MEDICAL COUNCIL REGULATION OF INDONESIA NUMBER 11 IN 2012 ABOUT STANDARD COMPETENCE INDONESIAN DOCTORS BY THE GRACE OF GOD ALMIGHTY

MEDICAL COUNCIL CHAIRMAN OF INDONESIA Weigh : a. that education medical essentially aims for produce doctor professional through process standardized according to the needs of public health services ; b . that doctors competency standards set out in decision Council medical Indonesia number 21A/KKI/KEP/IX/2006 on Ratification of Standards competence doctor be adapted with development knowledge technology medicine ; c . that for adjusting competency doctor with development knowledge medical technology , standards need to be rearranged physician competence ; d . that prepared competency standards profession doctor constitute reference in providing education profession of medicine ; e . that consider the implementation of the provisions Article 8 of Law No. 29 of 2004 of Medical Practice ; f . that based consideration as referred to in paragraphs a, b , c , d , and e , need to set a Council Regulation Indonesian Medical Standard for Competence Indonesian doctors ;

according : 1 . Law No. 20 Year 2003 on system education national ( Gazette state republic Indonesia year number Gazette of the Republic of Indonesia No. 4301 ) ; 2 . Law No. 29 Year 2004 on practice medical ( Gazette state republic Indonesia year number additional Republic of Indonesia Number 4431 ) ; 3 . Law No. 36 Year 2009 on Health (State Gazette of the Republic of Indonesia year number additional sheet Republic of Indonesia Number 5063 ) ; 4 . Law No. 44 Year 2009 on Hospitals (State Gazette of the Republic of Indonesia year No. 153 , additional sheet The Republic of Indonesia Number 5072 ) ; 5 . Law No. 12 Year 2012 on education high ( Gazette state republic Indonesia year No. 158 , additional Republic of Indonesia Number 5336 ) ; 6 . regulation government Numbers year about the National Standards ( Sheet Republic of Indonesia Year 2005 Number 41 , Gazette of the Republic of Indonesia No. 4496 ) ; 7 . Indonesian Medical Council Regulation No. 1 Year 2011 on the Organization and Work Council medical Indonesia ( News state republic Indonesia Year 2012 No. 351 ) ;

DECIDED: REGULATION COUNCIL COMPETENCE DOCTOR INDONESIA. Article 1

MEDICINE

INDONESIA

ABOUT

STANDARD

(1) Indonesian Doctors Competency Standards are part of the Professional Education Standards adopted by the Indonesian Doctors Indonesian Medical Council. (2) Indonesian Doctors Competency Standards referred to in paragraph (1) listed in attachment which is not part separated from the Indonesian Medical Council Regulations

Article 2

(1) Each college is organizing education profession physician, in developing curriculum standards should apply Indonesian Doctors Competency as referred to in Article 1 paragraph

Article 3

(1) At the time of this regulation comes into force, the Medical Council Decision Indonesia Number 21A/KKI/KEP/IX/2006 on Ratification of Standards Physician Competence, revoked and declared Article 4 (1) Indonesian Medical Council Regulation comes into force on the date of enacted. so that every person know, order enactment Indonesian Medical Council regulations shall be promulgated in Republic of Indonesia.

Jakarta December 27, 2012 MEDICAL COUNCIL CHAIRMAN OF INDONESIA Signed MENALDI RASMIN

PENDAHULUAN
Standar Kompetensi Dokter Indonesia (SKDI) merupakan standar minimal kompetensi lulusan dan bukan merupakan standar kewenangan dokter layanan primer. SKDI pertama kali disahkan oleh Konsil Kedokteran Indonesia (KKI) pada tahun 2006 dan telah digunakan sebagai acuan untuk pengembangan kurikulum berbasis kompetensi (KBK). SKDI juga menjadi acuan dalam pengembangan uji kompetensi dokter yang bersifat nasional. SKDI m emerluka n re visi se cara be rkala, m engingat pe rkembang an ya ng ad a te rkait

BAB I
sinergisme sistem pelayanan kesehatan dengan sistem pendidikan dokter, perkembangan yang terjadi di masyarakat serta perkembangan ilmu pengetahuan dan teknologi kedokteran. Berdasarkan pengalaman institusi pendidikan kedokteran dalam mengimplementasi- kan SKDI tersebut, ditemukan beberapa hal yang mendapatkan perhatian, sebagai berikut: 1. SKDI harus mengantisipasi kondisi pembangunan kesehatan di Indonesia dalam kurun waktu 5 tahun ke depan. Sampai dengan tahun 2015, Millenium Development Goals (MDGs) masih menjadi tujuan yang harus dicapai dengan baik. Untuk itu, fokus pencapaian kompetensi terutama dalam hal yang terkait dengan kesehatan ibu dan dan permasalahan penyakit tidak menular. 2. penyakit infeksi, tanpa mengesampingkan

Tantangan profesi kedokteran masih memerlukan penguatan dalam aspek perilaku profesional, mawas diri, dan pengembangan diri serta komunikasi efektif sebagai dasar dari rumah bangun kompetensi dokter Indonesia. Hal tersebut sesuai dengan hasil pertemuan Konsil Kedokteran se-ASEAN yang memformulasikan bahwa karakteristik dokter yang ideal, yaitu profesional, kompeten, beretika, serta memiliki kemampuan manajerial dan kepemimpinan. 3. Dalam mengimplementasikan program elektif, institusi pendidikan kedokteran perlu mengembangkan muatan lokal yang menjadi unggulan masing-masing institusi sehingga memberikan kesempatan mobilitas mahasiswa secara regional, nasional, maupun global. 4. Secara teknis, sistematika SKDI yang baru mengalami perubahan, yaitu: Penambahan Daftar Masalah Profesi pada Lampiran Daftar Masalah, sebagai tindak lanjut hasil kajian terhadap perilaku personal dokter.

Penambahan Lampiran Pokok Bahasan untuk Pencapaian 7 Area Kompetensi, sebagai tindak lanjut hasil kajian mengenai implementasi SKDI di institusi pendidikan kedokteran.

Consistency attachment list of problems , diseases and clinical skills are arranged by organ system . This is to provide more leads develop curricula , and to prevent unnecessary duplication . systematics by organ system is also easier for authors to determine the order of the thematic curriculum learning objectives in a systematic

In order SKDI can be implemented consistently by the institution of medical education , the variety of resources such as faculty , staff, infrastructure and funding to support all the activities necessary to effectively and efficiently prepared and adjusted to SPPDI .

Indonesian Doctors Competency Standards

CHAPTER II SYSTEMATICS OF PHYSICIAN COMPETENCE STANDARD INDONESIA

Indonesian Doctors Competency Standards consist of seven (7 ) areas of competence derived from the description of tasks , roles , and functions of primary care physicians . every area competencies defined definition called core competencies . Each competency area of competence translated into several components , which further detail be expected ability at the end of education . Schematically , the structure of the Indonesian Doctors Competency Standards can be illustrated in Figure 1 . Areas of Competence Core Competencies

components of Competence Capabilities expected by the end of the learning attachment List of Subjects List of Issues List of Diseases Clinical Skills List For the achievement of competence Figure 1 . schematic , the composition of the Indonesian Doctors Competency Standards . Indonesian Doctors Competency Standards is equipped with Highlights List , List of Issues , List of Diseases and Clinical Skills List . The main function of the fourth for developing the institutional curriculum . institutions education medical Subject list , containing the subject of the learning process to achieve the 7 areas of competence . The material can be further elaborated in accordance science -related fields , and mapped according to the structure of the curriculum of each institution . List of Issues , contains a variety of problems that will be faced by primary care physicians . Therefore , medical education institutions need to ensure that during education , medical students exposed to these issues , and given the opportunity to practice handling . Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA Disease Register , containing the name of the disease which is the differential diagnosis of the problems encountered in the problem list . This disease list gives direction for medical education institutions to identify the content of the curriculum . In each disease has been determined that the expected level of ability , making it easier for medical education institutions to determine the depth and breadth of curriculum content . Clinical Skills list , containing clinical skills need to be mastered by the primary care physicians in Indonesia . At each skill level has been determined expected ability . This list facilitates medical education institutions to determine the materials and means of learning clinical skills . Indonesian Doctors Competency Standards

CHAPTER III PHYSICIAN COMPETENCE STANDARD INDONESIA A. AREA OF COMPETENCE Competence is built with a foundation consisting of professionalism sublime , introspective and self-development , as well as effective communication , and supported by pillars form information management , the scientific basis of medicine , clinical skills , and management of health problems ( Figure 2 ) . Therefore the area of competence drawn up in the following order : 1 . The professionalism of the Sublime 2 . Self introspection and Personal Development 3 . Effective communication 4 . Information management 5 . The cornerstone of Scientific Medicine

