Judy Siegel-Itzkovich, Jerusalem

The faculty of the Hebrew University Hadassah Medical School in Jerusalem was caught with their stethoscopes down after a survey showed that most new graduates don't practise what they're supposed to preach. Their smoking prevalence (25%) is only slightly less that that of the general population (28%), and most new graduates take little or no physical exercise.

Most said that during their six years of medical studies, none or only a few of their teachers had advised them to stop smoking or to exercise. Of the Jerusalem medical school graduates surveyed, 67% thought the school should intensify its teaching of these subjects.

A graduate of the medical school, Dr Tal Haimov, surveyed 83 of his 110 peers after being shocked by seeing so many of them smoke. He found that many were ignorant of the proved dangers of active and passive smoking and of the benefits of regular exercise. One in 10 didn't know or denied that smoking has been proved to cause a quarter of all heart attacks and most lung cancers.

In addition, four in 10 graduates didn't know or rejected the fact that many more Israelis die from diseases related to smoking (10 000 a year) than road accidents (600). While 90% of students surveyed said that as doctors they would explain to their patients that they can prevent disease by observing healthy habits, only 30% thought that their own behaviour was important as a role model for patients.

Professor Avinoam Reches, head of the medical school's teaching committee, said he was "saddened" by the findings but welcomed the survey. "We will consider how to change our medical school curriculum next year to bolster students' awareness of health promotion. We put stress on physical activity and health, but the results show that there's a need to expand this awareness," he said.

Professor Rivka Carmi, dean of Ben Gurion University Health Sciences Faculty in Beersheba, said she was "shocked" by the findings at the medical school in Jerusalem. Although her medical school has a definite public health and community medicine orientation, it's course on disease prevention, smoking cessation, and the dangers to health of smoking only began this year. "I have to admit that we have taught this informally until now, but we saw the need for a separate course."

The findings were shameful, said Professor Jonathan Halevy, director general of Jerusalem's Shaare Zedek Hospital and an internal medicine specialist. "The most senior lecturers should be teaching healthy lifestyles as an integral part of the medical school. I lecture at three medical schools, and in all courses I stress that smoking is the number one preventable cause of disease. While ideally I would like to prevent a medical student who smokes from graduating, I don't think it's possible to do so."

A thoracic surgeon in a government hospital near Tel Aviv said, "While it's no compliment to the medical school that its graduates don't know the basic epidemiology of the number one killer in the Western world, it's too much to expect those students to behave any differently than the general public." One professor of vascular surgery told me (with a cigarette in his hand), "I'm not a rabbi; I don't have to be a role model. Smoking should be the top public health concern, but I doubt that education alone will persuade people to stop smoking. I have lectured in nursing and medical schools on diseases related to smoking, and although initially all the students are aghast and swear that they will stop, I don't think I have actually got anyone to quit."