The number of medical graduates in Indonesia has ranged from 11,000 to 14,000 annually over the past three years. As the number of graduates continues to increase, maintaining and improving quality remains essential. Recently, public attention has focused on the situation of thousands of prospective doctors who risk being unable to obtain their professional qualifications despite having completed all stages of professional medical education. This issue is not merely administrative; it reflects a broader structural challenge with significant implications for both aspiring doctors and efforts to ensure the availability of a competent healthcare workforce that safeguards patient safety.
Those commonly referred to as retakers are medical students who have completed all clinical rotations in the professional phase of their education but have not yet fulfilled the final requirement: passing the nationally administered medical competency examination. As a result, they are not yet eligible to receive a medical professional certificate because they have not successfully completed the final stage required to practice medicine.
In response to the issue, Universitas Gadjah Mada (UGM) health law expert Dr. Rimawati emphasized that the retaker phenomenon must be understood in a broader context. Philosophically, the Indonesian Medical Profession Student Competency Examination (UKMPPD) is part of the state’s responsibility to ensure that healthcare professionals who serve the public meet established competency standards. This aligns with Law No. 17 of 2023 on Health, which requires medical and healthcare professionals to demonstrate competency before entering practice.
“Healthcare is part of the constitutional mandate entrusted to the state to guarantee protection, patient safety, security, and the provision of healthcare services to the public,” she said on Friday (Jun. 12).
Dr. Rimawati explained that medical education does not end with the completion of academic and professional training. After completing coursework and clinical clerkships, prospective doctors must still demonstrate their competence through the national evaluation mechanism, namely the UKMPPD. From a health law perspective, the government occupies a position similar to the vertex of a right triangle, balancing two responsibilities at once: protecting future healthcare professionals and safeguarding the public as recipients of healthcare services.
“The government protects two parties. It protects future healthcare professionals and, at the same time, protects the public,” she explained.
Nevertheless, Dr. Rimawati acknowledged concerns about fairness when prospective doctors who have completed all stages of professional education risk losing the opportunity to obtain professional certification if they fail to meet competency examination requirements within a specified period. She argued that policymakers must consider the considerable time, effort, and financial resources these individuals have invested in their education.
“If we look at it from the perspective of justice and human rights, immediately dismissing retakers from the program would not be fair,” she said.
In addition, she stressed that the government should prepare clear solutions for those who ultimately fail to pass the competency examination.
“The government must also find a solution regarding the status of medical students who do not pass the competency examination,” she added.
Dr. Rimawati further noted that the large number of retakers should serve as an important evaluation point for medical education institutions. According to her, success or failure in the competency examination cannot be attributed solely to individual students. Educational institutions must also evaluate their teaching processes and the quality of their graduates.
She pointed to the rapid growth in the number of medical schools in recent years as a factor warranting closer examination. While Indonesia’s growing demand for physicians has spurred the establishment of new medical programs, these expansions must be accompanied by assurances of educational quality, curriculum standards, and adequate student support systems.
“We need more doctors, but what we need are doctors who possess the required competencies,” she said.
Dr. Rimawati added that low pass rates on competency examinations at a particular institution should serve as a key indicator for internal evaluation. Medical schools need to identify specific competencies that students have not yet mastered and provide appropriate support before they retake the examination. According to her, transparency and accountability within educational institutions are crucial to addressing the retaker issue.
Regarding the possibility of legal action by retakers who believe they have been disadvantaged, Dr. Rimawati explained that every citizen has the right to pursue legal remedies if they believe their rights have been violated. However, she noted that the requirement to pass the competency examination before obtaining authorization to practice medicine is grounded in strong legal provisions within Indonesia’s healthcare regulations.
Even so, she emphasized the importance of pursuing solutions that are not solely punitive. Evaluations should be conducted to determine which competencies remain unmet and what forms of assistance are needed before final decisions are made. She also reminded stakeholders that not all retakers share the same circumstances. Therefore, medical schools must assess each individual’s background, including whether they experienced periods of inactivity after completing professional education.
“The student’s status must also be examined. We need to know whether they became inactive for a period after completing their professional education but before taking the UKMPPD,” she concluded.
Author: Zabrina Kumara
Editor: Gusti Grehenson
Post-Editor: Zabrina Kumara
Photo: Magnific