The ETGAR program for clinical students

The transition from hospital to returning home is a critical time. Even educated patients face challenges, but when patients live in poverty, or lack health literacy for cultural and social reasons there are deleterious effects on health. Informed patients make speedier recoveries, and failing to understand leads to medication errors, lack of follow up and even readmission to hospital with significant costs for both patients and the health care system.

Most Western countries try to address this problem, but services are frequently lacking and are often directed towards medical problems such as cancer and chronic illness, rather than social need.

The ETGAR program is our newest Population Health initiative and Bar Ilan’s flagship community project. Set up with a major grant from Israel’s Higher Education Authority, matched by Bar Ilan University, it aims to help our neediest patients on discharge from hospital. The program has attracted interest internationally as it provides a model for how medical schools can help to resolve a universal health care problem. An advisory group involving Deans of Medical Schools from across the USA and UK is helping to guide ETGAR’s progress.


How does ETGAR work?

Patients with the greatest social needs – poverty, lack of Hebrew, cultural issues, poor and inadequate support – are visited soon after discharge to help them understand their condition, medical instructions, check their medication and link up with community services as necessary.

Our work force are medical students at Safed, Nahariya and Poria hospitals who are specially trained to communicate with patients from a variety of cultural backgrounds and to work their way round the complexity of services in the area. They also learn to use these skills to help municipalities during emergencies (not an uncommon eventuality in the Galilee).


ETGAR will bring benefits all round

  • Our most socially disadvantaged patients are supported during their transition from hospital to home.
  • Students learn to work with individuals from a variety of backgrounds and have the unforgettable experience of meeting patients in their own homes.
  • Students receive course credits and scholarships to help support their medical studies.
    The health care system benefits from prompt action following hospital discharge, with saving of costs due to less medication errors and avoidable re-admissions to hospital.


Funding opportunity:

This year ETGAR involves 48 students and 500 patients. Next year we aim to involve all 240 of our clinical students, with grants for those who wish to work intensively in the program. Funding is needed for coordination of the program, grants and resources

* ETGAR (אתגר ), is the Hebrew word for ‘challenge’ and is an acronym standing for Literacy, Support, a Bridge between Medicine and Society.