The recent death of a doctor undergoing specialist medical training in Indonesia has shed light on the prevalent bullying culture within medical institutions. Aulia Risma Lestari, a doctor studying for an anaesthesia specialist programme at Diponegoro University, was found dead in her room in August. She allegedly injected herself with a high dosage of an anaesthetic, prompting suspicions of suicide due to bullying. WhatsApp conversations between Aulia and senior students in her residency programme further indicated instances of bullying.

Indonesia’s Health Minister Budi Gunadi Sadikin acknowledged that Aulia’s death was a result of bullying and recognized that such behavior is widespread in the country’s medical training institutions. Studies conducted by the health ministry revealed that a significant number of medical students undergoing residency programmes exhibit signs of depression and suicidal tendencies due to stress and bullying. Mr. Budi vowed to take strict measures to address the issue and called for an end to the toxic seniority culture prevailing in medical training institutions.

Despite efforts by the health ministry to curb bullying in medical education with guidelines and complaint channels, bullying cases continue to persist. Reports indicate that since 2023, the ministry has received over 1,200 reports of bullying in specialist medical education programmes. Incidents of bullying have not only led to tragic outcomes such as Aulia’s death but also have implications for future interactions between junior doctors and patients once they graduate.

In response to a bullying case at Padjadjaran University’s neurosurgery specialist medical training programme, the university has taken disciplinary actions against alleged perpetrators. Two doctors involved have had their studies terminated, while others have faced sanctions ranging from repeating lecture classes to potential severe sanctions for a lecturer. The bullying at Padjadjaran University included physical and verbal abuse of junior doctors by their seniors, as well as demands for payment for seniors’ expenses.

Chairman of the Indonesian Doctors Association Mahesa Paranadipa highlighted the long-standing issue of bullying culture in medical training institutions and emphasized its potential impact on the interaction between junior doctors and patients. The mentality of students affected by bullying during their training could carry over into their professional interactions with patients, ultimately affecting the quality of healthcare provided. Efforts to address and eradicate bullying in medical education are ongoing, with the health minister reiterating the urgency of dismantling the toxic seniority culture within training institutions.

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