responsibility in the admissions decision. Candidates complete an autobiographical form including three standard questions (on a moral dilemma, a significant experience and a major achievement). Interviews take off from these responses, focusing as much as possible on students' actual deeds. ... With particularly promising candidates, interviewers shift to more stressful questioning.

While Ben-Gurion's admission process is more time-consuming than most schools, ... the results are worth the effort.


Promoting Medical Student's Ethical Development:
A Resource Guide
American Association of Medical Colleges
Prepared by Janet Bickel, Oct. 1993

 

The new approach to medical education begins with the admission procedure at BGU, for student selection is the very first step in training a new kind of physician. Believing that doctors need compassion at least as much as a high grade point average, at BGU emphasis is placed on interviews designed to reveal the applicant's personality, motivation and sensitivity. Competition is keen. Over 1,200 candidates vie each year for the 70 available places in the Medical School.

The unique approach to medical education is symbolized at each commencement ceremony. When the time comes for the recital of the Physicians' Oath it is not the graduates who take the pledge. Instead, the freshmen rise to pledge themselves as new practitioners of medicine. The graduates stand with them, reaffirming their own pledge taken seven years earlier, and saluting the new generation of students who are about to begin their medical careers.

From the very start of their medical education, the new students, under appropriate supervision, work in community clinics and hospitals throughout the Negev receiving a "hands-on" education. At BGU, medical students learn not merely from textbooks, case histories and lectures, but by personal interaction with patients.

The spiral system of teaching was considered to be unique. The integrated six-year program, followed by a year of internship, emphasizes the early acquisition of clinical skills in addition to the study of medical Sciences. Basic sciences, sometimes studied in small tutorial groups, are oriented toward practical application. Teaching methods include fewer lectures and more group discussions, tutorials, clinical and epidemiological projects and field work. The entire process encourages independent study and the maintenance of high standards while it develops the ability to care for others which originally motivated the student to choose medicine as a way of life.



The Beer-Sheva Experiment has become institutionalized and the justification for the program - the integration of medical education and medical delivery - has been realized. ... The medical program at BGU embodies a philosophy of health care service as the overall mission with medical education as a means to this end. A combination of extraordinary leadership and esprit de corps among students and faculty seems to contribute to sustaining Beer-Sheva's viability, especially as shown in the numbers of graduates who remain in the Negev to practice.


Ronald E. Richards
The Kellogg Foundation,
Battle Creek, Mich.

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An integrated Medical Program for the Negev

It seems incontrovertible that the establishment of the Medical School alone made possible the expansion and improvement of Soroka Medical Center into a major regional hospital with a broad array of sophisticated services. The placement of students, residents and faculty (part-time) throughout the Negev surely contributed to the improvement in the range and quality of medical care in the clinics of the region.

Eli Ginzburg
A. Barton Professor Emeritus of Economics, and Director, Conservation for Human Resources
Columbia University, NY



In partnership with Clalit Health Services, the largest provider of health services in Israel, and the Soroka University Medical Center, Ben-Gurion University participates in providing health care for the entire region. This is not a simple task, since the heterogeneous population of the Negev is scattered over 6,000 square miles. Its residents live in small cities, development towns, absorption centers, kibbutzim and other agricultural settlements. In addition, the health needs of, 520,000 Bedouin, some still semi-nomadic, require special attention.

A great deal of emphasis has been placed on education and prevention, on the continuity of care through various phases of illness and on developing outreach programs to handle populations that are not effectively served in a traditional medical care setting.

  • Dialysis treatment is regularly available to distant kibbutzim and to Bedouin tents through the mobile dialysis unit that travels throughout the region.
  • Special-cardiac preventive programs provide screening, testing, dietary advice and follow-up examinations for children who are at risk because one or more of their parents have heart disease. The service is available in Clallit Health clinics throughout the region.
  • Medical students have developed a number of unique programs for school children of all levels, from first grade through high school. The medical students teach programs in basic sciences, medical ethics, smoking prevention and clinical sciences in regional schools and at the Medical School itself.

