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Giulia Gal Addadi treats a patient in a dental lab at Nicolae Testemitanu Medical University in Moldova. (Andrei Ichim/ Nicolae Testemitanu Medical University)

Nearly 1,600 Arab and Jewish Israeli med students flock to Moldova for school

Giulia Gal Adaddi was born too late to meet her great-grandfather Arthur Cohen, but the stories about his concentration-camp heroics enthralled her as a child.

Cohen, a doctor, fought through typhus to tend the sick at the Vapniarka camp in Romania, now part of Ukraine. An ally of Nazi Germany, Romania imprisoned many of its Jewish doctors at Vapniarka in World War II.

Four years ago, after finishing her mandatory Israeli national service in the army, then-20-year-old Adaddi traveled through South America trying to decide what to do with her life. The poverty was gut-wrenching.

Inspired by her great-grandfather’s example, the Even Yehuda resident decided to trade her original passion — writing — for healing others. When a friend mentioned she had heard about a medical school in Moldova, Adaddi checked it out. The 24-year-old is now halfway through her five-year dental program at Nicolae Testemitanu Medical University in Moldova’s capital, Chisinau.

Adaddi is one of nearly 1,600 Israeli medical, dental and pharmacy students at the university, an important pipeline for Israel’s health care system. By far the largest group of foreign students at Nicolae Testemitanu, Israelis account for a quarter of the student body of 6,000, according to the vice rector for international relations, Dr. Mihail Gavriliuc.

Among the reasons: The school has an international reputation for excellence, offers instruction in English, boasts cutting-edge equipment like medical and dental simulation labs, has entrance exams that are far less formidable than Israel’s, doesn’t require a bachelors degree, gives students a chance to work with patients while still in school, and is incredibly cheap.

In addition, Chisinau is a quiet city of 670,000 that is conducive to learning. It’s inexpensive, friendly and safe — qualities that promote parent buy-in.

A whopping 94 percent of the Israeli medical graduates return home to practice, university records show. The figure for dentistry grads is a perfect 100%.

Adaddi, who will graduate in the summer of 2021, said a key reason she chose dentistry was to help people harness the power of a beautiful smile.

“It can open many doors, and even change lives,” she said.

If the program sounds too good to be true, that might be the case — the Israeli Health Ministry has put a fly into the ointment, at least for now. Following the publication of this article, the ministry reached out to The Times of Israel to clarify that after a recent visit to the Moldovan medical program, it has issued a freeze on enrollment at Testemitanu “for the purpose of attaining permission to engage in the medical profession in Israel,” or with the intention of taking Israeli medical licensing exams.

Despite dean Mircea Betiu’s claim that 75% of the program’s Israeli medical graduates and 90% of dentistry graduates passed Israel’s licensing exams on their first or second tries in 2017, the Israeli Health Ministry cited “a significant gap in the clinical teaching of medical students, due in part to the paucity of clinical fields relative to the number of students.”

“Clinical teaching is a central and vital component of medical studies and failure to adequately meet this important component constitutes a significant harm to the level of medical education,” said the ministry’s statement to The Times of Israel. “Clinical exposure will be taken into account in the overall considerations of the decision to grant approval to take the licensing examination in Israel and will constitute an important component of the licensing examination itself.”

Formed as a backlash to WWII

The university has had a reputation for excellence since the day it opened in October 1945. Its original 132 faculty members were evacuated from the renowned Leningrad Medical Institute when the Nazis reached the gates of the city in the summer of 1941. Josef Stalin ordered the evacuation to prevent the cream of the Soviet Union’s medical professors from being killed or captured.

Tuition at Nicolae Testemitanu is about 50 percent less than what students in Israel pay for the medical-classes portion of their degree. The Moldovan rate is $2,500 a year for a non-Moldovan student and an even cheaper $1,500 for Moldovans.

In comparison, tuition at Hebrew University Haddasah Medical School is 9,000 shekels, or $2,400, a year for a student’s three pre-med years and 14,000 shekels, or $3,700 a year, for the medical-courses portion of the program. By comparison, tuition at a high-end Israeli program — Ben-Gurion University’s Medical School for International Health — is $38,500 a year.

Eighty-four percent, or 1,325, of Nicolae Testemitanu’s 1,578 Israeli students are Arab and 250 Jewish. Eighty-five percent, or 1,346, are in medicine, 221 in dentistry and 11 in pharmacy.

You run into the students all over Chisinau — shopping, at restaurants, in fitness centers. More often than not, most of the crowd at a popular campus hangout, the Coffee Break cafe, are Israelis.

When a stranger asked locals if they knew where a nearby group of Middle Easterners was from, there was no hesitation. “They’re Israeli medical students,” was the reply.

Many of the Israeli students live in the same housing complexes, with most of the Jews staying in campus dorms and the Arabs in high-rises off campus.

Many Jewish and Arab students have developed close working relationships and friendships in class, a sampling of Israeli students indicates. Some socialize off-campus as well, playing football and basketball together and going to sports bars.

Adaddi, the dental student, said she has both Christian and Muslim Arab friends. The Israelis at Nicolae Testemitanu have developed a broader perspective on politics, she said — that there’s “something bigger than all the conflicts, and that is life and saving lives.”

The vast majority of Moldovans have been warm and welcoming to Israeli students, according to a 2017 graduate, Dr. Mohammad Dirawi Majdi of Kafr Yasif.

