Internship Dokter &

Peran Organisasi Profesi

Kedokteran
Sukman T Putra, SpA(K),FACC,FESC

MPPK
Ikatan Dokter Indonesia

PIT2 PDUI 2011

Curriculum Vitae
Dr. Sukman Tulus Putra,SpA(K),FACC,FESC
Kepala Divisi Kardiologi,Dep Ilmu Kes Anak FK.UI/RSCM Jakarta

Pendidikan:

Dokter Umum FK.UI 1977

Spesialis Anak FK.UI 1987

Ped.Cardiology Fellow, Childrens Hosp.Melbourne,Australia, 1990-1991

Fellow of American College of Cardiology (FACC) - 2003

Fellow of European Society of Cardiology (FESC) 2004

Organisasi:

Ketua Umum Pengurus Pusat Ikatan Dokter Anak Indonesai ( IDAI )

Wakil Ketua Umum II Pengurus Besar Ikatan Dokter Indonesia ( IDI )

General Secretary ASEAN Pediatrics Federation

International member of American Academy of Pediatrics (AAP)

Council member Asia Pacific Pediatric Cardiology & Pediatric Cardiac Surgery Society

Patients need Good

Doctors
Care of their patients their
first concern
Keep their knowledge and
skills up to date
Maintain good
relationships with patients
& colleagues
Honest & trustworthy
Act with integrity
PIT2 PDUI, 2011

Professionalism&
Medical Association
MEDICINE is, in essence, a moral

enterprise, and its professional

associations should be built on ethically
sound foundations.

At very least, when physicians form

associations,such occasions should
promote the interest of those they
serve
Pellegrino ED. JAMA 1999;282(10):984-986

Professionalism &
Medical Association
This, sadly has not
case.

always been the

economic, commercial
and political agendas so often take
precedence over ethic obligation.
When

Pellegrino ED. JAMA 1999;282(10):984-986

Medical Association
......When physicians form associations,
they should make this promise
collectively..............................
Whithout such commitment, they are

easily degenerate into self-serving

trade association, lobbies or

unions

OUTLINE
What is doctor & what does doctor do?
Professionalism in Medicine
Internship in Medicine
The Role of Medical Association
Medical Internship in Indonesia
Summary

 MEDICINE is more than the sum of our

knowledge about disease.
Medicine concerns the experiences, feelings,
and interpretations of human beings in often
extraordinary
moment of fears, anxiety and doubt.
Stern DT. Measuring Medical Professionalism (2006)

PIT PDUI, 2011

What is a Doctor &

What does a Doctor do ?
A century ago :
the role of doctors was clear & simple
to acquire facility in the art of diagnosis

clinical judgment
to appreciate the relative value of symptoms
to grow in

and the physical signs

to give the patients and his friends the

prognosis
to conduct the treatment that the patients
forecast or

may be restored t health

Prof. William Osler (Oxford)

MJA 2005;183:560-561

What is a Doctor &

What does a Doctor do ?

One
hundreds
years on.
...... ..........
Things has
changed
MJA 2005;183:560-561

7 Physician Role
Medical Experts

Applying medical knowledge, clinical skills &

professional attitude

Communicators

Fascilitating effective doctors-patients relationship

Collaborators
Managers

Achieve optimal patients care by effective tem work

Health Advocators

Influencing advancement of health and well being

individuals, communities,population

Scholars

Demonstrating lifelong commitment of learning,

application & translation medical knowledge

Professionals

Applying ethical practice, profession ledregulation,high personal standards of behavior

Contriobuting in health care organization and the

effcetive health care system

CanMEDS physician competency framwork (2005)

Doctors are often

portrayed as:

Poor communicators
Arrogant
Defensive
Too quick to use jargon
Resistant to change
Self-interested
Operating in an exclusive
Highly paid club culture

Doctors in Society :
Medical Professionalism in changing world
Royal College of Physicians (2005))

What is a Doctor &

What does a Doctor do ?
The medical profession is built
around a networks of relationships
created between the doctor and other
people not only sick people

Not all who visit DOCTORS are sick or Patients

DOCTORS always remain for EVERYONE
The Good Doctor ( 2002 )

What is Profession?
An occupation whose core elements is work,
based of mastery of a complex body of
knowledge and skills. It is a vocation in which
knowledge of some department of science or
learning , or practice of an art founded on it is
used in the service of others.

Its members profess a commitment to

competence, integrity, morality ,altruism and
the promotion of public goods within their
domain

What is
Professionalism?

People think of professionalism in three main

ways :
the mastery of technical knowledge and skills
strong ethical principles and values such as

honesty, respectfullness and reliability

notions of calling of service, in which altruism
comes before anythings else

Professionalis
m in Medicine

Measuring Medical Professionalism (2006)

Accountability of the physician

Private
Payerrs

Patient

Government
Proffessional competence
Legal and ethical conduct
Adequacy of access

Proffessional competence
Financial performance
All six domains

Lawyers
And
Courts

Proffessional competence
Legal and ethical conduct
Adequacy of access

Physician

Proffessional competence
Legal and ethical conduct
Adequacy of access
Public health promotion

Professional
Associations

Proffessional competence
Legal and ethical conduct
Financial performance

Hospitals

Proffessional competence
Financial performance

Employers

Financial performance

Proffessional competence
Legal and ethical conduct
Financial performance

Investors

Managed
Care Plants

Modified from Emanuel, E. J. et. Al. Ann Intern Med 1996;124:229-239

Professionalism &
Medical Association

Medical Association

.....Association should be aware of the

dangers of focusing attention on
the economic concerns of their
members at the expense of their of
more
important public and professional
responsibilities.................
Pellegrino ED,RelmanAS. JAMA 1999;282(10):984-986

The Role Medical

Professional
Organization

Education
Licensing
Regulation
Representation

Academic VS Professional
BASIC Medical Education
(S Ked)

Inernship in
MEDICINE

Master of
MEDICINE (S2)

Medical Doctor
(MD)

DOCTOR of Phylosophy
(PhD) /S3

Residency
( Specialty)

Fellowship
(SUB-Specialties)

What is Internship in Medicine ?

