Jakarta. Health Minister Budi Gunadi Sadikin has criticized Indonesia’s medical specialty training and certification system, calling it excessively expensive and overly bureaucratic -- making it accessible only to those from wealthy families.

He called for an overhaul of the expensive and lengthy specialist certification system.

Speaking at a hearing with lawmakers overseeing the healthcare sector on Tuesday, Budi argued that Indonesia is the only country where specialty medical training is embedded in the formal academic system, rather than treated as professional education.

“In other countries, becoming a medical specialist involves professional training. But in Indonesia, it’s an academic program that slows down the process of producing more specialists,” he said.

Budi underlined the need for reform, citing that the UK produces around 6,000 medical specialists annually -- more than double Indonesia’s 2,700 -- despite Indonesia having five times the UK’s population.

He said the high cost of entering a specialty program is one of the biggest barriers for general practitioners aspiring to become specialists, as they are often required to stop working while enrolled in the program.

“Doctors must pay hundreds of millions in upfront fees and tens of millions in tuition fees per semester, all while being unable to earn an income,” Budi said.

Citing research by the Corruption Eradication Commission (KPK) and the University of Indonesia's Faculty of Economics and Business, Budi underscored the financial burden aspiring specialists face.

The KPK survey of 1,400 specialty graduates found that some paid up to Rp 565 million ($33,784) in upfront fees and as much as Rp 250 million ($14,948) in tuition, depending on the institution and program. 

Another study by the University of Indonesia revealed total specialty training costs ranging from Rp 1.1 billion to Rp 2.2 billion ($65,775 - $131,537) at private universities, and between Rp 266 million and Rp 1.4 billion ($15,904 and $83,690) at public institutions.

“That’s why medical specialists in Indonesia generally come from affluent families who can afford to cover both tuition and living costs during training,” Budi said.

He added that the government is drafting a bill aimed at reforming the system to lower costs and reduce bureaucracy. The proposed reform would shift the training focus from academic campuses to hospitals, allowing doctors to continue working and earning salaries while undergoing specialist training.

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