6 . Clinical skills 7 . Management of Health Problems Figure 2 . Foundations and Pillars of Competence . B. COMPONENTS OF COMPETENCE Area professionalism Sublime 1 . Berke deity Almighty / Almighty 2 . Moral , ethical and discipline 3 . Conscious and law-abiding 4 . Insightful sociocultural 5 . behave professionally Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA Areas introspective and Personal Development 6 . Applying introspective 7 . Practicing lifelong learning 8 . develop knowledge Effective Communication Area 9 . Communicate with the patient and family 10 . Communicating with partners 11 . Communicating with the public Information Management Area 12 . Access and assess information and knowledge 13 . Disseminate information and knowledge effectively to health professionals , patients , the public and stakeholders to improving the quality of health services Areas of Scientific Basis of Medicine 14 . Applying Biomedical sciences , sciences , Humanities , Science Clinical Medicine and Science in Public Health / Preventive Medicine / Community Medicine best to manage health problems holistically and comprehensively . Areas of Clinical Skills 15 . Perform diagnostic procedures

16 . Management procedure that is holistic and comprehensive Management Area Health Issues 17 . Implement health promotion at the individual , family and community 18 . Implement the prevention and early detection of health problems on individuals , families and communities 19 . Perform management of health problems of individuals , families and communities 20 . Empower and collaborate with the community in an effort to improve the health 21 . Managing resources effectively , efficiently and in a sustainable health problem resolution 22 . Accessing and analyzing and implementing health policy that is specific priorities of each region in Indonesia C. TRANSLATION COMPETENCE 1 . The professionalism of the Sublime 1.1 . Core Competencies Able to carry out a professional medical practice in accordance with the values and principles to the divinity , noble moral , ethics , discipline , law , and social culture . 1.2 . Doctors Able graduates 1 . Berke divinity ( the Almighty / Almighty ) medical practice that maximum effort do medical constitute 2 . Moral, ethical , and disciplined tandards of high moral values in the practice of medicine

ethics of health care of individuals, families and communities disciplined in the practice of medicine and society Indonesian Doctors Competency Standards

3 . Conscious and law-abiding dentify legal issues in medical care and advise how to solve nsibility in law and public order apply

4 . Insightful socio-cultural - cultural - economic communities served age , gender , ethnicity , disability , and socio - cultural - economic in running medical practice and society rowing in a multicultural society 5 . behave professionally

interprofesional health and for the sake of patient safety service health care efforts in the framework of the national health system and global 2 . Self introspection and Personal Development 2.1 . Core Competencies Able to perform medical practice by recognizing the limitations , overcome personal problems , develop themselves , following the refresher and upgrading knowledge on an ongoing basis and to develop knowledge for the sake of patient safety . 2.2 . Doctors Able graduates 1 . Applying introspective sical , psychological , social and cultural self

-development feedback from others to 2 . Practicing lifelong learning - aware performance and identify learning needs to address weaknesses

3 . Developing new knowledge families and communities as well as the dissemination of the results

3 . Effective communication 3.1 . Core Competencies Able to explore and exchange information verbally and nonverbally with patients of all ages , members of families, communities , colleagues , and other professions . Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA 3.2 . Doctors Able graduates 1 . Communicate with the patients and their families Empathize by using language mannered

and can to be holistic and comprehensive dig problems health -related information ( including the bad news , informed consent ) and counseling in a way that is polite , good and true to biopsikososiokultural and spiritual aspects of patient and family 2 . Communicating with partners ( colleagues and other professions ) care law enforcement , health insurance companies , the media and other parties if needed

3 . Communicating with the public together families and communities . 4 . Information management 4.1 . Core Competencies Being able to utilize information technology and health information communication in medical practice . 4.2 . Doctors Able graduates 1 . Access and assess information and knowledge communication to improve the quality of health services information

health learning can 2 . Disseminate information and knowledge effectively to other health professionals , patients , the public and stakeholders for improvement quality of health services in the field of health information management . information dissemination 5 . The cornerstone of Scientific Medicine 5.1 . Core Competencies Able to resolve health problems based on the scientific foundation of medicine and health sciences edge to get optimum results . Indonesian Doctors Competency Standards

5.2 . Doctors Able graduates Applying Biomedical sciences , sciences , Humanities , Science Clinical Medicine and Science Public Health / Preventive Medicine / Community Medicine to manage current health problems holistically and comprehensively . iences , Humanities , Science Clinical Medicine and Science in Public Health / Preventive Medicine / Medical Communities related to health promotion of individuals , families , and communities sciences , Humanities , Science Clinical Medicine and Science in Public Health / Preventive Medicine / Medical Community prevention of problems related to the health of individuals , families , and communities ces , sciences , Humanities , Science Clinical Medicine and Science in Public Health / Preventive Medicine / Medical

Community to determine priority health problems in individuals , families , and communities ces , sciences , Humanities , Science Clinical Medicine and Science in Public Health / Preventive Medicine / Medical Community issues related to the health of individuals , families , and communities blish the diagnosis etiology , pathogenesis , and pathophysiology Biomedical sciences , sciences , Humanities , Science Clinical Medicine and Health sciences Community / Preventive Medicine / Community Medicine Medicine and Science in Public Health / Preventive Medicine / Medical Communities related to medical and social rehabilitation to individuals , families and communities Medicine and Science in Public Health / Preventive Medicine / Medical Community relating to the interests of law and justice the ability and willingness of the patient , medical scientific evidence , and limited resources in health care for decide 6 . Clinical skills 6.1 . Core Competencies Able to perform clinical procedures related to health problems by applying the principles of patient safety , the safety of themselves , and safety of others . 6.2 . Doctors Able graduates 1 . Perform diagnostic procedures - , allo - and hetero - anamnesis , physical examination in accordance with the general and specific patient problems

Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA 2 . Perform the procedure management of health problems holistically and comprehensively cation and counseling

protect yourself and others against harm at clinically by applying the principles of patient safety medicolegal approach to health / injury related legal against 7 . Management of Health Problems 7.1 . Core Competencies Being able to manage the health problems of individuals , families and communities in a comprehensive , holistic , integrated and sustainable in the context of primary health care . 7.2 . Doctors Able graduates 1 . Implement health promotion at the individual , family and community ttitude and behavior , as well as lifestyle modifications for health promotion in the various groups age , religion , society , gender , ethnicity , and culture in health promotion at the individual , family , and community framework 2 . Implement the prevention and early detection of health problems on individuals , families and communities

ase vention of complications and slow the progression of disease or disability and 3 . Perform management of health problems of individuals , families and communities rpreting family health data in order to identify family health problems

which is based on the principle of quality control , costs , and evidence -based the most appropriate ing health problems independently and responsibly ( see List Highlights and List of Diseases ) by taking into account the principle of patient safety care ( see List of Diseases )

events , medicolegal reports and other appropriate medical certificate authority including visum et repertum and identification of corpses Indonesian Doctors Competency Standards

dose , right frequency and route of administration , and according to the conditions of patients ) , clearly , complete , and legible . monitor the progress of treatment, repair , and modify therapy with right communities communities ply the principles of epidemiology and medical services

comprehensive , holistic , health problems continuous manage identification of problems to plague community rehabilitation disaster ranging from 4 . Empower and collaborate with the community in an effort to improve the health problems that occur and handle coovercome health problems 5 . Managing resources effectively , efficiently and in a sustainable health problem resolution efficiently management in primary health care approach to family medicine

6 . Accessing and analyzing and implementing health policy that is specific priorities of each region in Indonesia policy choices can affect public health programs from fiscal aspects , administrative , legal , ethical , social , and politics . Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA Resource Library

a. Anonymous . Quality Improvement in Basic Medical Education : WFME International Guidelines. University of Copenhagen , Denmark , in 2000 . Cerraccio C , Wolfsthal SD , Englander R , Ferentz K , Martin C. Shifting paradigms : From Flexner to competencies , Academic Medicine , 2002: 77 ( 5 ) . National Education of the Republic . Indonesia number 2003 on system d . Law of the Republic of Indonesia Number 12 of 2012 on Higher Education . e . Law of the Republic of Indonesia Number 29 of 2004 on the Practice of Medicine . Law of the Republic of Indonesia Number 14 of 2005 on Teachers and Lecturers . Government Regulation No. 19 of 2000 on National Education Standards . h . Ministry of National Education of the Republic of Indonesia ; Decree of the Minister of National Education No. 045/U/2002 . Indonesian Doctors Competency Standards

Annex - 1 sUBJECT REVIEW Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA Indonesian Doctors Competency Standards List of Highlights

preliminary One of the biggest challenges for medical education institutions in implementing competency based curriculum is to translate a standard competence in the form of materials or themes of education and teaching . Subject list is compiled based on input from stakeholders then analyzed and validated using focus group discussions ( FGD ) and the nominal group technique ( NGT ) along with the medical council , the institution medical education , professional organizations , and associations . destination Subject list is intended to assist institutions in medical education curriculum , and not to limit the materials or educational theme and teaching . systematics Subject list is compiled based on their respective areas of competence .

