How Residency Works in Israel: The Ultimate Guide
- Anglo Doctor in Israel
- Nov 17
- 6 min read
See all relevant Hebrew vocabulary in the table at the end of the blog
As Olim doctors, understanding how specialty training works in Israel is important. Maybe you arrived before specialising and want to explore your options, or you trained abroad and now need to have your specialty recognised. Or perhaps you simply want to understand the training pathway your colleagues and juniors are going through. This blog explains all you need to know.
Residency or specialty training, known as Hitmachut, is supervised by the Scientific Council of the Israel Medical Association (IMA). After medical school, every doctor completes a one year internship (staj) and then applies to hospitals or HMOs for a residency position.
For doctors who have already completed specialty training abroad and later choose to make Aliyah, there is also a pathway to have their specialty officially recognised in Israel. This is called the Green Pathway (see this blog), and it is available when the residency abroad is at least seventy percent the length of the equivalent program in Israel.
In this guide, we walk through the full structure of 6 popular residency programs: family medicine, pediatric medicine, emergency medicine, internal medicine, obstetrics and gynecology and psychiatry. Everything below is based directly on the official information published by the Israel Medical Association.
Exams in Hitmachut
Every resident in Israel must pass two national exams in order to complete their training and receive their specialist license. These are known as the Shlav Aleph and Shlav Bet exams (Stage One and Stage Two).
Stage A (Shlav Aleph): Written Exam
Shlav Aleph is the first of the two national specialist exams. It is a long, written exam, and usually solely made up of multiple choice questions.
It examines theoretical medical knowledge, pathophysiological processes, clinical presentations of disease, diagnostic methods and principles of treatment.
Residents may sit Shlav Aleph after about two years in residency, once they meet their specialty’s criteria. Registration is through the IMA website, and passing Shlav Aleph is required to progress to the Shlav Bet oral examination.
Stage B (Shlav Bet) – Oral Examination
Shlav Bet is the final specialist exam in Israel. It is an oral exam held twice a year, in spring and fall. It is based on real clinical cases and evaluates diagnostic reasoning, treatment planning, clinical judgement, use of current professional literature and familiarity with the relevant Israeli society position papers.
Residents may take Shlav Bet once they have passed Shlav Aleph and usually have one year remaining in residency. Passing Shlav Bet is required to receive specialist certification.
Residency Programs in Israel
Family Medicine Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=99
Total duration: 4 years
Fifteen months in a Family Medicine clinic – Shlav Alpeh clinic under supervision of a mentor
Nine months in Internal Medicine
Two months in Emergency Medicine
Five months in Pediatrics**, divided as follows:**
Two months in a Pediatric Department
Two months in Pediatric Emergency Medicine
One month in a Pediatric Clinic (hospital based or community based) or in a Pediatric Day Unit
Two months in an ambulatory psychiatric clinic, in the community or hospital
Two months of elective rotations, in one month or two month blocks, in one or more of the following specialties:
Oncology, Orthopedics, Clinical Immunology and Allergology, Endocrinology, Gastroenterology and Liver Disease, Geriatrics, General Surgery, ENT and Head and Neck Surgery, Infectious Diseases, Dermatology and Venereology, Ophthalmology, Pulmonology, Neurology, Nephrology, Psychiatry, Cardiology, Rheumatology, Physical Medicine and Rehabilitation, Occupational Medicine, Obstetrics and Gynecology, Child and Adolescent Psychiatry, Pediatric Neurology and Child Development, Pediatric Cardiology, Pediatric Pulmonology, Pediatric Gastroenterology, Pediatric Endocrinology, Pain Medicine, Palliative Medicine, Research.
One month in Family Medicine
Twelve months in Family Medicine – Shlav Bet clinic
Completion of an academic Family Medicine course, at least six semesters, recognised by the Director, with all university requirements fulfilled.
Pediatric Medicine Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=10
Total duration: 4.5 years
Thirty three months in a Pediatrics Department, which may include:
Two months in Pediatric Emergency Medicine
Three months in the Pediatric Intensive Care Unit (PICU)
Six months in the Neonatal Unit and Special Care Nursery
Six months in a Community Pediatrics Clinic or General Pediatric Consultation Clinic, in integrated work with a pediatric ward or pediatric day unit
One month in Pediatric Emergency Medicine
Two months, in continuous blocks of at least one month each, in one or more of the following:
Pediatric Hematology Oncology, Pediatric Endocrinology, Otolaryngology and Head and Neck Surgery, Pediatric Gastroenterology, Pediatric Intensive Care, Dermatology and Venereology, Pediatric Pulmonology, Newborn Medicine or Obstetrics and Gynecology (Neonatal Unit), Pediatric Neurology and Child Development, Pediatric Nephrology, Child and Adolescent Psychiatry, Pediatric Cardiology, Diagnostic Radiology, Physical Medicine and Rehabilitation, Medical Genetics, Pediatric Surgery, Infectious Diseases, Clinical Immunology and Allergy (Pediatrics), Pediatric Rheumatology, Pediatric Emergency Medicine, Pediatric Dermatology, Clinical Immunology and Allergy (General), Clinical Pharmacology, Community Pediatrics, Palliative Medicine.
