August 21, 2024
JAKARTA – Rasyid Syahdan, not his real name, had expected that he would face huge academic challenges once he entered a residency program nine years ago. But, he never realized that much pressure would also come from his seniors who arbitrarily abused their power through systematic bullying disguised under the name of “mental training”.
“I was fortunate enough not to face severe bullying as they only asked me to buy them food [with my own money], something I was still able to afford,” Rasyid recalled. “But I saw some of my friends suddenly resigned, or their names would just disappear from the list of students”.
Coming from a middle-class family, the then 29-year-old medical resident said spending hundreds of thousands of rupiah for his seniors’ meals was not really a big deal. He, however, did feel annoyed when being burdened with “tasks” outside his responsibilities as medical personnel.
“They [some senior doctors] view [bullying] as a mental training because later when we have already reached senior position, there will be other junior residents who will take care of [our personal needs]. But that means the vicious cycle is never stopped,” Rasyid told The Jakarta Post on Monday.
Although the seniority culture has undermined the country’s education system for many years, bullying among medical residents gained traction recently following the alleged suicide of a Diponegoro University (Undip) medical resident in Semarang, Central Java, on Aug. 12 due to bullying.
The 30-year-old medical resident, identified with initials ARL, was found dead in her rented room after reportedly injecting tranquilizers into her own body, Semarang Police said.
While the police investigation is still ongoing, the student is believed to have been bullied during her anesthesiology residency program at Dr. Kariadi General Hospital in the city, as described in a diary found at the scene.
The Health Ministry reacted by issuing a letter temporarily halting the anesthesiology residency program at the hospital until the police investigation was completed, and that both Undip and the hospital had to take responsibility for the tragedy.
The university’s rector Suharnomo was quick to deny the accusations related to bullying at the institution he headed. He claimed that the late student had health issues that hindered her studies.
However, Suharnomo gave an assurance that the university would follow through with the investigation.
“Diponegoro University’s medical school has implemented a zero-tolerance for bullying policy, which has been actively monitored by the Bullying and Sexual Violence Prevention and Handling Team, since Aug. 1, 2023,” he insisted.
Health Minister Budi Gunadi Sadikin confirmed last week that the latest case of alleged bullying was only the tip of the iceberg as he had received numerous reports on such practices. “This has become a huge phenomenon,” the minister said.
Health Ministry spokesperson Mohammad Syahril said later on Monday that the ministry had received 356 bullying reports between July 2023 and Aug. 9 this year.
Some of the 211 cases purportedly happened in teaching hospitals under the ministry’s jurisdiction, while the remaining 145 cases occurred in hospitals managed by other stakeholders.
Syahril said the ministry had investigated 156 cases from the report and had imposed sanctions on 39 medical residents and teaching doctors across the country so far.
“The Health Ministry will always take stern action against the bullies. Their names will also be flagged in the system as perpetrators,” he emphasized.
Last week, two senior residents in the neurosurgery program at Bandung’s Hasan Sadikin Hospital in West Java were dismissed from their positions by Padjadjaran University after being found guilty of severely bullying their juniors.
“[The medical faculties] must be serious in imposing sanctions. They can start by giving a stern warning for first-time offenses with the possibility of firing the residents if they continue to do it,” Rasyid said.
If the perpetrator keeps repeating their action when moving to other hospitals, then the related authorities may bring the case to the criminal court, he added. “Don’t let [the people] lose trust in all doctors in the country”.
More residency problems
Aside from pointing out rampant bullying cases among medical schools, the minister last week also said that many residents reportedly suffered from depression.
“We have conducted health surveys of medical residents and many of them have had suicidal thoughts,” he said.
In March, the ministry conducted a self-report survey involving 12,100 medical residents at 28 teaching hospitals under its jurisdiction to detect signs of depression and the severity of the disorder among the residents.
The results showed that one in five medical residents was suffering from depression with 3.3 percent of the respondents, or almost 400 resident physicians, admitting to having thoughts of self-harm or suicide in the two weeks before the survey.
The survey did not provide details on potential factors contributing to the depression. But, some doctors interviewed by the Post said that a heavy workload, long working hours and high-performance pressures during residency could be contributing factors.
Ministry spokesperson Siti Nadia Tarmizi told the Post on Friday that medical residents found to have mental health problems in the survey had been treated at Marzoeki Mahdi Psychiatric Hospital in Bogor, West Java.
“Some medical residents get counseling and others get [medical] treatment,” she added.