1 . Competency Area 1 : Professionalism is Sublime

1.1 . Religion as a moral value that determines the attitude and behavior of human beings 1.2 . Aspects of religion in medical practice 1.3 . Religious pluralism as a social value in the community and tolerance 1.4 . The concept of the public ( including patients ) of the healthy and diseased culture of medicine ( logiko socio -cultural) community with service 1.6 . Rights , obligations , and responsibilities related to human health 1.7 . Understanding bioethics and medical ethics ( eg the introduction of theories of bioethics , philosophy of medicine , the principles of applied ethics , clinical ethics ) 1.8 . Moral Basis Rule in medical practice 1.9 . Understanding of KODEKI , KODERSI , and other value systems associated with health care 1:10 . Theories solving ethical cases in medical services 1:11 . A description of the relationship between law and ethics ( similarities and differences ) 1.12. The principles and logic law in health care 1:13 . Legislation and other regulations under it relating to the practice of medicine 1:14 . Alternative dispute settlement legal issues in health care 1:15 . problem solving etikomedikolegal service health 1:16 . Rights and obligations of physicians

1.17. Professionalism of doctors ( as a form of social contract , an introduction to the professional character , teamwork , relationships with physicians interprofesional other health professionals ) 1:18 . Implementation of good medical practice in Indonesia ( including the disciplinary aspects of the profession ) 1:19 . Physician as part of the general public and the professional community ( IDI and other professional organizations related to the medical profession ) 1:20 . Physician as part of the National Health System 1:21 . Pancasila and citizenship in the context of the health care system Indonesian Doctors Competency Standards

2 . Competency Area 2 : introspective and Personal Development 2.1 . Principles of adult learning (adult learning ) a. self-learning b . critical thinking c . Constructive feedback d . self-reflection 2.2 . The basics of learning skills a. The introduction of learning style (learning style ) b . Search literature ( literature searching ) c . Search critical learning resources d . Active listening ( active listening ) e . Effective Reading ( effective reading ) f . Concentration and memory ( concentration and memory ) g . Time management ( time management) h . Making lecture notes ( note -taking ) i . Test preparation ( test preparation) 2.3 . Problem -based learning 2.4 . problem solving 2.5 . Research methodology and statistics a. The basic concept proposal writing and research results b . The basic concept of measurement c . The basic concept design study d . The basic concept of hypothesis testing and inferential statistics e . critical examination f . The principles of scientific presentations

3 . Competency Area 3 : Effective Communication

3.1 . The use of language is good, true , and easy to understand 3.2 . Principles of communication in health care a. Oral and written communication methods are effective provide effective communication cozy and conducive c . Methods to encourage patients to provide information voluntarily d . History-taking methods systematically e . Methods to identify the purpose of consulting patients f . Pervading spiritual biopsikososiokultural 3.3 . Various elements of effective communication a. Intrapersonal communication , interpersonal and mass communication b . Style in communicating c . Body language , eye contact , speech , speaking tempo , tone of voice , the words are used or avoided d . Active listening skills e . Facilitation techniques in difficult situations , for example a patient angry , sad , scared , or special conditions f . Techniques of negotiation , persuasion , and motivation 3.4 . Cross-cultural communication and diversity a. Degrading behavior or blame the patient , be patient , and sensitive to cultural 3.5 . Rule 3.6 writing and scientific reports . Communication in public speaking Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA 4 . Competency Area 4 : Management of Information 4.1 . Basic skills of information management techniques

4.2 . Research and application of statistical methods to assess the validity of scientific information 4.3 . Skills utilization of evidence - based medicine ( EBM ) 4.4 . Engineering charging medical records to improve the quality of health care 4.5 . Techniques in the field of health information dissemination both oral and written using appropriate media 5 . Competency Area 5 : Scientific Basis of Medicine 5.1 . Structure and function a. The structure and function at the molecular level , cellular , tissue , and organ b . The principle of homeostasis c . Regulatory coordination antarorgan function or system : endocrine Nefrogenitalia Blood and immune system Central - peripheral nerves and senses 5.2 . The cause of the disease a. Environment : biological , physical , chemical and b . genetic c . Psychological and behavioral d . nutrition e . degenerative

5.3 . Patomekanisme a disease . trauma b . Inflammatory c . infection d . immune response e . Hemodynamic disorders ( ischemia , infarction , thrombosis , shock ) f . The healing process ( tissue repair and healing) g . neoplasia h . Prevention of biomedical aspects i . genetic abnormalities j . Nutrition , environment , and lifestyle 5.4 . medical ethics 5.5 . Principles of medical law 5.6 . The principles of health care ( primary , secondary , and tertiary ) 5.7 . The principles of disease prevention 5.8 . The principles of family medicine approach 5.9 . Quality of health services 5:10 Principles of socio - cultural approach

Indonesian Doctors Competency Standards

6 . Competency Area 6 : Clinical Skills 6.1 . Principles and skills of history 6.2 . Principles 6.3 and physical examination skills . 6.4 Principles of basic laboratory tests . The principle of the other investigation 6.5 . Principles of therapeutic skills ( see the list of skills clinics ) 6.6 . The principle of standard precautions (standard precautions ) 6.7 . emergency clinics 7 . Competency Area 7 : Management of Health Problems 7.1 . The basic principle of medical practice and management of acute health problems , chronic , emergency , and behavioral disorders in various ages and gender ( Basic Medical Practice) a. Documentation of medical information and nonmedik b . The basic principle of the various diagnostic investigations ( simple laboratory , ultrasound , ECG , radiodiagnostic , tissue biopsy ) c . Clinical reasoning d . Principles of patient safety e . Fundamentals of management of the disease ( pharmacological and non-pharmacological ) f . prognosis g . Definition and principles of evidence based medicine h . Critical appraisal in diagnosis and therapy i . rehabilitation j . Five levels of disease prevention 7.2 . Health policy and management 7.3 . Minimum Service Standards ( MSS ) 7.4 . The National Health System ( SKN ) including referral system 7.5 . health financing 7.6 . 7.7 Quality assurance of health services . health education 7.8 . health promotion 7.9 . Consultation and counseling 7:10 . 7:11 Risk factors for health problems . epidemiology 7:12 . 7:13 disease risk factors . surveillance 7:14 . health statistics 7:15 . Principles of primary health care 7:16 . Principles of patient safety (patient safety and medication safety ) 7:17 . Interprofesionalisme principle in health education 7:18 . Warranties or public health insurance

Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA Appendix - 2 PROBLEM Indonesian Doctors Competency Standards

Indonesian Doctors Competency Standards List of Issues preliminary In carrying out the medical practice , the doctor works based on complaints or problems the patient / client , then proceed with the search history of the disease , physical examination , and investigation . In carrying out all these activities , the physician should consider the patient's condition holistically and comprehensively , The above interests / personal gain . During education , students need to be exposed on a variety of issues , complaints / symptoms , and trained how to handle each institution should be aware that the problems in the medical services do not only from patients or society , but can also come from private physicians . This perspective is important as learning material in order to form Indonesian doctors good character . The problem list is derived from the attachment list SKDI Issues 2006 then revised based on the results of the study and the data

stakeholder input . The draft revision of List problem then validated by the method of focus group discussion ( FGD ) and the nominal group technique ( NGT ) with the doctors and experts representing stakeholders . destination List of Issues are intended to be a reference for medical education institutions in preparing resources relating to the case and health problems as a source of student learning . systematic This problem list consists of two parts as follows: Part I contains a list of individuals and public health problems. Individual issues list contains a list of problems / symptoms / complaints that many common and are the main reasons that often lead to patient / client came to see the doctor at the primary health care level. While the list of health problems contains public health problem in the community and health care issues. Part II contains a list of problems that are often faced by doctors associated with the profession, such as ethical issues, discipline, law, and medicolegal aspects of the frequently encountered by primary care physicians. The composition of the list of health problems This problem does not indicate the order of priority problems.

Masalah Kesehatan Individu

Sistem Saraf dan Perilaku/Psikiatri
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Sakit kepala Pusing Kejang Kejang demam Epilepsi Pingsan/sinkop Hilang kesadaran Terlambat bicara ( speech delay ) Gerakan tidak teratur Gangguan gerak dan koordinasi Gangguan penciuman Gangguan bicara Wajah kaku Wajah perot Kesemutan Mati rasa/baal 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 Perubahan perilaku (termasuk perilaku agresif) Gangguan perkembangan (mental & intelektual) Gangguan belajar Gangguan komunikasi Penyalahgunaan obat Pelupa (gangguan memori), bingung Penurunan fungsi berpikir Perubahan emosi, mood tidak stabil Gangguan perilaku seksual (nonorganik) Gangguan pemusatan perhatian dan hiperaktif Kepercayaan yang aneh Gangguan perilaku makan Gangguan tidur Stres Depresi Cemas

17 18

Gemetar (tremor) Lumpuh

35 36

Pemarah Mengamuk Masalah akibat penggunaan lensa kontak Mata juling Mata terlihat seperti mata kucing/ orang-orangan mata terlihat putih Telinga nyeri/sakit Keluar cairan dari liang telinga Telinga gatal Telinga berdenging Telinga terasa penuh Tuli (gangguan fungsi pendengaran) Benjolan di telinga Daun telinga merah Benda asing di dalam liang telinga Telinga gatal Gangguan penciuman

Sistem Indra
1 2 3 4 5 6 7 8 9 10 11 12 13 14 Mata merah Mata gatal Mata berair Mata kering Mata nyeri Mata lelah Kotoran mata Penglihatan kabur Penglihatan ganda Penglihatan silau Gangguan lapangan pandang Buta Bintit di kelopak mata Kelilipan (benda asing di mata) 15 16 17 18 19 20 21 22 23 24 25 26 27 28

Sistem Respirasi dan Kardiovaskular

1 2 3 4 5 6 7 Bersin-bersin Pilek (ingusan) Mimisan Hidung tersumbat Hidung berbau Benda asing dalam hidung Suara sengau 11 12 13 14 15 16 17 Tersedak Benda asing dalam kerongkongan Batuk (kering, berdahak, darah) Sakit/nyeri dada Berdebar-debar Sesak napas atau napas pendek Napas berbunyi

