"Brain drain" amongst Israeli physicians who graduated abroad

Israel relies heavily on foreign-trained physicians, with approximately 58% of all its practicing physicians having received their medical education abroad. The Israeli Ministry of Health (MOH) has estimated a 30% non-return rate (i.e., the proportion of Israeli medical graduates who remain abroad after completing their studies, rather than returning to practice in Israel) among Israeli medical graduates studying abroad. However, this estimate is based on limited data. This study explores the self-reported class non-return rate among Israeli medical graduates from foreign medical schools and examines potential factors influencing their decision to remain abroad.

This study analyzed data provided by the Israeli MOH regarding Israeli medical graduates who completed their education at foreign medical schools accredited under the Yatziv Reform between 2023 and 2024. The data were collected via a structured online survey developed by the MOH in 2024-2025 and distributed through WhatsApp. Respondents provided self-reported information including: university attended, year of graduation, number of Israeli students in the cohort (hereafter referred to as class size), and the number of Israelis reported to have returned to practice in Israel. The primary outcome was the self-reported non-return rate at the class level.

Among 101 valid responses representing 37 classes and approximately 1,048 Israeli medical graduates across 11 countries, the overall non-return rate was 9.7%, with substantial variation by country, from 0% in Jordan to 40.5% in Italy. Excluding graduates from the Palestinian Authority (PA) increased the rate to 12.1%, though not significantly. A significant negative correlation was found between class size and non-return rate (ρ = - 0.51, p = 0.0011), while higher Human Development Index (HDI) values were associated with both smaller class sizes (ρ = - 0.72, p < 0.001) and higher non-return rates (ρ = 0.53, p = 0.0007). A multiple regression model with class size, HDI, and their interaction explained 31% of the variance in non-return rates (Adj. R² = 0.31; p = 0.002), with all terms significant.

The self-reported non-return rate was lower than expected but varied substantially by country. Class size, HDI, and their interaction were significant predictors of non-return, highlighting the need for targeted return policies and improved data to inform workforce planning.