Six months in Basic Sciences
Internal Medicine Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=1
Total duration: 4 years
Three years in Internal Medicine
One month in General Intensive Care or Medical Intensive Care
Five months, in continuous periods of at least one month each, in:
Clinical Immunology and Allergology, Oncology, Endocrinology, Gastroenterology, Geriatrics, Hematology, Bone Marrow Transplantation, Emergency Medicine, General Intensive Care, Cardiac Intensive Care, Pulmonology, Internal Medicine Clinic or Family Medicine Clinic or Internal Medicine Day Unit, Nephrology, Cardiology, Rheumatology, Diagnostic Radiology, Infectious Diseases, Pain Medicine, Medical Genetics, Palliative Medicine.
Six months in Basic Sciences
Obstetrics and Gynecology Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=20
Total duration: 6 years
Four and a half years in Obstetrics, Gynecology and Reproductive Medicine, including:
One and a half years in Obstetrics – mandatory
Twelve months in Gynecology – mandatory
Six months in Reproductive Medicine – mandatory
One and a half years in combined Obstetrics and Gynecology – mandatory
Twelve months of elective rotations, either:
Six months in each of two specialties, or
Four months in each of three specialties
Eligible specialties:
General Surgery, Urologic Surgery, Anesthesiology, General Intensive Care, Endocrinology, Neonatology, Oncology, Public Health (Mother and Child Clinic or Women’s Health Center), Ultrasound, IVF Unit, Medical Genetics, Pediatric Endocrinology.
Six months in Basic Sciences
Psychiatry Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=50
Total duration: 4.5 years
Two years in an active psychiatric department, which may include:
Up to one year in an active psychiatric day treatment unit (community or hospital)
Up to six months in a Child and Adolescent Psychiatry department – mandatory
One year in an adult ambulatory psychiatric service in a mental health clinic – mandatory
Six months in one of the following:
Six months in Neurology, or
Three months in Neurology and three months in Internal Medicine, or
Three months in Neurology and three months in Family Medicine
Six months in one of the following:
Adult psychiatric inpatient or outpatient unit, Child and Adolescent Psychiatry clinic, psychiatric day hospital, psychogeriatric unit, psychiatric rehabilitation unit or forensic psychiatry.
Six months in Basic Sciences
Emergency Medicine Residency
Full syllabus: https://www.ima.org.il/internship/Syllabus.aspx?SpId=293
Track 1 – Standard Track
Total duration: 4.5 years
Thirty months in the Emergency Medicine Department
Nine months in Internal Medicine
One month in Orthopedics
One month in Intensive Care
One month in a Family Medicine clinic
Three months in General Surgery
Three months in Pediatric Emergency Medicine
Six months in Basic Sciences
Note: One and a half consecutive months of the surgery rotation must be completed in a recognised Trauma Unit.
Additional requirement: At least twelve shifts in a Mobile Intensive Care Unit (MICU).
The IMA website provides full details on the five additional tracks (generally 30 months long) available for specialists in General Surgery, Internal Medicine, Anesthesiology, Pediatrics and Family Medicine.
Summary
We hope this guide helps clarify how residency programs work in Israel, and we look forward to sharing more specialties in future posts. If you have personal experience completing residency in Israel or navigating the process of converting your specialty, we would love to hear from you. Your insights can make a real difference for other doctors walking the same path.
Hebrew Vocabulary Table
English | Hebrew | Pronunciation |
Residency / Specialist Training | הִתְמַחוּת | hitmachut |
Resident | מִתְמַחֶה (m) / מִתְמַחָה (f) | mitmakheh / mitmakhah |
Internship | סְטָאז׳ | staj |
Intern | סְטַאז׳ֵר / סְטַאז׳ֵרִית | stazher / stazherit |
Scientific Council | הַמּוֹעֵצָה הַמַּדָּעִית | ha-mo'etza ha-mada'it |
Israel Medical Association | הַהִסְתַּדְרוּת הָרְפוּאִית בְּיִשְׂרָאֵל | ha-histadrut ha-refu'it be-Yisra'el |
IMA (short) | הָר״י | ha-ri |
Residency program / Track | מַסְלוּל הִתְמַחוּת | maslul hitmachut |
Department | מַחְלָקָה | machlaka |
Rotation | רוֹטַצְיָה | rotatsia |
Elective rotation | רוֹטַצְיַת בְּחִירָה | rotatsiat b’chira |
Mandatory rotation | רוֹטַצְיַת חוֹבָה | rotatsiat chova |
Basic Sciences | מַדָּעֵי יְסוֹד | mada'ei yesod |
Internal Medicine | רְפוּאָה פְּנִימִית | refu'a p'nimit |
Pediatrics | רְפוּאַת יְלָדִים | refu'at yeladim |
Family Medicine | רְפוּאַת מִשְׁפָּחָה | refu'at mishpakha |
Emergency Medicine | רְפוּאָה דְּחוּפָה | refu'a dchufa |
Obstetrics & Gynecology | יֵילוּד וּגִינֵקוֹלוֹגְיָה | yelud u-ginekologia |
Psychiatry | פְּסִיכִיאַטְרְיָה | psikhiatria |
Neonatal ICU / NICU | טִיפּוּל מְיֻחָד בַּיִּלוֹד | tipul meyuchad ba-yilod |
Emergency Department (ER) | חֲדַר מְיוּן | chadar miyun |
Specialty recognition | הַכָּרָה בְּמוּמְחִיּוּת | hakara be-mumchiyut |
Specialist certificate | תּוֹאַר מוּמְחֶה | to'ar mumcheh |
Green Pathway | מַסְלוּל יָרוֹק | maslul yarok |
Consultant / Specialist | מוּמְחֶה | mumcheh |