8 9 10

Nyeri menelan Suara serak Suara hilang

18 19

Sumbatan jalan napas Kebiruan

Sistem Gastrointestinal, Hepatobilier, dan Pankreas

1 2 3 4 5 6 7 8 9 10 11 12 13 Mata kuning Mulut kering Mulut berbau Sakit gigi Gusi bengkak Sariawan Bibir pecah-pecah Bibir sumbing Sulit menelan Cegukan/ hiccup Nyeri perut Nyeri ulu hati Perut kram 15 16 17 18 19 20 21 22 23 24 25 26 27 Perut berbunyi Benjolan di daerah perut Muntah Muntah darah Sembelit atau tidak dapat berak Diare Berak berlendir dan berdarah Berak berwarna hitam Berak seperti dempul Gatal daerah anus Nyeri daerah anus Benjolan di anus Keluar cacing

14

Perut kembung

28

Air kencing seperti teh

Sistem Ginjal dan Saluran Kemih

1 2 3 4 5 6 7 8 9 Nyeri pinggang Peningkatan atau penurunan frekuensi buang air kecil (BAK) Berkurangnya jumlah air kencing Tidak dapat menahan/urgensi kencing Nyeri saat BAK BAK mengejan Pancaran kencing menurun (poorstream) Akhir kencing menetes (dribling) BAK tidak puas 10 11 12 13 14 15 16 17 18 Kencing bercabang Waktu kencing preputium melembung/balloning Air kencing merah (hematuria) Air kencing campur udara (pnemoturia) Air kencing campur tinja Keluar darah dari saluran kencing Darah keluar bersama produk ejakulat (hemospermia) Duh (discharge) dari saluran kencing Benjolan saluran reproduksi eksternal

Sistem Reproduksi
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 1 2 ASI tidak keluar/kurang Benjolan di daerah payudara Puting terluka Payudara mengencang Puting tertarik ke dalam (retraksi) Payudara seperti kulit jeruk Nyeri perut waktu hamil Perdarahan vagina waktu hamil Anyang-anyangan waktu hamil Kaki bengkak waktu hamil Ambeien waktu hamil Kehamilan tidak diinginkan Persalinan prematur Ketuban pecah dini Perdarahan lewat vagina Duh (discharge ) vagina Nafsu makan hilang Gangguan gizi (gizi buruk, kurang, 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 6 7 Masalah nifas dan pascasalin Perdarahan saat berhubungan Keputihan Gangguan daerah vagina (gatal, nyeri, rasa terbakar, benjolan) Gangguan menstruasi (tidak menstruasi, menstruasi sedikit, menstruasi banyak, menstruasi lama, nyeri saat menstruasi) Gangguan masa menopause dan perimenopause Sulit punya anak Masalah kontrasepsi Peranakan turun Nyeri buah zakar Buah zakar tidak teraba Buah zakar bengkak Benjolan di lipat paha Gangguan fungsi ereksi (organik) Produk ejakulat sedikit atau encer Bau pada kemaluan Tremor Gangguan pertumbuhan

Sistem Endokrin, Metabolisme, dan Nutrisi

3 4 5

berlebih) Berat bayi lahir rendah Kelelahan Penurunan berat badan drastis/mendadak

8 9 10

Benjolan di leher Berkeringat banyak Polifagi, polidipsi, dan poliuria

Sistem Hematologi dan Imunologi

1 2 3

Masalah imunisasi (termasuk Kejadian Ikutan Pascaimunisasi Perdarahan spontan Pucat

4 5

Gatal-gatal (alergi makanan, alergi kontak, danlain-lain Bercak merah di kulit

Sistem Muskuloskeletal
1 2 3 4 5 Patah tulang Terkilir Gangguan jalan Terlambat dapat berjalan Gangguan sendi (nyeri, kaku, bengkak, kelainan bentuk) 6 7 8 9 10 Gerakan terbatas Nyeri punggung Bengkak pada kaki dan tangan Varises Gangguan otot, nyeri otot, kaku otot, otot mengecil

Sistem Integumen
1 2 3 4 5 6 7 8 9 10 11 Kulit gatal Kulit nyeri Kulit mati rasa Kulit berubah warna (menjadi putih, hitam, merah, atau kuning) Kulit kering Kulit berminyak Kulit menebal Kulit menipis Kulit bersisik Kulit lecet, luka, tukak Kulit bernanah 12 13 14 15 16 17 18 19 20 21 Kulit melepuh Benjolan kulit Luka gores, tusuk, sayat Luka bakar Kuku nyeri Kuku berubah warna atau bentuk Ketombe Rambut rontok Kebotakan Ruam kulit

Multisistem
1 2 3 Demam Lemah/letih/lesu Kelainan/ cacat bawaan 4 5 Bengkak/edema Gatal

Kesehatan Masyarakat/Kedokteran Komunitas/Kedokteran Pencegahan

1 2 Kematian neonatus, bayi dan balita Kematian Ibu akibat kehamilan dan persallinan Tiga terlambat pada penatalaksanaan risiko tinggi kehamilan: (terlambat mengambil keputusan; terlambat dirujuk, terlambat ditangani) Empat Terlalu pada deteksi risiko tinggi kehamilan (terlalu muda, terlalu tua terlalu sering, terlalu banyak) 20 21 Kesehatan lansia Cakupan pelayanan kesehatan yang masih rendah Perilaku pencarian pelayanan kesehatan (care seeking behaviour )

22

23

Kepercayaan dan tradisi yang memengaruhi kesehatan

Tidak terlaksananya audit maternal perinatal

24

Akses yang kurang terhadadap fasilitas pelayanan kesehatan (misalnya masalah geografi, masalah ketersediaan dan distribusi tenaga

kesehatan) 6 7 8 Laktasi (termasuk lingkungan kerja yang tidak mendukung fasilitas laktasi) Imunisasi Pola asuh 25 26 27 Kurangnya mutu fasilitas pelayanan kesehatan Sistem rujukan yang belum berjalan baik Cakupan program intervensi Kurangnya pengetahuan keluarga dan masyarakat terkait program kesehatan pemerintah (misalnya KIA, kesehatan reproduksi, gizi masyarakat, TB Paru, dll.) Gaya hidup yang bermasalah (rokok, narkoba, alkohol, sedentary life, pola makan ) Kejadian Luar Biasa Kesehatan pariwisata ( travel medicine ) Morbiditas dan mortalitas penyakitpenyakit menular dan tidak menular Kesehatan lingkungan (termasuk sanitasi, air bersih, dan dampak pemanasan global) Kejadian wabah (endemi, pandemi) Rehabilitasi medik dan sosial Pengelolaan pelayanan kesehatan termasuk klinik, puskesmas, dll Rekam Medik dan Pencatatan pelaporan masalah kkejadian penyakit di masyarakat Pembiayaan pelayanan kesehatan

Perilaku hidup bersih dan sehat (PHBS) pada masyarakat termasuk anak usia sekolah

28

10 11 12 13

Anak dengan difabilitas Perilaku berisiko pada masa pubertas Kehamilan pada remaja Kehamilan yang tidak dikehendaki Kekerasan pada wanita dan anak (termasuk child abuse dan neglected , serta kekerasan dalam rumah tangga) Kejahatan seksual Penganiayaan/perlukaan Kesehatan kerja Audit Medik Pembiayaan pelayanan kesehatan

29 30 31 32

14 15 16 17 18 19

33 34 35 36 37 38

Kedokteran Forensik dan Medikolegala

1 2 3 4 5 6 Kematian yang tidak jelas penyebabnya Kekerasan tumpul Kekerasan tajam Trauma kimia Luka tembak Luka listrik dan petir 10 11 12 13 14 15 Tenggelam Pembunuhan anak sendiri Pengguguran kandungan Kematian mendadak Keracunan Jenasah yang tidak teridentifikasi

7 8 9

Barotrauma Trauma suhu Asfiksia

16 17

Kebutuhan visum di layanan primer Bunuh diri

2. These problems can come from private physicians, health care institutions where he worked, other health professions, or other parties related to health care. This section gives an overview of the various The problems thus allowing for the delivery of medical education medical education can be discussed from different points of view, both in terms of professionalism, ethics, discipline, and law.

