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Shortage of medical specialists worsened by unequal distribution

Jakarta Globe - January 5, 2023

Heru Andriyanto & Chairul Fikri, Jakarta – Indonesia gets around 12,000 medical school graduates every year but few will have advanced medical training in a specific area while there is a disproportionate number of specialists working in urban areas.

"It's no simple math in the health system. The shortage of specialist doctors cannot be solved merely by adding the number. We must ensure a fair distribution of their presence across the country," Indonesian Medical Association (IDI) Chairman Adib Khumaidi said during a visit to the Jakarta Globe newsroom on Thursday.

The country of 273 million has only around 54,000 specialist doctors and they are heavily concentrated in provinces across Java and Sumatra, or in rich provinces like East Kalimantan, South Sulawesi, and North Sulawesi.

"This won't happen if the government imposes a moratorium on medical practice licenses in crowded districts," Adib said.

Of 95 medical faculties across the country, only 20 have extended specialty programs. "We are still lacking at least 37,000 specialist doctors," Adib said.

The government has offered financial incentives and even issued mandatory assignments of specialist doctors to remote districts for a certain period, but inequality still persists.

There are around 4,700 obstetrics and gynecology specialists, 900 of them work in Greater Jakarta, according to Ari Kusuma Januarto, who heads the national association of ob-gyn specialists.

"We used to have a government mandate for the assignment of specialist doctors in designated places but a Supreme Court ruling annulled the mandate," Ari said.

Health Minister Budi Gunadi Sadikin said separately a lack of cardiologists and pediatricians contributed to the thousands of deaths among children annually.

Speaking at a press conference in Jakarta on Thursday, Budi said more than 7,000 children have died in Indonesia from heart disease every year.

"There are around 48,000 children in Indonesia born with inherited heart disease every year and 12,500 of those are in critical category," Budi said.

"However, the capacity of pediatric heart surgery is only 5,000 patients a year and the rest [of those in critical condition] may have died in the absence of medical treatment because we are short of cardiologists."

The minister said 4.8 million babies were born every year in Indonesia and one in every 100 newborns has a heart problem.

"The health ministry is working together with all stakeholders including the private sector on a speedy process to produce a lot more cardiologists in Indonesia," he added.

Part of the program is providing scholarships for medical students specializing in cardiology, the minister added.

"In order to overcome the shortage of specialist doctors at the local level, we continue to ease procedures for doctors to register and obtain practice licenses," Budi said.

Source: https://jakartaglobe.id/news/shortage-of-medical-specialists-worsened-by-unequal-distributio