The Israel Radiological Association (ISRA) was founded in 1927 and is the oldest medical society in the country. We have about 530 active certified radiologists and about 150 members in training. Radiology is in the midst of a technological revolution that is especially felt in Israel.
Israel is a start-up nation. The number of start-ups per capita is the highest in the world, with one start-up per 1,800 Israelis. Israel is number two in terms of the absolute number of start-ups and number three in terms of the number of companies traded on NASDAQ, after the United States and Canada. The per-capita venture capital investment in Israel is 30 times higher than in European countries, and Israel has the highest R&D spending per capita.
Artificial intelligence (AI) is an exciting field in general and especially in medicine and radiology. In Israel there are about 150 start-ups in the field of AI in medicine, of which about 25 are devoted to imaging. About 800 million Euros have already been invested in this field in Israel.
The combination of a technology-driven country with a high level of medical services also makes Israel an excellent place for the development and implementation of novel technological advances in CT, MRI, nuclear medicine and future automatisation of imaging studies, including robotics.
Although Israel spends 7.3% of GDP on medical services, which is quite low compared to European countries, health metrics put us ahead of many other OECD countries. The standard of radiological practice in Israel is similar to the high professional levels prevailing in Europe and we also face the same challenges.
The main obstacle to our profession is the shortage of radiologists. The workload has increased dramatically and there has been a commensurate increase in the workload for individual radiologists that make use of AI. There has been a disturbing trend towards reducing reimbursement for imaging studies, which is opposed by our community. The economic pressure on ISRA, our radiologists, and our medical centres is unrelenting, forcing our leadership to dedicate increasing time and resources to representing our profession in the political arena.
Radiology is very popular among medical school graduates but the number of open positions for training is limited. This factor, as well as the increased need for more radiologists (not less, as some anticipated due to the use of AI), makes the situation even more difficult. We see increased burnout among practising radiologists and even among trainees. Increased workload is also a threat to academic radiology.
The solutions are multifactorial and include increasing the number of training positions on one hand and on the other hand increasing the number of positions for radiologists after training. A way to reduce burnout is to provide a more reasonable work/life balance.
Purchase of all advanced modalities is controlled by the government, and a Certificate of Need is required to obtain approval for each MRI and CT scanner. The number of MRI scanners has historically been one of the lowest among developed countries, with about 50 MRI licences for a population of over nine million (in contrast, Switzerland has about 200 MRI scanners for the same population). The number of studies per scanner is relatively high in Israel, up to 16,000 annually in some places, because many systems operate around the clock. It is thus not unusual for a patient to have an MR scan appointment at 3am. Nevertheless, the waiting time for an MRI examination has been up to three months for regular studies and six to eight months for MR under anaesthesia. Although the Ministry of Health has changed this policy and there was a plan to reduce waiting times to three days, this initiative failed, as the demand for MR studies has increased while the number of radiologists has remained relatively stable.
Medical training programmes are established under the auspices of the Scientific Council of the Israel Medical Association, and a committee of the IMA conducts re-accreditation reviews at each of the 18 training facilities once every five years. Some of our radiology departments are currently involved with providing fellowship training through the European School of Radiology. We anticipate more harmonisation of our training with the ESR Training Curriculum.
Academic activity on a national level centres around ISRA’s annual meeting, which is an international English-language forum consisting of parallel sessions of peer-reviewed scientific presentations together with invited lectures by radiologists of international standing in their subspecialties. The next meeting will be held October 20–22, 2020. We invite our European colleagues to join us for this high-level meeting in a beautiful resort setting.
ESR meets Session, Friday, July 17, 09:45–10:15
ESR meets Israel, Croatia, Slovakia and Slovenia
- Welcome from the ECR 2020 Congress President
Boris Brkljačić; Zagreb/HR
- Messages from:
Jacob Sosna; Jerusalem/IL; President of the Israel Radiological Association
Damir Miletić; Rijeka/HR; President of the Croatian Society of Radiology
Viera Lehotská; Bratislava/SK; President of the Slovak Association of Radiology
Maja Marolt Music; Ljubljana/SI; President of the Slovenian Association of Radiology