Medical School in Indonesia
Today I’m excited to introduce to you Anna, a 22 year old medical student from Bogor, West Java province in India. She is in her last year of clinical clerkships at Universitas Pelita Harapan medical school, a bilingual (Indonesian and English) open to both local and foreign students.
Currently, Anna is undecided on a specialty, but is interested in both Neurology and Emergency Medicine. She has five more rotations before she finishes, so it will be interesting to see what she decides on! She blogs at Surreal Hours and you can catch her on Twitter @a_elissa.
She contacted me a few weeks ago asking if I was still open to having more posts in the Medical Education Monday series. I’m so thrilled that y’all find medical education in various countries as interesting as I do…it’s certainly been great to hear about all the different systems.
If you are (or someone you know is) a medical student or physician in a country not yet covered, please have them contact me! Here’s what Anna had to say about Medical School in Indonesia:
Getting In:
How old is one when they begin medical school?
We begin medical school directly after high school. However, some schools are open for students who already have an undergraduate degree, this is usually the case for foreign graduates.
What exams does one have to take to get in?
- Public Schools: National exam called SPMB that is designed for a specific major, but is valid for any universities. This exam is not the actual entrance exam, it’s only for filtering out students who are academically eligible for a certain major, in this case for medical school. A prospective student sitting the medical school SPMB also needs to fill out a list of schools of their choice. The result of the exam is then sent out to those schools, and he will receive a notification about his acceptance. There is then another exam and an interview from each school that he has to complete and pass before being formally enrolled.
- Private Schools: Each school has its own entrance exam, usually consisting of basic science focusing on human biology and chemistry, and an interview. Students applying for scholarship may be required to sit an additional exam.
Is there any required pre-requisite coursework?
The national high school system divides the curriculum into two major programs: Ilmu Pengetahuan Alam or IPA (Natural Sciences), and Ilmu Pengetahuan Sosial or IPS (Social Sciences). One has to do the IPA / Natural Sciences program to be eligible for medical school. If a student graduates from a foreign curriculum, like Cambridge or the International Baccalaureate (as in my case), then he must have taken at least biology, chemistry, and maths.
Is it a competitive occupation?
Very.
What are you called at this stage of training?
A high school graduate.
Being In:
How long is it?
5 years.
How are the years broken down?
- The first 3 – 3.5 years are pre-clinical years. Using the new block system, we learn basic anatomy, physiology, biochemistry, and immunology for the first year, then system-based approach for the remaining pre-clinical years. The actual division of the organ systems depends on each school. In my school, it is musculoskeletal, cardiology, pulmonology, gastroenterology, genitourinary, endocrinology, neurology, obstetrics and gynecology, dermatology and venereology, tropical medicine, hemato-oncology, and emergency medicine.
- Students who have completed the first 3.5 years are considered graduates already, and are granted the title “Sarjana Kedokteran” (Bachelor of Medicine). They can quit at this time and start working non-clinical jobs.
- The last 1 to 1.5 years are clinical/clerkship years. We do 9 minor rotations and 5 major ones. They differ by duration: minors last 4-5 weeks, majors last for 10-12 weeks. Minor Rotations: Neurology, radiology, psychiatry, ophthalmology, ENT, oral medicine, dermato-venereology, anesthesiology (including critical care), and forensic medicine. Major Rotations: Surgery (including emergency medicine), internal medicine, obs/gyn, pediatrics, and public health. Upon completing the clerkship, we then graduate as Medical Doctors.
Describe your typical day.
- Pre-clinical: Class starts at 7:30 AM. Some days start with lectures, some with PBL discussions. Labs are usually in the midday. On the last period every Friday, there is a plenary session where the PBL case study that week is discussed with an expert. The day usually ends at 3:00 PM.
- Clinical: In my hospital, office hours start at 7:00 AM and end at 2:00 PM, while outpatient clinic starts at 9:00 AM. The first thing we do in the morning is write SOAP notes of ward patients, then wait for the attending physicians to come for the morning round. After rounds, activities vary according to department. We may have academic activities, like tutorials or case study presentations, or we may go to outpatient clinic and have academic stuff later in the day. For surgical specialties, most operations commence at around 10:00 AM, depending on the number and difficulty of the cases that day.
If you choose a specialty, when do you have to decide by?
There’s no requirement for that. Age-wise, residency programs only require applicants to be less than 30 years old by the time of entrance.
What are you called at this stage of training?
- Pre-Clinicals Years: Medical Students.
- Clerkship Years: Our formal name is “dokter muda” or junior physicians, but we are more often called with our colloquial names, “co-ass”, from the Dutch word co-assistant. We still use a lot of Dutch medical terms in spoken conversations.
Getting Out:
What exams do you have to take?
The law is changing as I’m typing this. There used to be no exam getting out, as each rotation in clerkship already has its own exam. However, the new bill proposes for a national board exam. It is still undecided whether the exam will be a test for theory or clinical skills, or both.
Do most people graduate?
Yes.
When are you finally considered a “doctor?”
When we have taken our Hippocratic Oath at the end of clerkship (and after the board exam, if the new bill passes).
Do you have additional training after MS or do you start working immediately?
Again, the law is under some changes. The new law requires an unpaid 1-year internship in a hospital chosen by the government. After that year, doctors can work independently.
What’s the average debt for attendance?
There is no debt, except for scholarship students. Regular students pay the full fee. Scholarship students will pay back by working for their universities or teaching hospitals immediately upon graduation for a certain period of time, usually 2n + 1.
What are you called at this stage of training?
A doctor. More formally, a general physician.
Being Out:
What’s the average salary?
Depends on where you work. The general rule is the same everywhere: it’s higher in private institutions than public ones, and is also higher in bigger cities than in rural communities.
Is the job security good?
Yes. There is a high demand for doctors throughout the country, especially outside the main islands of Java and Bali.
Can you switch specialties?
Yes, but people rarely do this.
Can you go back and choose a different specialty?
Technically, yes, as long as one has not reached the age of 30 by the time of entrance. However, I have never heard of anybody doing that.
What are you called at this stage of training?
A specialist.