Indonesia pledges to overhaul medical training programme after deaths of four intern doctors

JAKARTA – Indonesia’s Health Ministry has pledged to overhaul the country’s medical internship programme to ensure fewer working hours and adequate leave, following the deaths of four intern doctors in just two months amid mounting scrutiny over overwork in the system.

The statement came after the death of Sriwijaya University intern doctor Myta Aprilia Azmy on May 1. She had suffered a lung infection but continued working without taking sick leave, even as her condition worsened.

Her death marks the fourth case in 2026, with three other interns dying in March alone across different regions.

At a recent press conference in Jakarta, the ministry revealed violations in the implementation of the internship programme at KH Daud Arif Regional Hospital (RSUD) in Jambi, where Dr Myta had been assigned since February, following an investigation launched shortly after her death.

One identified violation was excessive working hours. During ward rotations, interns reportedly worked every day without rest days. They were also assigned tasks that should have been handled by permanent doctors.

Health Minister Budi Gunadi Sadikin stressed during the briefing on May 7 that intern doctors are not substitutes for permanent physicians, but trainees under supervision.

“They cannot, and must not, replace doctors. Yet in practice, that is what is happening. This is not permitted. The principle is clear: interns must be supervised at all times and can never be treated as substitutes for permanent physicians,” Mr Budi said.

Other violations included the absence of additional allowances beyond the 3.2 million rupiah (S$234) to 6.4 million rupiah living stipend provided by the ministry, depending on the placement location.

Acting inspector-general of the Health Ministry Rudi Supriatna further explained that interns at RSUD KH Daud Arif were required to meet on-call schedules and performance targets to graduate. In addition, they were entitled to only four days of leave that did not require replacement; any additional leave would result in an extension of the internship period.

“If they are sick, they are expected to ask fellow interns to replace them so that the required number of doctors in the emergency department is maintained. So, interns end up pushing themselves to keep working,” he said.

This situation is suspected to be one of the reasons why Dr Myta chose not to take sick leave, in order to avoid prolonging her internship period, Mr Rudi added.

Following these findings, the Health Ministry issued a formal warning to supervising doctors at RSUD KH Daud Arif and suspended the internship programme there. Interns have subsequently been relocated to other facilities.

In March, three intern doctors reportedly died after falling ill amid reports of overwork.

The first case occurred on March 17 in Denpasar, Bali, with a final diagnosis of dengue haemorrhagic fever complicated by shock.

The second died on March 25 in Surabaya, East Java, with a preliminary diagnosis of anaemia.

The third was reported on March 26 in Cianjur, West Java, with diagnoses including measles accompanied by heart and brain complications.

Revised regulations

The Health Ministry has reaffirmed its commitment to improving the governance of the medical internship programme, with Mr Budi ordering an immediate revision of standard operating procedures to ensure the safety and rights of interns going forward.

“We are not waiting any longer. The regulatory revision will be carried out swiftly so that it can take effect for interns starting this May,” Mr Budi said.

The revised rules will include a set of protections that will apply to all internship training facilities, including a stricter standardisation of working hours capped at 40 hours per week. This may be structured as eight hours per day over five working days, or around seven hours per day over six days, while ensuring interns receive at least one day off each week.

The new regulations will also clarify the role of interns to focus on supervised learning under active guidance. In addition, leave entitlements will be increased from four to 10 days a year, with sick leave or other absences no longer extending the duration of the internship, provided competency requirements are met.

Dr Myta’s mother Okta Yusri welcomed the ministry’s response and expressed the hope that “the internship system will improve to prevent similar cases from recurring”. THE JAKARTA POST/ASIA NEWS NETWORK