The Joyce and Irving Goldman Medical School of BGU does not operate in an ivory tower. It plays a vital role in planning and providing health care for residents of the Negev, and has developed creative models for other institutions in Israel and abroad.

Representing more than 2,500, ASRN, The Medical Students Association of the Negev, which embodies the true meaning of "The spirit of Beer-Sheva" is active in a large number of community projects including: Ma'amatz, a high-school intervention and educational program on sexual violence; A Teddy Bear Hospital aimed at alleviating the"white coat syndrome" in children 4 to 6 years of age, Dr. Clown, a seven month training program in the art of clowning aimed at alleviating the pain, grief, fears and stress of a hospitalized child and Nitzanai Refuah, an affirmative action initiative that offers special pre-academic courses and tutoring to high school students from the Negev's development towns and Bedouin community seeking careers in the health professions.  .

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Achieving the Goals

This school ... is looked to as one of the boldest and most imaginative innovations in medical education in a very long time. The combining of service and educational activities in a truly integrated way, and the inclusion of services other than those that are hospital based are important efforts that are significant to all parts of the world.

Frederick C. Robbins, Former President
Institute of Medicine,
National Academy of Sciences,
Washington D.C. 1982



The Medical School of Ben-Gurion University has grown from fragile infancy to thriving maturity in its 33 years, exceeding the vision of its founders while fulfilling its basic principles:

  • Community Medicine: The orientation in this regard is represented by a strong Department of Family Practice as well as Units for Community Health, Health Administration and Management, Epidemiology and Health Care Evaluation, and Health Promotion and Disease Prevention. Some of these units are unique in Israel.
  • Improving Health Care in the Negev: Close ties with Clalit Health Services, the main health care provider in the Negev, the Soroka Hospital and community clinics has had a pronounced effect on raising the standards of medical care in the Negev.
  • A 'New Breed' of Doctors: A recent survey found that 80% of hospital department heads outside Beer-Sheva specifically cited BGU graduates as outstanding in doctor-patient relationships and as good or better than graduates of other Israeli schools in 14 other categories.
  • Research: Research programs in neuroanatomy and neurophysiology, immunology, microbiology, and molecular biology are excellent. The Epidemiology and Nutrition research programsare the best in the country and among the best in the world. The Faculty has established eleven research centers in order to expand the scope of research, increase the emphasis in certain academic and research areas and streamline interdisciplinary cooperation.  These centers include:- the Zlotowski Center for Neuroscience, the S. Daniel Abraham International Center for Health and Nutrition, the University Center for Cancer Research, the Moshe Prywes Center for Medical Education, the Center for Multidisciplinary Research in Aging, the Center for Medical Ethics, the Center for Women's Health Studies and Promotion (in collaboration with the Department of Social Work), the Leslie & Susan Gonda Center for Diabetes Research and Education, the Center for Medical Decision Making, the  Health Policy Center and the Sial Research Center for Family Medicine and Primary Care.

    Researchers attract impressive amounts of competitive research funding per scientist, while most physicians perform clinical or basic research, in addition to normal patient care.
  • Education: The Medical School is the focus for the development and growth in Israel of academic family medicine and research in medical education.. The School has pioneered a number of programs for medical professionals from the Gaza Strip and the West Bank. The introduction of a degree program in Health Care Management was the first of its kind in the country.

Through the establishment of the Medical School, several hundred highly qualified physicians and health-care professionals have settled in the Negev. They are based in Beer-Sheva at the Soroka Medical Center and in the various community clinics throughout the desert, serving all its residents. For them teaching, research and service go hand in hand.

 

It seems to me that we did not discover America. What we did in essence was to shift the emphasis from exclusively hospital-based clinical education to primary care ... Consequently, population needs in health gain in value, and human and comprehensive medicine becomes a pattern of medical practice in health and diseases. The introduction of change in our own sound medical tradition created a new tradition for the medicine of tomorrow.


Moshe Prywes
Israeli Journal of Medical Science, 1987

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From Experiment to Example

If one were to ask whether this model program is replicable elsewhere, I would have to answer affirmatively. ...Other institutions may well build on this experience in launching new programs.