Reports of anti-Semitic or anti-Arab sentiment are rare, added the vice rector for international relations, Gavriliuc.

An inorganic growth

Between 1996 and 2009, only 80 Israelis enrolled at Nicolae Testemitanu. Most were Russian-speaking or Romanian-speaking children of doctors and dentists who had studied in Moldova during Soviet times, then emigrated.

Israeli enrollment began exploding in 2010. That was when the rector, Ion Ababii, began implementing a bold decision to offer courses in English as well as the traditional teaching languages of Romanian — Moldova’s de-facto mother tongue — plus Russian and French.

The result was Israeli enrollment soaring from 59 students a year in 2010 to 272 in 2018.

Today, about 60% of the student body takes medical and dental courses in Romanian, 30% in English, 8% in Russian and 2% in French. Foreign students learn Romanian in their first two years so they can speak with patients when their practical training begins in the third year of the dental program, and fourth year of the six-year medical program.

While some faculty had scoffed at the notion of teaching in English, Ababii considers the program his greatest achievement in 25 years as rector.

That’s surprising, given his long list of accomplishments, most of which have involved adding Western medical program touches to Nicolae Testemitanu.

Among those accomplishments were starting a residency program modeled on the one at the University of Minnesota Medical School, opening a university clinic so students could minister to real patients, persuading the European Union to build a $5 million medical simulation center, opening a mirror-image dental simulation center, and forging a partnership that gives faculty and students free access to the University of North Carolina School of Medicine’s multimillion-volume online library. At the simulation center, students practice their treatment skills on special mannequins rather than patients.

Not only did offering courses in English lead to enrollment jumping, Ababii said, but “it opened up great opportunities for our faculty — because most of the world’s medical journals and conference presentations are in English.”

The rector will leave the university when he turns 74 next year with one major goal unrealized: He has long wanted to open a Nicolae Testemitanu teaching hospital. He said he’s confident his successor will pull it off, adding that he is so eager for it to happen that he’s offered to be an unpaid advisor on it.

Israeli students say one of the things they appreciate most about Nicolae Testemitanu is an opportunity to work with patients before they graduate — unlike in most Western programs.

“I had three years of treating patients in Moldova,” said Majdi. “This gave me confidence when I began working in Israel.”

Another confidence booster was passing Israel’s medical licensing exam on the first try. “It’s a very difficult examination,” said Majdi, a general practitioner who plans to become an endocrinologist.

Not a graduate degree

Another feature of Nicolae Testemitanu that appeals to foreign students is not needing a bachelors degree. In the United States and many other countries, students must spend four years in a bachelors program, four to five years in medical or dental school and a year or two in residency. This means most are in their late 20s before beginning their practice.

In Israel, there is the option of a seven-year medical degree, but students who do not declare medicine in their first year can study in a four-year program following a first degree.

Michael Matatov, a Tel Aviv resident who spent 10 years in New York as a boy, entered Nicolae Testemitanu’s dental program right out of high school at 18.

“I love to be productive and to use my time wisely, and I saw this as an opportunity to become a dentist by the age of 23,” Matatov said.

In general, both the Soviet-educated and younger professors at the university are quite erudite, the Israeli students say, although unsurprisingly they add that the new generation of teachers is more knowledgeable about cutting-edge approaches.

The university has used partnerships with overseas medical and dental schools and advice from other countries’ licensing boards to tweak its curriculum. The vice dean of dentistry, Andrei Mostovei, said the program revised its content to incorporate standards in Israel and California — a move that prompted a number of Californians to enroll recently.

International medical ties

Many of the Israeli students say they have formed close bonds with their Moldovan professors.

Alfred Khazen, a sixth-year medical student from Banna, said that in his first year he continually worried whether he was absorbing the material well enough. Professor Angela Babuci, who is also the vice dean of medicine, was a reassuring presence, he said.

“She always asked if we understood the material, and told us that if we didn’t understand it, to ask,” Khazen said. “Her support that first year helped me keep going.”

Another sixth-year medical student, Simaan Adham from Rama, said he has been touched by how caring many of his professors are — not just with students, but also with patients.

A lot of poor people come to the university clinic because they can’t afford treatment elsewhere. As in the rest of the former Soviet Union, free health care tanked when Moldova became independent in 1992. This means Moldovans must pay doctor, hospital and pharmacy bills themselves.

“I have seen professors at the university pay the bills of poor patients,” including both the costs of medical procedures and prescriptions, Adham said.

The rewards from the professor-student relationship go both ways, of course.

Nicolae Testemitanu professors said they love to see their Israeli students’ extended families flocking to the university’s graduation ceremonies. Not only are the family members chattering with joy, but they are decked out in everything from suits to fancy dresses to Bedouin robes.

Gavriliuc, whose job includes continuing to recruit bright, motivated Israeli students, will never forget a question he was asked when he visited the Knesset one day.

“One of the leaders of the Taal Party — a physician — asked me, ‘Why do our children love Moldova so much?’” said Gavriliuc.

The question put a smile on Gavriliuc’s face. It indicated that Nicolae Testemitanu was doing right by a cherished part of its student body, he said.

By HAL FOSTER

This article has been updated to reflect a recent Israeli Health Ministry freeze on enrollment at the Nicolae Testemitanu Medical University in Chisinau for the purposes of practicing medicine in Israel

The Times of Israel