A transitional training period for newly
graduated doctors starting their carreers.(1940)
One-year in different clinical placement
Interns as active learners, practice based
learning.

Physician in training who has

completed medical school but
DOES NOT
have full license to practice
Medicine unsupervised

Education
Educational standards and
curriculum : undergraduates
(medical students, internship and
residency training)
Continuing medical education
(CME) and continuing professional
development (CPD)

Licensing
For practice of medicine in the
areas of expertise
The requirement for licensure
may vary significantly by country
or region.
In some countries separate license
is required in each region

The Challenges of
Medical Associations at Present

Bioterrorism

Explosion
technology

Changing market
Forces

Problems in health
care delivery

Globalisation
Medical professinalism in millenium : a physician charter, MJA (2002)

Health Care in the

Late 19th and 20th Century

Patients
Physician

Medical
Associations

Emmanuel EJ. What is accountability in health care.

Ann Intern Med.1996;124:229-239

A set of Professional
Responsibilities
Commitment to:
1.
2.
3.
4.

Professional competence
Honesty with patients
Patients confidentiality
Mainataining appropriate
relationship with patients
5. Improving quality of care

Maintaining Trust
by managing Conflict of Interest
Threatening personal- organisation
ineraction with for-profit industries
(pharmaceutical, devices company)

Physician have an obligation to recognize,

disclose to general public, and deal with

conflict of interest that arise in the

course of their professional

INTERNSHIP DOKTER di INDONESIA

(2009)
Stakeholder :
Departemen Kesehatan
Institusi Pendidikan Kedokteran
KD/KDDKI (IDI)
RS Pendidikan
Penyelenggara:
Komite Internship Dokter Indonesia
(Pusat dan Propinsi)

The Role of
Perofessional Medical
Association

Professional
School of
Medicine

Medical
Education

CME/CPD

Tujuan INTERNSHIP
Memberikan kesempatan kepada dokter
baru, lulusan Program Studi Pendidikan
Profesi Dokter berdasarkan kurikulum
berbasis komtensi (KBK)
Menerapkan serta mempraktikkan
kompetensi yang diperoleh selama
pendidikan dalam rangka penyelarasan
antara hasil pendidikan dan praktek
di lapangan

Wahana Pelayanan Kedokteran

Dilaksanakan di wahana pelayanan
kesehatan primer (pemerintah/swasta)
yang telah memenuhi syarat internship

Rumah Sakit
Puskesmas :dengan atau tanpa perawatan
Klinik layanan primer lainnya

Pendampingan
Setiap peserta internship mendapat
pendampingan/ disupervisi oleh
seorang dokter yang memenuhi kriteria:
Bersedia menjadi pendamping internship
Masih praktik aktif minimum 2 tahun
dengan rekam jejak yang baik
Memiliki SIP yang masih berlaku
Telah mengikuti pelatihan menjadi
pendamping.

Permasalahan/Kendala
Kewenangan dokter intern dalam hal
penanganan pasien perlu diperjelas.
Interaksi antara dokter intern dan dokter
spesialis yang ada belum berjalan baik,
sehingga transfer of knowledge &skills tidak
optimal.
Peran dokter pendamping perlu diperjelas
termasuk rewards
Proses administratif (penerbitan STR dan SIP
sementara lambat. Tempat tinggal tidak
disediakan oleh RS wahana

Permasalahan/Kendala
Peran KIDI (Komite Internship Dokter Indonesia)
di tingkat propinsi kurang berperan
IDI Wilayah di beberapa tempat belum
mengambil peran yang optimal, bahkan terkesan
mempersulit dalam rekomendasi SIP/STR ?
RS wahana belum mersakan pentingnya
kehadiran dokter intern dalam peningkatan
kualitas pelayanan kesehatan.

MASALAH/ TANTANGAN YANG KITA HADAPI SEKARANG

DESENTRALISASI

SISTEM
YANDOK

TRUST
MENURUN

MASALAH/
TANTANGAN
DOKTER

GLOBALISASI

UUPK
UUSISDIKNAS

INDONESIA

KESEJAHTERAAN

PENDIDIKAN
DU/Spes.

AKB/AKAB
TINGGI

UU RS
UU KES.

Kesimpulan & Saran

Intership merupakan proses pendidikan
professional yang penting bagi sorang dokter
dalam meniti jenjang karir di masa depan.
Oleh karena internship adalah suatu sistem
jenjang pendidikan profesi yang berlaku global
maka perlu segera diadakan evaluasi untuk
perbaikan oleh pemegang otoritas masalah ini.
Peran Perhimpunan Profesi (ditingkat cabang/
wilayah) perlu ditingkatkan dalam pembekalan
pengetahuan dan keterampilan dokter intern