John Beck
UCLA School of Medicine, University of California, Los Angeles
Israel Journal of Medical Science l987



"The Beer-Sheva Experiment" has made a bold imprint upon modern medical education with a reputation for excellence that has traveled from the Negev to all of Israel, to the third world and the developed world.

The World Health Organization (WHO) designated BGU as a Collaborating Center for Integrated Health Services and Manpower Development. Reports of the Center's diverse activities are disseminated by WHO throughout the world. The introduction of medical school curricula modeled after BGU's is helping to improve health standards in the developing world and to train qualified physicians. BGU has been instrumental in establishing medical schools or health care programs throughout the developing world and has given several international courses in epidemiology, health care systems, pediatrics and perinatal medicine.

 

  • In 2004, BGU's Medical School was reassessed by the WHO  and accredited as a Full Member Institution of the Network, Towards Unity for Health (TUFH).

    In highly developed countries there is growing interest in the Medical School, which was in the very vanguard of the trend toward increased emphasis on the individual patient's needs.. Students from many parts of the world are eager to spend time in Beer-Sheva visiting the Medical School to study the way in which it functions as part of the community and the region.


 

Israeli medical education represents a highly sophisticated and well differentiated national effort which has achieved considerable successes but which is faced with significant challenges. ... In particular, the Ben-Gurion University program has become an acknowledged model for international reform in medical education.

David M. Mirvis
Medical Education in Israel: History, Structure and Current Challenges,
Jerusalem, 1993

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Looking to the Future



The Joyce and Irving Goldman Medical School of Ben-Gurion University looks ahead to the 21st century anticipating an era of peace in our region and to playing an even greater role in the world of nations. It has recently launched new programs in clinical pharmacology, laboratory technology, emergency medicine and health care policy and management. It is vigorously entering into collaborative enterprises abroad.

In 1998, the Medical School finally moved to its new home. The modern campus, some 9,000 square meters in size, lies between the University and the Soroka Medical Center. Ada Carmi, one of Israel's most talented architects designed the building which is one of the architectural hallmarks of Beer-Sheva.

In 1978, upon its inauguration, Recanati School for Community Health Professions included two departments (nursing and physiotherapy) with a total of 146 students and 9 staff members.  In 1997, the first Master Program was introduced for graduate nurses and in the same year, the school admitted the first 39 students in the new Department of Emergency Medicine.  In  2003, the school moved to a permanent campus adjacent to the medical school with an enrollment of over 800 students in three professional departments.  The move to the spacious and modern Deichmann building was not merely an administrative event.  Rather, it symbolized the School's maturity and pays tribute to the School's previous achievements in spite of poor, unacceptable conditions in temporary premises.  It was also opens new horizons both in quantity and quality of the School's educational level.


The future is full of promise. The Joyce and Irving Goldman Medical School of Ben-Gurion University will reinforce its existing achievements, augment academic resources, enhance research programs and expand its involvement in the local and world communities. Most important of all, it will do everything in its power to prepare the students of today to be the very best physicians of tomorrow.

While looking to the future of Beer-Sheva, I remember the story about Winston Churchill. As is well known, he liked French brandy and he enjoyed it quite frequently. When he was appointed Prime Minister, he continued for a while to work out of his office at the Admiralty, which had rooms with rather high ceilings. One day, a delegation of ladies from the Salvation Army came to visit him requesting him to limit his drinking habits and give a better example to the younger generation. They said "If we filled up this room with the boxes of brandy you drank, they would probably fill it up at least halfway." Sir Winston looked up, then looked down and said: "So much to do, so little done."

There is still a lot to be done in Beer-Sheva.


Moshe Prywes
Israel Journal of Medical Science 23, 1987

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The Joyce and Irving Goldman Medical School and the World

International Cooperation

 

In order to assist students and members of the Faculty and for the advancement of research and development, the Faculty has signed international scientific and education cooperation agreements with many overseas universities and institutions that share mutual interests with BGU.

