Mamak2, Kakak2, sarato Dunsanak di lapau,
Rancak juo dibaco2 artikel di bawah ko sambia maunjua2. Nan takana dek ambo 
sasudah mambaco artikel ko: baa caro e ujian tes masuak Fakultas Kedokteran di 
universitas2 di Indonesia (tamasuak di Unand?). Kok lai kualitas isi kapalo nan 
jadi patokannyo, tantu rancak hasilnyo. Tapi kabanyo masuak Fakultas Kedokteran 
ko iyo harus bakambuik nek'e pitih rang gaek. Iyo tu?

http://portraitindonesia.com/2012/04/a-sick-system-produces-dumb-doctors-in-indonesia/

A sick system produces dumb doctors in Indonesia
“Why don’t you go to Penang/Singapore?” is the first thing most Indonesians say 
when they hear I don’t have kids. Obviously childlessness must be fixed, and 
obviously it is far too important to be left to the Indonesian health system. I 
usually give people short shrift when they trash the health system here. I have 
several smart friends who were once great doctors. Ok, they’ve mostly shifted 
into management jobs now, but Indonesia’s med schools are full of bright young 
things to take their place.
Or are they? A recent report from the World Bank wrings its hands over the 
quality of medical education in Indonesia. It finds that accreditation 
standards for health schools are wonky in the first place, are not properly 
applied, and are in any case not published. Not too surprising really. Another 
recent report from the World Bank notes politely how absolutely crap 
Indonesia’s education system is. In internationally standardised tests of 15 
year-olds, over half of Indonesians scored less than one out of six on maths 
tests, and not a single Indonesian student reached the score of five or six 
that, according to the OECD which runs the tests, indicates decent critical 
thinking skills. When basic education is so poor, it would be miraculous for 
medical education to be much better. But the World Bank health worker report 
doesn’t even mention the thing that worries me most: training for doctors and 
jobs as nurses are for sale.
 
Even the best state universities, the ones that in the past gave scholarships 
to my smart friends, are raking in money selling places in med school. The 
starting price to get in, for students with exceptional grades, is 10 million 
rupiah, over US$ 1,000. The lower your grades, the more you have to pay to get 
in. Medical school is so fashionable these days that I’ve heard of people 
paying up to 250 million rupiah just to get in. That’s not for tuition, of 
course, that’s purely for the privilege of being able to say “My eldest is 
studying to be a doctor”. If they are either stupid or lazy or both, they will 
have to pay another great whack each year to pass their exams. When they 
graduate they’ll have had a very expensive education. But would you want them 
taking care of your tumour?
 
The sale of jobs starts at a much lower level. Nurses and even midwives now 
have to put out to get hired even in small town health centres. The going price 
in Aceh, where I’ve spent the last few weeks, is 60 million rupiah for an entry 
level job (assuming that you have already earned, or indeed bought, the 
appropriate qualifications). Sixty million rupiah, US$ 6,600 dollars, to get a 
job that will earn less than US$ 300 a month. Is it any surprise that most 
health centre staff, doctors, nurses and midwives included, go to work in the 
morning and run a private practice in the afternoons or evenings?
 
I often ask people why they pay to see the doctor in the evening when they 
could see exactly the same doctor for free in the morning. The universal 
response is that doctors keep the “strong” medicine for their private patients. 
At the health centre you get obat warung – “kiosk drugs”, cheap, 
over-the-counter stuff. Given the deterioration of standards required of people 
studying medicine in the first place, I would have thought the drugs they give 
you would be the least of your concerns.
 
April 30th, 2012 | Tags: Corruption, Education, Health, World Bank | Leave a 
comment, in English or Indonesian | Category: Indonesia 

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