Masalah Terkait Profesi Dokter

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Melakukan praktik kedokteran tidak sesuai dengan kompetensinya Melakukan praktik tanpa izin (tanpa SIP dan STR) Melakukan praktik kedokteran lebih dari 3 tempat Mengiklankan/mempromosikan diri dan institusi kesehatan yang tidak sesuai dengan ketentuan KODEKI Memberikan Surat Keterangan Sakit atau Sehat yang tidak sesuai kondisi sebenarnya Bertengkar dengan tenaga kesehatan lain atau dengan tenaga non-kesehatan di insitusi pelayan kesehatan Tidak melakukan informed consent dengan semestinya Tidak mengikuti Prosedur Operasional Standar atau Standar Pelayanan Minimal yang jelas Tidak membuat dan menyimpan rekam medik sesuai dengan ketentuan yang berlaku Membuka rahasia medis pasien kepada pihak yang tidak berkepentingan dan tidak sesuai denga ketentuan yang berlaku Melakukan tindakan yang tidak seharusnya kepada pasien, misalnya pelecehan seksual, berkata kotor, dan lain-lain Meminta imbal jasa yang berlebihan Menahan pasien di rumah sakit bukan karena alasan medis Memberikan keterangan/kesaksian palsu di pengadilan Tidak menangani pasien dengan baik sesuai dengan ketentuan yang telah ditetapkan oleh Konsil Kedokteran Indonesia Melakukan tindakan yang tergolong malpraktik Tidak memperhatikan keselamatan diri sendiri dalam melakukan tugas profesinya Melanggar ketentuan institusi tempat bekerja ( hospital bylaws , peraturan kepegawaian, dan lain-lain)

19 20 21 22 23

Melakukan praktik kedokteran melebihi batas kewajaran dengan motivasi yang tidak didasarkan pada keluhuran profesi dengan tidak memperhatikan kesehatan pribadi Tidak mengikuti perkembangan ilmu pengetahuan dan teknologi kedokteran Melakukan kejahatan asuransi kesehatan secara sendiri atau bersama dengan pasien (misalnya pemalsuan hasil pemeriksaan, dan tindakan lain untuk kepentingan 2 Pelanggaran disiplin profesi Menggantikan praktik atau menggunakan pengganti praktik yang tidak memenuhi syarat

24 25 26 27 28

Melakukan tindakan yang melanggar hukum (termasuk ketergantungan obat, tindakan kriminal/perdata, penipuan, dan lain-lain) Merujuk pasien dengan motivasi untuk mendapatkan keuntungan pribadi, baik kepada dokter spesialis, laboratorium, klinik swasta, dan lain-lain Peresepan obat tidak rasional Melakukan kolusi dengan perusahaan farmasi, meresepkan obat tertentu atas dasar keuntungan pribadi Menolak dan/atau tidak membuat Surat Keterangan Medis dan/atau Visum et Repertum sesuai dengan standar keilmuan yang seharusnya wajib dikerjakan

3. Indonesian Doctors Competency Standards List of Diseases

preliminary This disease list compiled sourced from the attachment list SKDI Diseases 2006, which stakeholders . The collected data is then analyzed and validated by the method focus group discussion ( FGD ) and the nominal group technique ( NGT ) with the doctors and experts representing stakeholders . This disease list is important as reference for medical education institutions in organizing educational activities is included in determining the educational vehicle . destination This disease list is compiled with the aim of becoming a reference for educational institutions doctor so the doctor produced have sufficient competence to

make a proper diagnosis , giving initial treatment or complete , and appropriate referral within the framework of the management of patients . The level of competence of each disease is the ability to be achieved by the end of medical education . systematics Diseases in this list are grouped according to the system of the human body with the ability level to be achieved at the end of education .

Ability levels to be achieved : Ability level 1 : identify and explain Graduates doctors are able to recognize and explain the clinical picture of the disease , and find out the most appropriate way to get more information about the disease , then determine the most appropriate referrals for patients . Graduates are also able to follow the doctor after returning from referral .

Ability level 3 : diagnose , perform initial management , and refer 3A . Not emergency Graduates doctor is able to make a diagnosis and give treatment clinics in the state that is not a preliminary emergency . Graduates capable doctor determine the most appropriate referral for further patient management . Graduates are also able to follow the doctor after returning from a referral . 3B . emergency Graduates doctor is able to make a diagnosis and give treatment clinics introduction on the state of emergency to save lives or prevent the severity and / or disability in patients . Graduates doctor is able to determine the most appropriate referral for treatment The next patient . Graduates are also able to follow the doctor after returning from a referral . Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA

Ability level 4 : diagnosis , management independently perform and complete Graduates are able to make a doctor's diagnosis and clinical management of the disease do independently and thoroughly . 4A . Competence is achieved when passing doctor 4B . Proficiency ( proficiency ) is achieved after completion internsip and / or Continuing Medical Education ( CLA ) 4C. Thus in the Schedule of this disease is the highest level of competence 4A

1. Sistem syaraf

No
Genetik dan Kongenital
1 Spina bifida

Daftar Penyakit

Tingkat Kemampuan
2

2 3 4

Fenilketonuria Duchene muscular dystrophy Kejang demam Infeksi sitomegalovirus Meningitis Ensefalitis Malaria serebral Tetanus Tetanus neonatorum Toksoplasmosis serebral Abses otak HIV AIDS tanpa komplikasi AIDS dengan komplikasi Hidrosefalus Poliomielitis Rabies Spondilitis TB Tumor primer Tumor sekunder Ensefalopati Koma Mati batang otak Tension headache Migren Arteritis kranial Neuralgia trigeminal Cluster headache TIA Infark serebral Hematom intraserebral Perdarahan subarakhnoid Ensefalopati hipertensi B e l l s palsy Lesi batang otak Meniere's disease Vertigo ( Benign paroxysmal positional vertigo ) Cerebral palsy Demensia

1 1 4A 2 3B 3B 3B 4A 3B 2 2 4A 3A 2 3B 3B 3A 2 2 3B 3B 2 4A 4A 1 3A 3A 3B 3B 3B 3B 3B 4A 2 3A 4A 2 3A

Gangguan Neurologik Paediatrik

Infeksi
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39

Tumor Sistem Saraf Pusat

Penurunan Kesadaran

Nyeri Kepala

Penyakit Neurovaskular

Lesi Kranial dan Batang Otak Gangguan Sistem Vaskular

Defisit Memori

40

Penyakit Alzheimer

Gangguan Pergerakan

41 Parkinson 42 Gangguan pergerakan lainnya Epilepsi dan Kejang Lainnya 43 Kejang 44 Epilepsi 45 Status epileptikus

3A 1 3B 3A 3B 1 1 3B 2 3A 2 2 2 3B 3A 3A 2 2 2 3A 3A 2 3A 3A 3A 3A 3B 3B 1 2 3A 2 2

Penyakit Demielinisasi
46 Sklerosis multipel Penyakit pada Tulang Belakang dan Sumsum Tulang Belakang Amyotrophic lateral sclerosis (ALS) 47 Complete spinal transaction 48 49 Sindrom kauda equine Neurogenic bladder 50 51 Siringomielia 52 Mielopati Dorsal root syndrome 53 Acute medulla compression 54 Radicular syndrome 55 Hernia nucleus pulposus (HNP) 56

Trauma
57 58 59 Hematom epidural Hematom subdural Trauma Medula Spinalis Reffered pain Nyeri neuropatik Sindrom Horner Carpal tunnel syndrome Tarsal tunnel syndrome Neuropati Peroneal palsy Guillain Barre syndrome Miastenia gravis Polimiositis Neurofibromatosis ( Von Recklaing Hausen disease) Amnesia pascatrauma Afasia Mild Cognitive Impairment (MCI)

Nyeri
60 61 62 63 64 65 66 67 68 69 70 71 72 73

Penyakit Neuromuskular dan Neuropati

Gangguan Neurobehaviour

2. Psikiatri

No
Gangguan Mental Organik

Daftar Penyakit

Tingkat Kemampuan
3A 3B 3A

Delirium yang tidak diinduksi oleh alkohol atau zat psikoaktif lainnya Gangguan Mental dan Perilaku akibat Penggunaan zat Psikoaktif 2 Intoksikasi akut zat psikoaktif 3 Adiksi/ketergantungan Narkoba 1

Delirium yang diinduksi oleh alkohol atau zat psikoaktif lainnya

3A

Psikosis (Skizofrenia, Gangguan Waham menetap, Psikosis Akut dan Skizoafektif) 5 Skizofrenia 3A 6 3A Gangguan waham 7 3A Gangguan psikotik 8 3A Gangguan skizoafektif 9 3A Gangguan bipolar, episode manik 10 3A Gangguan bipolar, episode depresif 11 2 Gangguan siklotimia 12 2 Depresi endogen, episode tunggal dan rekuran 13 2 Gangguan distimia (depresi neurosis) 14 2 Gangguan depresif yang tidak terklasifikasikan 15 Baby blues (post-partum depression ) 3A Gangguan Neurotik, Gangguan berhubungan dengan Stres, dan Gangguan Somatoform Gangguan Cemas Fobia 16 2 Agorafobia dengan/tanpa panik 17 2 Fobia sosial 18 2 Fobia spesifik Gangguan Cemas Lainnya 19 3A Gangguan panik 20 3A Gangguan cemas menyeluruh 21 Gangguan campuran cemas depresi 3A 22 Gangguan obsesif-kompulsif 2 23 Reaksi terhadap stres yg berat, & gangguan penyesuaian 2 Post traumatic stress disorder 24 3A 25 2 Gangguan disosiasi (konversi) 26 4A Gangguan somatoform 27 3A Trikotilomania Gangguan Kepribadian dan Perilaku Masa Dewasa 28 2 Gangguan kepribadian 2 29 Gangguan identitas gender 2 30 Gangguan preferensi seksual Gangguan Emosional dan Perilaku dengan Onset Khusus pada Masa Anak dan Remaja 31 32 33 34 Gangguan perkembangan pervasif Retardasi mental Gangguan pemusatan perhatian dan hiperaktif (termasuk autisme) Gangguan tingkah laku (conduct disorder) 2 3A 2 2

