July 31, 2023
JAKARTA – The Health Ministry is redoubling its efforts to stop the rampant bullying of doctors in medical specialist training, promising to take “stern measures” to end a decades-long cycle of harassment.
Health Minister Budi Gunadi Sadikin issued a ministerial regulation last week that formally banned all forms of hazing in government-owned teaching hospitals and launched a bullying reporting platform for medical residents.
The regulation enumerates actions that constitute bullying during medical residencies, including hitting, punching, biting, name-calling, harassing, mocking, blackmailing, ignoring, treating residents as personal assistants and demanding that residents pay for items that are unrelated to their education.
If found guilty, offenders face sanctions ranging from a warning to expulsion from the teaching hospital, depending on the severity of the violation.
Victims of bullying, or their friends or family members, can report incidents anonymously through a ministry website or a WhatsApp hotline, and a team from the ministry’ inspectorate general will investigate the case.
Budi said the team would ensure that victims remained anonymous and protected after reporting instances of bullying. The ministry would also provide psychological and legal counseling if necessary.
“We want to create a safe, comfortable and conducive environment for doctors to learn so that they can graduate to become medical specialists who have strong empathy and humanity,” he said.
The ministry said reports of abuse and harassment of medical residents had increased in recent years.
The harassment, Budi said, included treating residents as personal assistants, making newly admitted residents pay out of their own pocket for their superiors’ dinner parties or expenses and demanding that junior residents carry out their seniors’ tasks and duties.
“There’s a systematic denial to cover up bullying in hospitals”, Budi said, adding that the culture of hazing was most prevalent among doctors out of all healthcare professionals.
“We want to carry out strict and tough measures to end this culture. That’s the only way to cut off this bullying cycle,” Budi said.
Incidents of bullying during medical residencies have been reported in the past.
In 2020, a surgical resident from Airlangga University in Surabaya, East Java, killed himself three days after beginning his medical residency at a teaching hospital, after allegedly being bullied by senior residents.
The issue resurfaced in April of this year when an anonymous doctor told minister Budi, during an online press conference, about the bullying he had experienced during his residency. The doctor said the incident caused him to quit his medical specialty training and that he had been diagnosed with post-traumatic stress disorder.
Budi said the recently launched anti-hazing measures were to apply only at government-owned teaching hospitals because most medical specialty training in the country was conducted there.
But the ministry was planning to expand the policy to private hospitals, he added, and was considering enlisting the help of the Education, Culture, Research and Technology Ministry so that a similar policy could be implemented at medical schools.
Out of the more than 1,122 hospitals in the country, both government and privately owned, about 240 are currently used as teaching hospitals.
The Health Ministry’s new bullying policy is part of its efforts to address Indonesia’s severe shortage of medical specialists.
The country has 0.28 medical specialists per 1,000 people and needs 30,000 more specialists to meet the World Health Organization’s minimum standard.
Health officials say many doctors are reluctant to undergo medical specialty training because of the high tuition costs, difficult admission tests, long training times and the fact that doctors earn no salary during their residencies.
The recently passed omnibus Health Law seeks to address the issue by allowing more hospitals to offer medical residency programs and streamlining the licensing process for doctors, among other things. The government is also providing medical specialty scholarships for more than 2,000 doctors this year.
The dean of the University of Indonesia’s School of Medicine (FKUI), Ari Fahrial Syam, welcomed the government’s initiative to end bullying in teaching hospitals.
“The FKUI has had a policy in place since 2018 to address bullying problems. But the new ministerial regulation could fill current gaps in regulation, for example, if those who commit bullying are hospital staff or doctors who are not affiliated with the university,” he said.
Public health expert Tjandra Yoga Aditama said the government should collect data on hazing during medical residencies to determine how effective the new policy was.