Free and Paid, Hospital-Based Specialist Doctor Education for Disadvantaged Areas
It is hoped that the hospital-based specialist medical education program can accelerate the fulfillment and distribution of doctors.
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An eye specialist in Malacca was performing a cataract operation in the area recently. There are sufficient specialist doctors available in Malacca.
JAKARTA, KOMPAS — The hospital-based specialist doctor education program has officially been launched. In the first stage, the number of participants who will be accepted into the program is 38 people. Participants are prioritized from disadvantaged areas, borders and islands.
The implementation of the hospital based specialist doctor education program or hospital based is expected to accelerate the fulfillment of the number of specialist doctors in Homeland. This effort also ensures that the distribution of specialist doctors can be evenly distributed throughout Indonesia.
President Joko Widodo stated that the urgency of increasing the number of specialist doctors is becoming more pressing due to the low ratio of specialist doctors compared to the population. The shortage of specialist doctors in Indonesia is estimated to reach 29,000. This condition is further exacerbated by uneven distribution.
"On average, all specialist doctors are in Java and in the city. (As many as) 59 percent of specialist doctors are concentrated on the island of Java. Therefore, once again, there must be a breakthrough. "We have to make a breakthrough," he said at the inauguration of the Specialist Medical Education Program Based on the Teaching Hospital Organizing Utama (RSPPU) in Jakarta, Monday (6/5/2024).
President Joko Widodo delivered a speech at the inauguration of the Specialist Doctor Education Program based on the Main Education Hospital (RSPPU) in Jakarta on Monday, May 6th, 2024.
Also present at the event were the Coordinating Minister for Human Development and Cultural Affairs, Muhadjir Effendy; the Coordinating Minister for Maritime Affairs and Investment, Luhut Binsar Pandjaitan; the Minister of Health, Budi Gunadi Sadikin; the Minister of Education, Culture, Research, and Technology, Nadiem Makarim; and the Cabinet Secretary, Pramono Anung.
Don't let the equipment that has already arrived in the districts and provinces become useless due to the absence of specialist doctors.
The President said that the procurement of medical equipment was now better in a number of health facilities, both in hospitals and community health centers. However, during his visits to the area, medical equipment, such as MRI (Magnetic Resonance Imaging) was not used optimally. The lack of specialist doctors is a problem that is complained about.
Also read: Education of Specialist Doctors Examined Together
"Do not let the equipment that has already arrived in districts and provinces become useless due to the lack of specialist doctors," said Jokowi.
Minister of Health Budi Gunadi Sadikin stated that the number of specialist doctors produced in Indonesia per year is approximately 2,700 doctors. The current shortage of specialist doctors has reached 29,000 doctors.
That number, said Budi, is much lower compared to the UK. With a population of around 50 million people, the annual production of specialist doctors reaches 12,000 doctors, or almost five times that of Indonesia.
Disparity in the number of doctors in Indonesia
"After we observed it, we realized that the system is different. That is why there is a policy to open hospital-based and college-based education because that is what the standard is in the whole world," he said.
With the launch of the hospital-based specialist doctor education program, the implementation of specialist doctor education in Indonesia will be carried out through two programs, namely hospital-based education and university-based education. As many as 420 educational hospitals will be strengthened to accompany the 24 medical faculties that have been conducting specialist doctor education programs based on universities.
Also read: Overcoming the Doctor Shortage, Hospital-Based Medical Education Will Be Strengthened
Budi ensures that participants in the hospital-based specialist doctor education program will not be charged tuition fees. Participants will receive health protection, legal protection, reasonable working hours, and incentives.
The quality of education provided will also be guaranteed in accordance with international standards. Curriculum preparation will be carried out together with all specialist medical colleges with assistance from ACGME (Accreditation Council for Graduate Medical Education). ACGME is the accrediting body for medical training programs in the United States.
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The atmosphere at RSO Prof Dr R Soeharso, a national referral hospital for orthopedic services in Sukoharjo, Central Java, some time ago.
Thus, the quality of hospital-based education programs can be ensured to be the same as the university-based education that has been running, even in accordance with international standards.
Distribution of doctors
Director General of Health Personnel Ministry of Health Arianti Anaya said, apart from accelerating the fulfillment of the number of specialist doctors, the hospital-based specialist doctor education program also aims to ensure an even distribution of specialist doctors throughout Indonesia. Therefore, participants in this hospital-based education program will be prioritized for participants from disadvantaged border and island areas (DTPK).
Quoting data from the Ministry of Health, there are 34 percent of regional general hospitals that still do not have seven complete specialist doctors. In addition, the Education STR data (PPDS) 2020-2024 also shows that out of a total of 15,523 active PPDS currently, 67 percent of the PPDS come from Java and Bali, while the total PPDS in eastern Indonesia only contributes 1 percent and Kalimantan 2 percent.
Arianti said that in the first stage, the total quota of participants to be accepted in the program is 38 people. Education will be conducted in six hospitals owned by the Ministry of Health.
The need for seven basic specialist doctors in RSUD
As for the opened quota in detail, there are 6 people at the Harapan Kita Heart and Blood Vessel Hospital for the cardiology study program, 6 people at the Harapan Kita Children and Mother Hospital for the pediatric study program, and 10 people at the Soeharso Orthopedic Hospital for the orthopedic and traumatology study program. In addition, the quota is also given to 5 people at Cicendo Eye Hospital for the ophthalmology study program, 5 people at the National Brain Center Hospital for the neurology study program, and 6 people at the Dharmais Cancer Hospital for the oncology study program.
"The consideration for the quota above is based on the lecturer ratio because the teaching hospital that supports it currently also accepts students from university based (college based). However, efforts are being made to increase the quota for this batch. "Even if it can't be done, we will add to the second batch later by adding more (teaching hospital) networks," said Arianti.
He added that matriculation will also be given to participants from the DTKS. This is done to ensure that each participant has the same competency and quality standards before entering the education process. In addition, participants in the hospital-based education program will receive incentives of IDR 2 million to IDR 5 million depending on their educational level.
Also read: Emergency Conditions in Specialist Medical Education
"In the past, participants of specialist doctor education did not receive any salary and had to pay for their education. Now, with hospital-based education, they no longer have to pay and receive incentives ranging from Rp 2 million to Rp 5 million, depending on their level. Efforts are also being made to recruit them directly as civil servants at the hospital," said Arianti.
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Muhammad Asroruddin (in batik attire), a specialist in ophthalmology at the University Hospital of Tanjungpura, Pontianak, West Kalimantan, guided medical students in their residency program (koasistensi) at the Faculty of Medicine of Untan, several years ago.
The Director General of Health Services at the Ministry of Health, Azhar Jaya, added that participants in the hospital-based PPDS program from certain regions are guaranteed to return to their respective areas after completing their education. "They must serve in their place of origin, and if they refuse and run away, we will lock their practice permit (SIP), so they cannot practice anywhere," he said.
Separately, Dean of the Faculty of Medicine at the University of Indonesia (FKUI), Ari Fahrial Syam stated that the goal of hospital-based specialist doctor education must be well-guided, especially to ensure an even distribution of doctors. Ensure that every graduate doctor can fulfill the needs of doctors in their respective regions.
Furthermore, improvements also need to be made simultaneously. Educational system improvements must be made in all medical faculties that produce medical graduates, especially medical faculties in eastern Indonesia regions. The welfare and security of doctors serving in these regions also need to be well guaranteed.
"Currently, there are still issues of doctors not receiving their wages. Therefore, local governments must be held accountable in ensuring the welfare of these doctors. Without taking care of the bottom part, no matter how the education system is reformed, distribution issues will still remain," said Ari.
