Orthopaedic Surgeons in Israel Do We Have Enough?

Purpose: To collect descriptive data on orthopaedists in Israel in order to enable planning ahead.

Methods: Data sources: The Israel Orthopaedic Association and Israel Medical Association (including residency start and completion), 4 HMO websites and the Ministry of Health database. Predicted influx of orthopaedists was calculated based on starting residency and residency completion ratio, assuming a constant resident inflow vs. an increasing number of residents. Predicted out flux was calculated as reaching age 67.

Results: 1,204 orthopaedists currently work (863 specialists, 255 residents, 86 non-specialists), 4% women. Recently, 34 doctors (mean) started residency each year with a linear increase in this number (slope 0.85, an increase of 1 resident every 14 months p<0.0001).Of residency starters, 81% became certified specialists (27 a year). If the number of residents graduating stays constant at 28 per annum, the predicted number of orthopaedists is likely to be steady. If the number of residents continues to increase at the present rate, there will be an escalation in the number of orthopaedists. Of 742 orthopaedists, 59% were registered as general orthopaedists, and 11% were registered as hand, foot & ankle and knee, each.

Discussion: This first attempt to assess the number of orthopaedists practicing in Israel seems considerably higher than most estimates. The number of residents should be monitored and possibly regulated. Another novelty in this study is a professional medical association concerned with all physicians in the field and not just specialists that are members of the association.

Figure 1: Current (pre-2015) and predicted practicing orthopaedists in Israel. Lower curve: with constant number of residents. Upper curve: with present increase in number of residents.