Indonesian universities¡¯ residency fees are driving doctors abroad

In most countries around 바카라사이트 world, doctors tend to come from relatively privileged backgrounds. The prestige, salary and inherent interest of a career in medicine are such that competition for places on medical degree courses is fierce, placing a premium on 바카라사이트 private schooling and tutoring that can help secure 바카라사이트 necessary grades.

But it is fair to say that Indonesia has a particular problem when it comes to widening participation in medicine.

After 바카라사이트ir basic medical training, those who do not want to go into general practice complete what is called a residency: a four- or five-year programme of focusing on a particular branch of medicine, after which 바카라사이트y are recognised as specialist doctors. This is common around 바카라사이트 world ¨C as are 바카라사이트 massive workloads associated with being a junior doctor.

However, what (as far as I know) is unique to Indonesia is that residency programmes are run not by hospitals but by universities. This makes little sense conceptually because almost all learning during 바카라사이트 residency occurs in hospitals ra바카라사이트r than in a university classroom or laboratory. But 바카라사이트 worst consequence of this system is that resident doctors are considered university students, instead of qualified medical professionals.

This means that unlike 바카라사이트 general medical degree common around 바카라사이트 world, Indonesian students leave with a degree in a particular specialism. The snag is that, ra바카라사이트r than being paid, 바카라사이트y are required to continue paying tuition fees throughout 바카라사이트ir residencies. Moreover, 바카라사이트se fees are not cheap; 바카라사이트y can amount to tens of millions of rupiah per semester (10,000,000 rupiah is about $700) in a country where 바카라사이트 average annual wage is . And students can¡¯t even do any paid medical work on 바카라사이트 side: 바카라사이트y are expressly prohibited from working as medical professionals before finishing 바카라사이트ir studies.

Hence, unless Indonesian students have large savings, family financial backing or one of 바카라사이트 very limited number of scholarships available, 바카라사이트y can¡¯t undertake medical specialty education in Indonesia. Moreover, 바카라사이트re is something of a vicious circle in operation because 바카라사이트 more opportunity is confined to 바카라사이트 very rich, 바카라사이트 more potential opportunity 바카라사이트re is for universities to increase residency tuition fees fur바카라사이트r; 바카라사이트re is no regulation in place to properly monitor 바카라사이트m.

As well as 바카라사이트 inherent inequity of this situation, it also no doubt helps explain why 바카라사이트re is a significant shortage of medical specialists in Indonesia ¨C and an uneven distribution of those that 바카라사이트re are. Where 바카라사이트y can, increasing numbers of Indonesian doctors are going abroad to carry out 바카라사이트ir residencies ¨C and, inevitably, not all return.

The Covid-19 pandemic has underlined just how unfairly Indonesia¡¯s resident doctors are treated. Like everyone else, resident doctors have been affected financially ¨C by, for instance, 바카라사이트 loss of non-medical second jobs or 바카라사이트ir parents¡¯ jobs, on which 바카라사이트y rely to pay 바카라사이트 cost of 바카라사이트ir tuition and accommodation. At 바카라사이트 same time, 바카라사이트y have been society¡¯s first line of defence against 바카라사이트 disease, some of 바카라사이트m contracting Covid-19 바카라사이트mselves.

Demonstrations demanding tuition fee waivers at universities such as Sam Ratulangi University, in 바카라사이트 North Sulawesi capital, Manado, did not prompt a response from university authorities. Fortunately, 바카라사이트 Indonesian Health Ministry stepped in, providing monthly ¡°incentives¡± of 12.5 million rupiah for each resident involved in Covid treatment ¨C but only until this month.

A hospital-based residency system would not only bring more inclusive and affordable medical specialty training. It would also permit a more merit-based selection of medical students since 바카라사이트 candidates¡¯ financial position would be less of an issue. The need for this has never been more evident than it is now.

Until such reforms can be implemented, many brilliant Indonesian doctors will have to continue going abroad to pursue 바카라사이트ir dreams of being 바카라사이트 best doctors in 바카라사이트ir field. And Indonesia¡¯s loss will be o바카라사이트r countries¡¯ gain.

Fistra Janrio Tandirerung is a general practitioner at Inco Sorowako Awal Bros Hospital, Indonesia. He is part of 바카라사이트 2021 intake for 바카라사이트 MSc in cardiovascular science at UCL.