These agreements are aimed at developing, advancing and strengthening excellence in our own academic programs, research, health care delivery and instruction of students, residents and professionals, through ongoing exchange programs with universities and institutions.  These agreements also aim to promote and develop medical schools in developing countries and to assist Western universities who seek curricular reforms.  BGU holds agreements with the following institutions (in alphabetical order):

McGill University, Montreal, Canada

Hospital for Sick Children, Toronto, Canada

University of Toroto, Toronto, Canada

Esculela Colombiana de Medicina, Columbia

Addis Ababa Faculty of Medicine, Addis Ababa, Ethiopia

Ulm University, Ulm, Germany

Wesftaler Wilhelms University, Munster, Germany

Christian Medical College, Valor, India

Moi University, Eldoret, Kenya

Kohn-Kaen University, Kohn-Kaen, Thailand

Albert Einstein College of Medicine, Yeshiva University, New York, USA

Berkshire Medical Center, Massachusetts, USA

Case Western Reserve University, Cleveland, USA

Columbia University, New York, USA

Fox Chase Cancer Center, Philadelphia, USA

Stanford University, Palo Alto, USA

Tulane University Medical Center, New Orleans, USA

University of Birmingham, Birmingham, USA

University of California, Los Angeles (UCLA), USA

University of Chicago, Chicago, USA

University of Miami, Miami, USA

University of North Carolina, Chapel Hill, USA

University of Rochester School of Medicine and Dentistry, Rochester, USA

 

Whether being on the side of the donor or recipient, these cooperative agreements have proved to be of great value and mutual benefit.  BGU enjoys the unique educational opportunities that world class institutions may provide to BGU students and staff by exposing them to some of the leading medical center in the Western World.  BGU students benefit from high level elective rotations, clinicians gain specialty and subspecialty experience and basic scientists enjoy participating in joint research projects in some of the world's most advanced research laboratories.

 

Some partners provide BGU students and staff with exclusive opportunities to become familiar with medical reality in developing countries.  The experience of   different cultural and geographical orientation, provides them with both enrichment and a window on global health issues.  These experiences are important especially, but not only, for students and staff of our School for International Medicine in collaboration with Columbia University..  These collaborative schools include: Addis Ababa Faculty of Medicine, Ethiopia, Moi University, Kenya; Christian College of Medicine, India; Koirala Institute of Health Sciences, Nepal; Medical School, Iquitos,  Peru.

 

The other side of the same coin is the placement of foreign undergraduate, graduate and post-graduate students in various BGU clinical and basic science departments.  The visits range from a month or two in the case of undergraduates elective clerkships, and from two to three years for fellowship or post graduate doctoral candidates.  The visiting students are mainly from the Western countries, but occasionally, students come from African and Far Eastern countries and the Palestine Authority.


BGU's assistance in establishing new community-oriented medical schools or reforming curricula in existing Western, and sometimes highly reputed schools, goes far beyond the institutions with which BGU has signed an agreement.  Examples include the Catholic University of Ecuador in Quito, Ecuador (1996); University of Hawaii, Honolulu (2001-3) and the University of Hanoi, Vietnam (2003).

 

BGU can boast a history of providing assistance beyond medical schools.  BGU participated in providing emergency medical services to world disaster areas such as to refugees after the Cambodian holocaust (1981); to San-Salvador and Belize victims of a cholera epidemic (1991); to victims of the earthquake in Kosovo (2002) and to Congolese victims of a volcanic eruption in Goma (2003).

 

Further, BGU scholars continue to advice governments and regional health authorities in various developing countries including the fight against the spread of HIV in Ethiopia; treatment of famine in Ethiopia (2000); reforming rural health services in Somalia and primary care services in Kyrgyzstan and Tajikistan (2001) and Papua-New-Guinea (2003-4).

BGU has made several past efforts to promote regional cooperation but most of the projects were disrupted by the eruption of violence in the area from 2000.  We are however, hoping reinitiate cooperation with Jordan on a collaborative research project related to cerebral palsy.

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