Author: drg Nyiayu H. A Sonia, M. Kes (Center for Health Resource System Policy, BKPK, Ministry of Health)
Constitutional Court Decision No. 111/PUU-XXII/2024, read out on January 30, 2026, marked a crucial chapter in the restructuring of the medical profession in Indonesia. This decision not only has legal implications but also provides direction for reforming the governance of the medical profession to align it more closely with the principles of scientific independence, public accountability, and the state's responsibility to ensure quality healthcare.
In recent times, various interpretations have emerged in the public sphere regarding the meaning and implications of this ruling. Some narratives have even developed simplistic narratives, as if the Constitutional Court decided to disband the council, ban hospital-based specialist medical education, or place the collegium entirely outside the framework of the state system. Such interpretations certainly need to be clarified so that the public can fully understand the substance of the Constitutional Court's ruling.
Constitutional Court Decision
First, it is important to emphasize that the Constitutional Court never ruled to disband the council. The council remains a crucial institution in the medical profession's regulatory system, ensuring registration, professional development, and public protection in healthcare services. The Court's concern is the design of the institutional relationship between the council and the collegium, particularly ensuring that the collegium, as a scientific institution, is not placed in a subordinate position that could potentially compromise its scientific independence.
In other words, what the Court emphasized was not the elimination of institutions, but rather the restructuring of institutional governance so that each function could run more proportionally, transparently, and accountably.
Second, the Constitutional Court's ruling does not prohibit hospital-based specialist medical education. In modern medical education practices across many countries, hospitals are the primary venue for clinical learning, enabling students to gain comprehensive medical practice experience. Without hospital involvement, clinical education cannot proceed optimally.
The Court's decision essentially emphasizes the importance of clear governance in the implementation of professional medical education. Universities retain their role as academic institutions responsible for providing education. Hospitals serve as a vehicle for clinical education. Meanwhile, the collegium carries out its scientific function by establishing competency standards, professional education standards, and developing medical disciplines in their respective areas of specialization.
Third, the Constitutional Court emphasized the importance of the collegium's independence as a scientific institution. This independence is necessary to ensure that professional competency standards are established objectively, based on science, and free from non-scientific interests. However, this independence cannot be interpreted as a position completely detached from the framework of state responsibility.
The state remains constitutionally obligated to ensure patient safety, quality healthcare services, and an accountable medical personnel education system. Therefore, the governance of the healthcare profession must maintain a balance between professional independence and the state's public responsibility.
Strengthening Medical Professional Governance
It is within this framework that the government views the Constitutional Court's decision as a momentum to strengthen the governance of the medical profession to be more transparent, more independent, and more accountable.
As a follow-up to this decision, the government is currently adjusting various derivative regulations under Law Number 17 of 2023 concerning Health. One step being taken is restructuring the implementing regulations, including through revisions to government regulations and the Minister of Health regulations governing the governance of councils and collegiums.
This regulatory adjustment aims to clarify the council's position and function as an institution responsible for registering, developing, and supervising the medical profession. At the same time, the regulation will also affirm the collegium's position as an independent scientific institution in establishing competency standards and professional education standards.
Furthermore, the revised regulations also aim to strengthen synergy between universities, teaching hospitals, and colleges in providing specialist medical education. This synergy is crucial to ensuring that professional medical education is not only academically sound but also relevant to the needs of public health services.
This regulatory reform is also intended to strengthen transparent and accountable governance mechanisms, so that the medical professional education system in Indonesia can continue to develop while maintaining quality, patient safety, and public trust in the medical profession.
The Constitutional Court's decision should not be understood as a form of disruption to the existing system, but rather as an opportunity to improve the design of health profession governance to make it stronger, clearer, and more adaptive to the needs of the national health system.
During this restructuring process, the government will continue to foster dialogue with various stakeholders, including collegiums, professional organizations, universities, teaching hospitals, and other relevant institutions. This collaborative approach is crucial to ensure that the policy adjustment process proceeds constructively and does not disrupt public health services or the continuity of ongoing professional education.
Ultimately, the primary goal of all these efforts remains the same: ensuring the availability of competent medical personnel, a quality professional education system, and safe and high-quality health services for all Indonesians.
