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Hospital-based specialist training, up against the odds?
While there are more than 3,000 hospitals in Indonesia, only about 210 of them are educational hospitals, and only one-third of them are primary educational hospitals that can serve as full specialist education centers.
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Transfer of knowledge: Optician Muhammad Asroruddin (right) of Tanjungpura University Hospital in Pontianak, West Kalimantan coaches professional education students of the university’s School of Medicine on Feb. 5, 2015. (Kompas/Emanuel Edi Saputra)
Specialist doctors require additional training, typically lasting 3-6 years, beyond their general practitioner education. In Indonesia, the specialist doctor training program is structured around a university-based model where universities are responsible for the entire education process, including selection and diploma issuance. This model has produced 50,000 specialist doctors, working in various institutions both within and outside the country.
The shortage of specialist doctors in Indonesia has prompted discussions about increasing their production. This scarcity has led to untreated medical cases that require immediate attention. To address this issue, the government is exploring alternatives to the university-based model, which has limited specialist training programs available in only 20 out of 92 schools of medicine.
Instead, the government is proposing a hospital-based model, which would allow hospitals to educate and produce specialist doctors. With over 3,000 hospitals in Indonesia, the government hopes that if even 10 percent of them implement this program, the shortage of specialist doctors can be resolved.
It appears the government is committed to the implementation of the hospital-based model program. This is evidenced in the omnibus bill on health care being deliberated, which supports this model.
Article 183 of the bill allows hospitals to be designated as educational hospitals and to independently establish specialist and subspecialist doctor programs, subject to certain conditions. These include being part of the academic education system for at least five years and obtaining the highest accreditation. Furthermore, diplomas issued under this model will be signed by both the hospital director and the affiliated university rector.
The government's idea is based on the fact that Indonesia endures severe shortage of specialist doctors. According to data of January 2023, Indonesia has a total of 215,000 doctors, with 50,000 of them specialists in various fields. The number of doctors varies by specialization; and therefore, the level of scarcity also differs.
