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View all search resultsWhen young doctors serve as 'shock absorbers' of a fragile health system
When we glorify the exhaustion of young doctors as heroism, we ignore the systemic cracks that turn healers into "shock absorbers" for a failing healthcare system.
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Health workers in protective suits prepare a patient on May 13, 2020, for transferring from the COVID-19 intensive care unit to the surgical unit at Persahabatan Central General Hospital in Pulo Gadung, East Jakarta. (Reuters/Willy Kurniawan)
F
our medical interns have died in Indonesia over the past two months. While the causes may differ, the broader message must not: These deaths are not isolated tragedies or unfortunate coincidences. They are warning signs.
In mature healthcare systems, the death of a practitioner during training is treated as a sentinel event: rare, unacceptable and demanding immediate systemic evaluation.
Unfortunately, the Indonesian system still tends to interpret such events through an individual lens. We ask what happened to the doctor, but we rarely ask what kind of system allowed the situation to occur in the first place.
This is where the real problem begins.
On paper, Indonesia’s medical internship program is meant to bridge the gap between medical school and independent clinical practice. Ideally, this should be a protected learning environment where newly graduated doctors refine their skills under close supervision.
In reality, however, the system functions as a hidden labor buffer for an overstretched healthcare network. Young doctors exist in a dangerous gray zone: They carry real clinical responsibilities and work grueling shifts, yet they are not fully protected as employees, nor are they consistently supervised as trainees. They are expected to function like workers, but without the associated rights, and learn like students without the necessary protections.
A healthy system cannot operate on ambiguity. If interns are trainees, supervision must be rigorous and structured. If they are workers, labor protections must be enforceable. Indonesia’s internship system currently struggles to provide either.
