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Background: The modern medical world is dynamic and boundless. There is a need for the medical training system currently existing in Israel to undergo a thorough conceptual change in order to strive for excellence and innovation on the one hand and to prevent the "brain drain" from Israel on the other., Objective: To report on the "Talpiot" program at the "Sheba Medical Center", which identifies, promotes and prepares the most talented young doctors to fill key positions in the fields of medicine and health in Israel., Methods: This study is based on a project with the same name in the Israeli Defense Forces (IDF). It promotes an elite group of physicians and researchers at the medical center and includes the provision of scholarships, personal guidance and customized educational opportunities for its members. Conversely, every member in the program is committed to complete five years of training followed by another five years as a senior physician or a researcher at the medical center., Results: Since 2002, there have been six cycles of "Talpionaires". The current 46 members of the program fill key leadership roles in the medical center and are considered leaders in their field. Among the program's alumni are managers of institutes, units and research institutes. This group is responsible for the publication of hundreds of scientific papers studies and dozens of patents in medical technology. Some of them have progressed academically far beyond their peers., Conclusions: Excellence programs are an integral part of any institution which considers itself a leader, both in medicine and beyond. The exciting and visionary "Talpiot" program is Sheba's contribution to the quality of the medical system in the country of Israel in the long run. Promoting young doctors and researchers to become leaders in the Israeli medical system is an integral part of national interests.

The decline in the attraction and prestige of the clinician-scientist paradigm is due to the dissonance between clinical work and conducting research in basic science. Medicine entails alleviating distress and prolonging life. Thus, medical research deals directly with the questions: what ails our patients and what shortens their lives? How can it be prevented? How can we alleviate suffering and prolong life? Research designs that fit these questions are: researcher (or patient) initiated randomized controlled trials; systematic reviews and meta-analysis; high-quality observational studies that address risk factors, natural history of disease, side-effects, and efficiency of treatment; research in ethics; and qualitative research. The clinician-scientist should perform medical research. Investing in this paradigm wilt encourage young doctors to conduct research directly oriented to benefit their patients.