Using Israel as a case study, Che paper considers the social mechanisms by means of which the medical profession seeks to maintain its boundaries and control in a social context characterised by the recent arrival of twelve thousand immigrant physicians from the former Soviet Union. This situation poses a threat to the veteran medical profession which is described as combining elitist and proletarian elements in an uneasy balance. In the past the principal mode of resolution with regard to this duality has taken the form of demonstrative assertions of the elitist component. With the large influx of immigrant doctors, three mechanisms geared to maintain control have been utilised: (1) the formal licensing examination for general practice; (2) full control of employment options in the health care system and (3) a widespread negative stereotype regarding the level of immigrant physicians' professional skills. The paper discusses these mechanisms and their implications for the profession.