Gangguan Makam
35 36 37 Anoreksia nervosa Bulimia Pica Gilles de la tourette syndrome 2 2 2 2

Tics
38

39 40 41 42 43 44 45 46 47 48 49 50 51 52

Chronic motor of vocal tics disorder Transient tics disorder Functional encoperasis Functional enuresis Uncoordinated speech Parafilia Gangguan keinginan dan gairah seksual Gangguan orgasmus, termasuk gangguan ejakulasi (ejakulasi dini) Sexual pain disorder (termasuk vaginismus, diparenia) Insomnia Hipersomnia Sleep-wake cycle disturbance Nightmare Sleep walking

2 3A 2 2 2 2 3A 3A 3A 4A 3A 2 2 2

Gangguan Ekskresi

Gangguan Bicara Kelainan dan Disfungsi Seksual

Gangguan Tidur

3.sistem indra

No

Daftar Penyakit

Tingkat Kemampuan

MATA
Konjunctiva
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Benda asing di konjungtiva Konjungtivitis Pterigium Perdarahan subkonjungtiva Mata kering Blefaritis Hordeolum Chalazion Laserasi kelopak mata Entropion Trikiasis Lagoftalmus Epikantus Ptosis Retraksi kelopak mata Xanthelasma Dakrioadenitis Dakriosistitis

4A 4A 3A 4A 4A 4A 4A 3A 3B 2 4A 2 2 2 2 2 3A 3A

Kelopak Mata

Aparatus Lakrimalis

19 20 Sklera 21 22

Dakriostenosis Laserasi duktus lakrimal Skleritis Episkleritis Erosi Benda asing di kornea Luka bakar kornea Keratitis Kerato-konjungtivitis sicca Edema kornea Keratokonus Xerophtalmia Endoftalmitis Mikroftalmos

2 2 3A 4A 2 2 2 3A 2 2 2 3A 2 2 3A 3A 1 3A 2

Kornea
23 24 25 26 27 28 29 30

Bola Mata
31 32

Anterior Chamber
Hifema 33 34 Hipopion Cairan Vitreous 35 Perdarahan Vitreous

Iris dan Badan Silier

36 37 Iridosisklitis, iritis Tumor iris

Lensa
38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Katarak Afakia kongenital Dislokasi lensa Hipermetropia ringan Miopia ringan Astigmatism ringan Presbiopia Anisometropia pada dewasa Anisometropia pada anak Ambliopia Diplopia binokuler Buta senja Skotoma Hemianopia, bitemporal, and homonymous Gangguan lapang pandang Ablasio retina Perdarahan retina, oklusi pembuluh darah retina Degenerasi makula karena usia Retinopati (diabetik, hipertensi, prematur) Korioretinitis 2 2 2 4A 4A 4A 4A 3A 2 2 2 4A 2 2 2 2 2 2 2 1

Akomodasi dan Refraksi

Retina
53 54 55 56 57

Diskus Optik dan Saraf Mata

58 59 60 61 62 Glaukoma 63 64 Optic disc cupping Edema papil Atrofi optik Neuropati optik Neuritis optik Glaukoma akut Glaukoma lainnya 2 2 2 2 2 3B 3A

TELINGA
Telinga, Pendengaran, dan Keseimbangan
65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 Tuli (kongenital, perseptif, konduktif) Inflamasi pada aurikular Herpes zoster pada telinga Fistula pre-aurikular Labirintitis Otitis eksterna Otitis media akut Otitis media serosa Otitis media kronik Mastoiditis Miringitis bullosa Benda asing Perforasi membran timpani Otosklerosis Timpanosklerosis Kolesteatoma Presbiakusis Serumen prop Mabuk perjalanan Trauma akustik akut Trauma aurikular 2 3A 3A 3A 2 4A 4A 3A 3A 3A 3A 3A 3A 3A 2 1 3A 4A 4A 3A 3B

HIDUNG
Hidung dan Sinus Hidung
86 87 88 89 90 91 92 93 94 95 Deviasi septum hidung Furunkel pada hidung Rhinitis akut Rhinitis vasomotor Rhinitis alergika Rhinitis kronik Rhinitis medikamentosa Sinusitis Sinusitis frontal akut Sinusitis maksilaris akut 2 4A 4A 4A 4A 3A 3A 3A 2 2

96 97 98 99 100 101 102 103 104

Sinusitis kronik Benda asing Epistaksis Etmoiditis akut Polip Fistula dan kista brankial lateral dan medial Higroma kistik Tortikolis Abses Bezold

3A 4A 4A 1 2 2 2 3A 3A

Kepala dan Leher

3. Respiratory

No
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Daftar Penyakit
Influenza Pertusis Acute Respiratory distress syndrome (ARDS) SARS Flu burung Faringitis Tonsilitis Laringitis Hipertrofi adenoid Abses peritonsilar Pseudo-croop acute epiglotitis Difteria (THT) Karsinoma laring Karsinoma nasofaring Trakeitis Aspirasi Benda asing Asma bronkial Status asmatikus (asma akut berat) Bronkitis akut Bronkiolitis akut Bronkiektasis Displasia bronkopulmonar Karsinoma paru Pneumonia, bronkopneumonia Pneumonia aspirasi Tuberkulosis paru tanpa komplikasi Tuberkulosis dengan HIV Multi Drug Resistance (MDR) TB Pneumothorax ventil

Tingkat Kemampuan 4A
4A 3B 3B 3B 4A 4A 4A 2 3A 3A 3B 2 2 2 3B 2 4A 3B 4A 3B 3A 1 2 4A 3B 4A 3A 2 3A

Laring dan Faring

Trakea
15 16 17 Paru 18 19 20 21 22 23 24 25 26 27 28 29 30

31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46

Pneumothorax Efusi pleura Efusi pleura masif Emfisema paru Atelektasis

Penyakit Paru Obstruksi Kronik (PPOK) eksaserbasi akut

Edema paru Infark paru Abses paru Emboli paru Kistik fibrosis Haematothorax Tumor mediastinum Pnemokoniasis Penyakit paru intersisial Obstructive Sleep Apnea (OSA)

3A 2 3B 3A 2 3B 3B 1 3A 1 1 3B 2 2 1 1

5.crdio

No

Daftar Penyakit

Tingkat Kemampuan
2 2 3B 3B 3B 3B 3A 3b 2 3B 3A 3B 3B 3A 2 2 2 3B 3A 4A 3A

Gangguan dan Kelainan pada Jantung

Kelainan jantung congenital ( Ventricular Septal Defect, Atrial Septal Defect, Patent Ductus Arteriosus, Tetralogy of Fallot ) Radang pada dinding jantung (Endokarditis, 2 Miokarditis, Perikarditis) 3 Syok (septik, hipovolemik, kardiogenik, neurogenik) 4 Angina pektoris 5 Infark miokard 6 Gagal jantung akut 7 Gagal jantung kronik 8 Cardiorespiratory arrest Kelainan katup jantung: Mitral stenosis, Mitral 9 regurgitation, Aortic stenosis, Aortic regurgitation, dan Penyakit katup jantung lainnya 10 Takikardi: supraventrikular, ventrikular 11 Fibrilasi atrial 12 Fibrilasi ventrikular 13 Atrial flutter 14 Ekstrasistol supraventrikular, ventrikular 15 Bundle Branch Block 16 Aritmia lainnya 17 Kardiomiopati 18 Kor pulmonale akut 19 Kor pulmonale kronik Gangguan Aorta dan Arteri 20 Hipertensi esensial 21 Hipertensi sekunder 1

22 Hipertensi pulmoner 23 Penyakit Raynaud 24 Trombosis arteri 25 Koarktasio aorta 26 Penyakit Buerger's ( Thromboangiitis Obliterans ) 27 Emboli arteri 28 Aterosklerosis Subclavian steal syndrome 29 30 Aneurisma Aorta 31 Aneurisma diseksi 32 Klaudikasio 33 Penyakit jantung reumatik Vena dan Pembuluh Limfe 34 35 36 37 38 39 40 41 Tromboflebitis Limfangitis Varises (primer, sekunder) Obstructed venous return Trombosis vena dalam Emboli vena Limfedema (primer, sekunder) Insufisiensi vena kronik

1 2 2 1 2 1 1 1 1 1 2 2 3A 3A 2 2 2 2 3A 3A

6 gt hepato

No
Mulut
1 2 3 4 5 6 7 8 9

Daftar Penyakit
Sumbing pada bibir dan palatum Micrognatia and macrognatia Kandidiasis mulut Ulkus mulut (aptosa, herpes) Glositis Leukoplakia Angina Ludwig Parotitis Karies gigi Atresia esofagus Akalasia Esofagitis refluks Lesi korosif pada esofagus Varises esofagus Ruptur esofagus

