EDITORIAL: Problems in Medical Education

May 10, 2016

The opening of eight new schools of medicine in the 2016/2017 school year, despite 45 percent of all school of medicines nationwide having C accreditation, has triggered a discussion.

There are different approaches between the Research and Technology and Higher Education Ministry and the Indonesian Doctors Association (IDI). Between the fulfillment of needs so that each province has at least one school of medicine on one hand, and the fulfillment of quality of doctors in line with the prerequisites so that the problems lies in the distribution of doctors on the other.

The ministry’s quantitative approach tries to improve the ideal ratio of one doctor for every 2,500 citizens. The IDI, on the other hand, is concerned that this will only set aside the quality of doctors and has decided to focus more on improving health management. The Indonesian Medical Council (KKI) said that, as of April 2016, Indonesia had 110,773 doctors for 250 million citizens. This has exceeded the minimum quota of 40 for 100,000 citizens.

The IDI and KKI’s concerns make sense. The results of a competence exam for undergraduate students in the medical professional program, which was begun in 2015, showed that around 25 percent of graduates of schools of medicine failed to pass the exam. This makes sense as they are the products of various schools of medicine with C accreditation. The KKI had previously advised the government to open new schools of medicine only if the 75 existing schools of medicine all had either A or B accreditations.

What complicates things for these schools, including the new ones, is not only the availability of lecturers but also ownership of academic hospitals. Opening new schools of medicine demands true passion, both from lecturers and students, including motivation from the founders.

Passion is an important requirement and factor to produce doctors who are not only skillful but also have hearts, who do not prioritize themselves over their patients, who are not only able to cure sickness but also improve health. This is not to dream that our doctors are all “divine angels”, but producing doctors without developing the passion will only blunt the doctors’ pledge as created by the “father of medicine”, Hippocrates in the fifth century BC. Healthcare ethics and laws will be easy to break if money, not safety of lives, is prioritized.

Therefore, the process of medical education is not only expensive but also unique. It is expensive to cover the expenses for all learning facilities and it is unique as the students are trained to take care of more than just infrastructure. In managing schools of medicine, this uniqueness in training new doctors needs to be considered. Establishing schools of medicine without the proper preparations, and based only on commercial motivations, will serve only to erode the reputation of medical education and the dignity of the profession of medical doctors in Indonesia.

It is impossible to call off the plan to open eight new schools of medicine across the country. However, improving the preparations is still very much possible. This is to say that, if the eight new schools have yet to fulfill the required lecturer-to-student ratio and availability of academic hospital, it is much better to delay the opening.