Table 3 Observations and Knowledge Related to Financing of Medical Education

• Funding goes directly to universities and colleges. Even though it is based upon the educational programs of those institutions, the distribution of it within the institutions is a local responsibility.

• In the first decade of the 21^st century there was a cutback in funding

o In the second decade, there has been restoration of some of the funds.

o Each medical school expressed concern about the number of faculty positions for which it had funding, particularly basic science faculty.

• Three Israeli medical schools have four-year English language programs for non-Israelis with prior baccalaureate degrees that have high tuitions.

o These programs share faculty with the Hebrew language programs.

o English-language programs produce significant revenue for the university.

• Schools have understandable concerns that development of ambulatory medical education will require significant financial resources that do not currently exist.

• Promotions for clinical faculty are generally based on research criteria (see Table 2).

o The majority of clinical teachers do not have any university appointment.

• Academic promotions to senior faculty positions in Israeli universities carry financial benefits including supported sabbatical time and supported meeting travel.

o Most clinical teachers work for the health system.

o Universities are expected to fund the benefits associated with academic promotions.

• Students reported needing to work while in medical school to gain necessary income to support family obligations or the high cost of living in some areas.

• The support for the PhD component of MD-PhD programs tends to be short (2–4 years).

o It is difficult to take on an important and challenging research project when supported research time is short.