Tingkat Kemampuan
2 2 4A 4A 3A 2 3A 4A 3A 2 2 3A 3B 2 1

Esofagus
10 11 12 13 14 15

Dinding, Rongga Abdomen, dan Hernia

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48

Hernia (inguinalis, femoralis, skrotalis) reponibilis, irreponibilis Hernia (inguinalis, femoralis, skrotalis) strangulata, inkarserata Hernia (diaframatika, hiatus) Hernia umbilikalis Peritonitis Perforasi usus Malrotasi traktus gastro-intestinal Infeksi pada umbilikus Sindrom Reye Gastritis Gastroenteritis (termasuk kolera, giardiasis) Refluks gastroesofagus Ulkus (gaster, duodenum) Stenosis pilorik Atresia intestinal Divertikulum Meckel Fistula umbilikal, omphalocoele-gastroschisis Apendisitis akut Abses apendiks Demam tifoid Perdarahan gastrointestinal Ileus Malabsorbsi Intoleransi makanan Alergi makanan Keracunan makanan Botulisme Penyakit cacing tambang Strongiloidiasis Askariasis Skistosomiasis Taeniasis Pes Hepatitis A Hepatitis B Hepatitis C Abses hepar amoeba Perlemakan hepar Sirosis hepatis Gagal hepar Neoplasma hepar Kolesistitis Kole(doko)litiasis Empiema dan hidrops kandung empedu

2 3B 2 3A 3B 2 2 4A 1 4A 4A 4A 3A 2 2 2 2 3B 3B 4A 3B 2 3A 4A 4A 4A 3B 4A 4A 4A 4A 4A 1 4A 3A 2 3A 3A 2 2 2 3B 2 2

Lambung, Duodenum, Jejunum, Ileum

Infestasi Cacing dan Lainnya

Hepar
49 50 51 52 53 54 55 56 57 58 59

Kandung Empedu, Saluran Empedu, dan Pankreas

60 61 62 Kolon 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83

Atresia biliaris Pankreatitis Karsinoma pankreas Divertikulosis/divertikulitis Kolitis Disentri basiler, disentri amuba Penyakit Crohn Kolitis ulseratif Irritable Bowel Syndrome Polip/adenoma Karsinoma kolon Penyakit Hirschsprung Enterokolitis nekrotik Intususepsi atau invaginasi Atresia anus Proktitis Abses (peri)anal Hemoroid grade 1-2 Hemoroid grade 3-4 Fistula Fisura anus Prolaps rektum, anus Limfoma Gastrointestinal Stromal Tumor (GIST)

2 2 2 3A 3A 4A 1 1 3A 2 2 2 1 3B 2 3A 3A 4A 3A 2 2 3A 2 2

Neoplasma Gastrointestinal

7.ginjal sal kemih

No
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Daftar Penyakit
Infeksi saluran kemih Glomerulonefritis akut Glomerulonefritis kronik Gonore Karsinoma sel renal Tumor W ilms Acute kidney injury Penyakit ginjal kronik Sindrom nefrotik Kolik renal Batu saluran kemih (vesika urinaria, ureter, uretra ) tanpa kolik Ginjal polikistik simtomatik Ginjal tapal kuda Pielonefritis tanpa komplikasi Nekrosis tubular akut Hipospadia Epispadia

Tingkat Kemampuan 4A
3A 3A 4A 2 2 2 2 2 3A 3A 2 1 4A 2 2 2

Alat Kelamin Pria

18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38

Testis tidak turun/ kriptorkidismus Rectratile testis Varikokel Hidrokel Fimosis Parafimosis Spermatokel Epididimitis Prostatitis Torsio testis Ruptur uretra Ruptur kandung kencing Ruptur ginjal Karsinoma uroterial Seminoma testis Teratoma testis Hiperplasia prostat jinak Karsinoma prostat Striktura uretra Priapismus Chancroid

2 2 2 2 4A 4A 2 2 3A 3B 3B 3B 3B 2 1 1 2 2 2 3B 3A

SISTEM repro
No
Infeksi
1 2 3 4 5 6 7 8 9 10 11 12 13 Sifilis Toksoplasmosis Sindrom duh ( discharge ) genital (gonore dan nongonore) Infeksi virus Herpes tipe 2 Infeksi saluran kemih bagian bawah Vulvitis Kondiloma akuminatum Vaginitis Vaginosis bakterialis Servisitis Salpingitis Abses tubo-ovarium Penyakit radang panggul Kehamilan normal Infeksi intra-uterin: korioamnionitis

Daftar Penyakit

Tingkat Kemampuan
3A 2 4A 2 4A 4A 3A 4A 4A 3A 4A 3B 3A 4A 3A

Kehamilan
14 15

Gangguan pada Kehamilan

16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

Infeksi pada kehamilan: TORCH, hepatitis B, malaria Aborsi mengancam Aborsi spontan inkomplit Aborsi spontan komplit Hiperemesis gravidarum Inkompatibilitas darah Mola hidatidosa Hipertensi pada kehamilan Preeklampsia Eklampsia Diabetes gestasional Kehamilan posterm Insufisiensi plasenta Plasenta previa Vasa previa Abrupsio plasenta Inkompeten serviks Polihidramnion Kelainan letak janin setelah 36 minggu Kehamilan ganda Janin tumbuh lambat Kelainan janin Diproporsi kepala panggul Anemia defisiensi besi pada kehamilan Intra-Uterine Fetal Death (IUFD) Persalinan preterm Ruptur uteri Bayi post matur Ketuban pecah dini (KPD) Distosia Malpresentasi Partus lama Prolaps tali pusat Hipoksia janin Ruptur serviks Ruptur perineum tingkat 1-2 Ruptur perineum tingkat 3-4 Retensi plasenta Inversio uterus Perdarahan post partum Tromboemboli Endometritis Inkontinensia urine Inkontinensia feses Trombosis vena dalam Tromboflebitis Subinvolusio uterus Kista dan abses kelenjar bartolini Abses folikel rambut atau kelenjar sebasea

3B 3B 3B 4A 3B 2 2 2 3B 3B 2 2 2 2 2 2 2 2 2 2 3A 2 2 4A 2 3A 2 3A 3A 3B 2 3B 3B 3B 3B 4A 3B 3B 3B 3B 2 3B 2 2 2 2 3B 3A 4A

Persalinan dan Nifas

Kelainan Organ Genital

65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88

Malformasi kongenital Kistokel Rektokel Corpus alienum vaginae Kista Gartner Fistula (vesiko-vaginal, uretero-vagina, rektovagina) Kista Nabotian Polip serviks Malformasi kongenital uterus Prolaps uterus, sistokel, rektokel Hematokolpos Endometriosis Hiperplasia endometrium Menopause, perimenopausal syndome Polikistik ovarium Kehamilan ektopik Karsinoma serviks Karsinoma endometrium Karsinoma ovarium Teratoma ovarium (kista dermoid) Kista ovarium Torsi dan ruptur kista Koriokarsinoma Adenomiosis, mioma Malpresentasi

1 1 1 3A 3A 2 3A 3A 1 3A 2 2 1 2 1 2 2 1 1 2 2 3B 1 2

Tumor dan Keganasan pada Organ Genital

Payudara
89 90 91 92 93 94 95 96 97 Inflamasi, abses Mastitis Cracked nipple Inverted nipple Fibrokista Fibroadenoma mammae (FAM) Tumor Filoides Karsinoma payudara Penyakit Paget 2 4A 4A 4A 2 2 1 2 1

98

Ginekomastia

Masalah Reproduksi Pria

89 90 91 Infertilitas Gangguan ereksi Gangguan ejakulasi 3A 2 2

9. mtabolik endokrin

No
Kelenjar Endokrin
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

Daftar Penyakit
Diabetes melitus tipe 1 Diabetes melitus tipe 2 Diabetes melitus tipe lain (intoleransi glukosa akibat penyakit lain atau obat-obatan) Ketoasidosis diabetikum nonketotik Hiperglikemi hiperosmolar Hipoglikemia ringan Hipoglikemia berat Diabetes insipidus Akromegali, gigantisme Defisiensi hormon pertumbuhan Hiperparatiroid Hipoparatiroid Hipertiroid Tirotoksikosis Hipotiroid Goiter Tiroiditis Cushing's disease Krisis adrenal Addison's disease Pubertas prekoks Hipogonadisme Prolaktinemia Adenoma tiroid Karsinoma tiroid Malnutrisi energi-protein Defisiensi vitamin Defisiensi mineral Dislipidemia Porfiria Hiperurisemia Obesitas Sindrom metabolik

Tingkat Kemampuan
4A 4A 3A 3B 3B 4A 3B 1 1 1 1 3A 3A 3B 2 3A 2 3B 3B 1 2 2 1 2 2 4A 4A 4A 4A 1 4A 4A 3B

Gizi dan Metabollisme

10. hemato imuno

No
1 2 3 4

Daftar Penyakit
Anemia aplastik Anemia defisiensi besi Anemia hemolitik Anemia makrositik

Tingkat Kemampuan 2
4A 3A 3A

5 6 7 8 9 10 11

Anemia megaloblastik Hemoglobinopati Polisitemia Gangguan pembekuan darah (trombositopenia, hemofilia, Von Willebrand's disease ) DIC Agranulositosis Inkompatibilitas golongan darah

2 2 2 2 2 2 2 1 1 2 1 3A 4A 3B 4A 3B 4A 2 3A 4A 3B 3A 1 3A 4A 3A 3A 2 2 2 2

Timus
12 Timoma Kelenjar Limfe dan Darah 13 Limfoma non-Hodgkin's, Hodgkin's 14 Leukemia akut, kronik 15 Mieloma multipel 16 Limfadenopati 17 Limfadenitis

