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Scholarships alone won’t solve specialist doctor shortage
In Indonesia, general practitioners who come from a better socio-economic background stand a better chance of getting into medical residency earlier.
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Standing for their rights – Doctors of the Indonesian Doctors Association (IDI) stage a peaceful rally to protest the government’s plan to establish a Primary Healthcare Physicians (DLP) education program in Kediri, East Java, on Oct.24, 2021. (Antara/Prasetia Fauzani)
T
he Indonesian medical residency system has made medical education more exclusive. This will result in inequality and unfairness regarding access to medical residency programs that will be of advantage to those from higher and privileged social classes.
The Health Ministry has just announced that it will now provide a funding scheme as financial aid for those who are struggling with funding issues. While this program deserves appreciation, there are reasons to believe that scholarships are not a fit solution for medical residency inequality and fairness.
This concern arises from Indonesia’s medical residency system itself, which is managed by universities, instead of a hospital-centered system as in other countries. Thus, the Indonesian residency system is usually known as a university-based system.
In this system, if a general practitioner wants to apply for a residency position, they need to apply to the university and pay tuition fees each semester for four to five years. The resident doctors will remain unpaid throughout the course of study and be unable to provide a professional medical service before graduating from university.
With this kind of system, the resident doctor’s family will be the one in charge of all the expenses of their study. Hence, those who come from a better socio-economic background stand a better chance of getting into a medical residency earlier. Therefore, considering the limited number of providers (mostly state universities) and high cost, Indonesia is still dealing with a specialist scarcity, especially in the remote regions since most specialist doctors prefer to stay in urban areas, which promise better opportunities, safety, convenience and higher pay.
To date, some government institutions, such as the Finance Ministry through its Endowment Fund for Education (LPDP), private organizations and foundations have provided some funding schemes to assist the prospective specialist doctors who have to cope with financial constraints. Unfortunately, this approach offers only short-term assistance and not a long-term solution.
Providing a scholarship does not necessarily solve the core problem of the Indonesian medical residency system. The fundamental reason why the Indonesian residency program has become a privilege not everyone can experience is because Indonesia adopts an anomalous approach in implementing the medical residency program.
