In Palestine, training to be a doctor is impeded by the occupation

Attacks on medical education add new scars on the face of Palestine’s medical education.”

A new report by the International Federation of Medical Students’ Associations (IFMSA), a network of 1.3 million medical students, has highlighted the significant barriers to medical education in the occupied Palestinian territory (oPt).

The report, Attacks on Medical Education, explores the impact of violence and other violations against medical schools and students across the globe. In the oPt, IFMSA found “significant challenges for sustainable and strategic approach towards medical education”.

Attacks on medical education

Under international law Israel, as the occupying power, must respect the protected status of civilians and civilian infrastructure, including Palestinian universities. However, in the oPt these institutions have come under attack by Israel, detrimentally impacting the safety and learning of Palestinian medical students.

The IFMSA report documents that medical universities have come under repeated attack in Gaza. The Islamic University in Gaza was bombed in six airstrikes during Israel’s military offensive in 2008/9. This resulted in the destruction of the university’s laboratories and damage to the central library and computer facilities. It was bombed again in 2014, “causing further destruction of already fragile facilities”.

Regarding Israel’s 2014 military offensive on Gaza, and an examination by UNESCO found that “[t]here was a failure to protect education from attack during the 50-day crisis”. Higher education institutes, including medical schools, “were directly targeted during the hostilities, sustaining significant injury and loss of life among staff and student populations, as well as damage to vital infrastructure, including buildings and equipment. Such attacks have had a devastating impact on access to higher education and have implications for long-term development”.

Ensuring accountability for violations of international law is an issue central to Medical Aid for Palestinians’ (MAP) advocacy work. Continuing impunity fuels future violations against Palestinians’ rights to education and the highest attainable standard of health, as evidenced by repeated attacks on essential medical education institutions in Gaza.

Barriers medical training

Restrictions on free movement between different areas of the oPt and abroad limit medical students’ access to training. Medical students from elsewhere in the West Bank or Gaza require a permit from the Israeli authorities to access clinical training at hospitals in East Jerusalem, where specialty departments and training not available in the rest of the oPt are located.

The report focuses on restrictions to the freedom of movement of medical students studying at Al-Quds University, which is located in Abu Dis – close to occupied East Jerusalem, but cut off from the city by Israel’s separation wall. Medical students at the university wishing to undertake residencies or training placements at the major Palestinian hospitals in East Jerusalem but who do not have Jerusalem IDs must therefore apply to Israel for permits to cross the checkpoints.

Procedures for students to obtain … permits are very complicated and bureaucratic. There are reports of deliberate delays in processes, often forcing students to wait for their decisions about permits for hours, even days.”

Students unable to obtain permits or access these training placements reported feeling at a learning disadvantage. IFMSA stresses that “[v]ariety in training opportunities and learning styles is…important to equip medical students with abilities to adapt to different local and practical contexts of hospital and healthcare management.”

Frequent delays at checkpoints further impede medical students’ access to training. Medical students reported that the time needed to pass through a checkpoint is often unpredictable, often frustrating their ability to arrive on time each day.

IFMSA emphasised that “[t]he majority of medical students from Al-Quds University felt that their education and quality of life had been strongly negatively affected by their experience trying to access … hospital training sites.”

Such attacks and barriers have serious long-term consequences for the sustainable development of the skilled workforce needed in the Palestinian health system as it seeks to meet the increasing needs of the population. This is particularly true in Gaza, where Israel has imposed a devastating 11-year blockade and closure, severely restricting the movement of students and health professionals.

You can read more about barriers to the development of the Palestinian health sector in Chapter Four of our Health Under Occupation report, here.

To read IFMASA’s full report click here.