Infeksi
18 Bakteremia 19 Demam dengue, DHF 20 Dengue shock syndrome 21 Malaria 22 Leishmaniasis dan tripanosomiasis 23 Toksoplasmosis 24 Leptospirosis (tanpa komplikasi) 25 Sepsis Penyakit Autoimun 26 Lupus eritematosus sistemik 27 Poliarteritis nodosa 28 Polimialgia reumatik 29 Reaksi anafilaktik 30 Demam reumatik 31 Artritis reumatoid 32 Juvenile chronic arthritis 33 Henoch-schoenlein purpura 34 Eritema multiformis 35 Imunodefisiensi

11.muskulo skeletal

No
1 2 3 4 5 6 7 8

Daftar Penyakit
Anemia aplastik Anemia defisiensi besi Anemia hemolitik Anemia makrositik Anemia megaloblastik Hemoglobinopati Polisitemia Gangguan pembekuan darah (trombositopenia, hemofilia, Von Willebrand's disease )

Tingkat Kemampuan 2
4A 3A 3A 2 2 2 2

9 10 11

DIC Agranulositosis Inkompatibilitas golongan darah

2 2 2 1 1 2 1 3A 4A 3B 4A 3B 4A 2 3A 4A 3B 3A 1 3A 4A 3A 3A 2 2 2 2

Timus
12 Timoma Kelenjar Limfe dan Darah 13 Limfoma non-Hodgkin's, Hodgkin's 14 Leukemia akut, kronik 15 Mieloma multipel 16 Limfadenopati 17 Limfadenitis

Infeksi
18 Bakteremia 19 Demam dengue, DHF 20 Dengue shock syndrome 21 Malaria 22 Leishmaniasis dan tripanosomiasis 23 Toksoplasmosis 24 Leptospirosis (tanpa komplikasi) 25 Sepsis Penyakit Autoimun 26 Lupus eritematosus sistemik 27 Poliarteritis nodosa 28 Polimialgia reumatik 29 Reaksi anafilaktik 30 Demam reumatik 31 Artritis reumatoid 32 Juvenile chronic arthritis 33 Henoch-schoenlein purpura 34 Eritema multiformis 35 Imunodefisiensi

12. sistem in tegument

No
Infeksi Virus
1 2 3 4 5 6 7 8 9 10

Daftar Penyakit
KULIT
Veruka vulgaris Kondiloma akuminatum Moluskum kontagiosum Herpes zoster tanpa komplikasi Morbili tanpa komplikasi Varisela tanpa komplikasi Herpes simpleks tanpa komplikasi Impetigo Impetigo ulseratif (ektima) Folikulitis superfisialis

Tingkat Kemampuan
4A 3A 4A 4A 4A 4A 4A 4A 4A 4A

Infeksi Bakteri

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42

Furunkel, karbunkel Eritrasma Erisipelas Skrofuloderma Lepra Reaksi lepra Sifilis stadium 1 dan 2 Tinea kapitis Tinea barbe Tinea fasialis Tinea korporis Tinea manus Tinea unguium Tinea kruris Tinea pedis Pitiriasis vesikolor Kandidosis mukokutan ringan Cutaneus larva migran Filariasis Pedikulosis kapitis Pedikulosis pubis Skabies Reaksi gigitan serangga Dermatitis kontak iritan Dermatitis kontak alergika Dermatitis atopik (kecuali recalcitrant ) Dermatitis numularis Liken simpleks kronik/neurodermatitis Napkin eczema Psoriasis vulgaris Dermatitis seboroik Pitiriasis rosea

4A 4A 4A 4A 4A 3A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 4A 3A 4A 4A 3A 4A 3A 4A 4A

Infeksi Jamur

Gigitan Serangga dan Infestasi Parasit

Dermatitis Eksim

Lesi Eritro-Squamosa

Kelainan Kelenjar Sebasea dan Ekrin

43 44 45 46 47 48 49 50 51 Akne vulgaris ringan Akne vulgaris sedang-berat Hidradenitis supuratif Dermatitis perioral Miliaria Toxic epidermal necrolysis Sindrom Stevens-Johnson Urtikaria akut Urtikaria kronis 4A 3A 4A 4A 4A 3B 3B 4A 3A

Penyakit Vesikobulosa

Penyakit Kulit Alergi

52 53 54

Angioedema Lupus eritematosis kulit Ichthyosis vulgaris Exanthematous drug eruption, fixed drug eruption Vitiligo Melasma Albino Hiperpigmentasi pascainflamasi Hipopigmentasi pascainflamasi Keratosis seboroik Kista epitel Squamous cell carcinoma (Karsinoma sel skuamosa) Basal cell carcinoma (Karsinoma sel basal) Xanthoma Hemangioma Lentigo Nevus pigmentosus Melanoma maligna Alopesia areata Alopesia androgenik Telogen eflluvium Psoriasis vulgaris Vulnus laseratum, punctum Vulnus perforatum, penetratum Luka bakar derajat 1 dan 2 Luka bakar derajat 3 dan 4 Luka akibat bahan kimia Luka akibat sengatan listrik

3B 2 3A 4A 3A 3A 2 3A 3A 2 3A 2 2 2 2 2 2 1 2 2 2 2 4A 3B 4A 3B 3B 3B

Penyakit Autoimun Gangguan Keratinisasi Reaksi Obat

55 56 57 58 59 60

Kelainan Pigmentasi

Neoplasma
61 62 63 64 65 66 67 68 69

Tumor Epitel Premaligna dan Maligna

Tumor Dermis

Tumor Sel Melanosit

Rambut
70 71 72 73

Trauma
74 75 76 77 78 79

13. forensic

No
1 2 3 4 5 Kekerasan tajam Trauma kimia Luka tembak

Daftar Penyakit
Kekerasan tumpul

Tingkat Kemampuan 4A
4A 3A 3A 2

Luka listrik dan petir

6 7 8 9 10 11 12 13

Barotrauma Trauma suhu Asfiksia Tenggelam Pembunuhan anak sendiri Pengguguran kandungan Kematian mendadak Toksikologi forensik

2 2 3A 3A 3A 3A 3B 3A

Indonesian Doctors Competency Standards

List of Clinical Skills

preliminary

Clinical skills need to be trained from the beginning to the end of continuous medical education . In carrying out the practice , doctors must master graduates clinical skills to diagnose and perform management of health problems . Clinical Skills List was compiled from the attachment list Clinical Skills SKDI 2006, then revised based on the results of the survey and input from stakeholders . The collected data is then analyzed and validated by the method focus group discussion ( FGD ) and the nominal group technique ( NGT ) with the doctors and experts representing stakeholders .

Clinical ability in this competency standard can be increased through education and continuous training in order to absorb the development of science and medical technology organized by professional organizations or other institutions that are accredited by professional organizations , as well as for other clinical capabilities in outside physician competency standards that have been set . Education and training setting both of these are made by professional organizations , in order to meet

need for affordable health care and justice ( Article 28 of the Medical Practice Act no.29/2004 ) . purposes Clinical Skills List are intended to be a reference for medical education institutions in preparing resources related to skills minimum that must be mastered by graduate primary care physicians .

systematics

to avoid repetition . At each clinical skill set level of ability to be achieved at the end of medical education by using the Pyramid Miller ( knows , knows how, shows, does ) .

Figure 3 shows the distribution according to the ability level of the Pyramid Miller and alternative way to test the student .

Ability level 1 ( Knows ) : Knowing and explaining

Graduates doctors are able to master the theoretical knowledge including biomedical and psychosocial aspects of these skills so that they can explain to the patient / client and his family , colleagues , and other professional principles, indications , and complications that may arise . These skills can be achieved through student lectures, discussions , assignments , and self-learning , while assessment can using a written test

Picture Pyramid ability levels according to Miller and alternative . Quoted from Miller (1990), Shumway way to test Ability level 2 ( Knows How ) : Ever seen or demonstrated

Graduates master the theoretical knowledge of the physician 's skills with an emphasis on clinical reasoning and problem solving as well as the opportunity to see and observe these skills in the form of demonstration or implementation of direct patient / community . Testing skill level 2 the ability to use multiple-choice written test or the settlement in writing and / or oral ( oral test) .

Ability level 3 ( Shows ) : Never done or never applied under supervision

Graduates doctor master these skills include knowledge of theoretical background in biomedical and psychosocial impact of these skills , the opportunity to see and observe these skills in the form of demonstration or

practicing these skills on props and / or standardized patient . testing skills

Clinical Examination ( OSCE ) or the Objective Structured Assessment of Technical Skills ( OSATS ) .

Ability level 4 (Does ) : Able to perform independently

Graduates physician can demonstrate their skills by mastering the entire theory , principles , indications , steps on how to perform , complications , and

supervision , testing skill level 4 ability to use Workbased For example, the mini - CEX assessment , portfolio , logbook , etc. .

Skills achieved during graduate doctors

4B . Proficiency ( proficiency ) is achieved after completion internsip and / or Continuing Medical Education ( CLA )

Thus in the Clinical Skills List is the highest level of competence is 4A .

Indonesian Doctors Competency Standards

MEDICAL COUNCIL INDONESIA

Table Matrix Level Clinical Skills , Learning Methods and Assessment Methods for every level of ability