Residensi/Spesialis di Luar Negeri

PPDS/residensi di luar negeri merupakan salah satu alternatif pengembangan spesialistik untuk general practitioner. Negara maju (developed country) biasanya menjadi referensi bagi dokter-dokter di Indonesia untuk memperdalam ilmu spesialis dalam bidang kedokteran. Pertimbangan kemajuan IPTEK dan honour sering menjadi alasan utama. Walaupun pada dasarnya setiap negara dan tempat pasti memiliki kekhasan dalam penanganan penyakit terkait dengan epidemiologi. Karena itu sekalipun residensi di luar negeri menjanjikan setumpuk kemanfaatan dan nilai positif kita juga harus mempertimbangkan aplikasi dan implementasi ilmu yang kita pelajari di tanah ibu pertiwi kita, sejauh mana kemanfaatan ilmu yang kita dapatkan di luar negeri untuk diterapkan pada kasus-kasus di daerah tropis seperti negara kita. 

Not less, but sure. It's about Learning and It's enriched by experiences.

Long-life study was the principal of Doctor :)

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Sebagaimana kita ketahui, pendidikan program spesialis di Indonesia cukup banyak memakan biaya. Nah kalau kita ingin meringankan beban orang tua, ada baiknya untuk melihat kemungkinan mengikuti program spesialis (residency) di Amerika Serikat. Tentu untuk masuk program tsb, sangat kompetitif. Beberapa program, e.g., kulit, mata, radiology, anasthesi, hampir tidak mungkin ditembus oleh orang asing (i.e., yg bukan lulusan medical school di US). Tapi untuk beberapa jurusan lain, e.g., anak, penyakit dalam, psychiatry, peluang mendapatkan tempat cukup terbuka. Tapi, tentunya sangat kompetitif, karena akan bersaing bukan hanya dgn mereka yg lulusan amerika (yg tentunya lebih diminati oleh tiap2 program) tapi juga orang india, pakistan, amerika latin, china, eropa, afrika dll. Jadi persaingan sangat ketat, tapi kalau kita sudah diterima maka kita tidak akan dibebani oleh uang sekolah, iuran ini, iuran itu. Yang ada, kita malah dibayar alias digaji sekitar $40.000 - $50.000 (which is 500jt sampe 600 jt)per tahun. Lama pendidikan tergantung jurusan yg ditempuh. Untuk penyakit dalam & jurusan anak sekitar 3 tahun.

Bagaimana cara masuknya?

Ok..pertama...tentunya harus punya sertifikasi ECFMG (Educational Commission for Foreign Medical Graduates). Lihat di website mereka untuk tahu lebih jauh tentang ini

http://www.ecfmg.org/cert/index.html

Untuk dapat ECFMG sertifikat, maka kita harus lulus ujian USMLE (United States Medical Licensing Examination). Ujian tersebut ada 3 ujian theory dan 1 ujian klinik. Jadi ada USMLE step 1, step 2, step 2 cs (clinical skill) dan step 3. Untuk dapat sertifikasi kita harus sudah lulus USMLE step 1, step 2 dan step 2 cs. Masing2 ujian sekitar 8 jam. Untuk info lebih jauh, silahkan lihat di website:
http://www.usmle.org/examinations/index.html

Tapi INGAT...untuk bisa mendapatkan tempat di program residency, nilai ujian-ujian tsb sangat penting. Jika nilai kita hanya pas2-an. Jangan harap akan mendapatkan tempat di sini. Jadi cobalah untuk mendapatkan nilai 90 percentile ke atas. Untuk mempersiapkan diri, bisa beli buku2 dari KAPLAN, atau USMLE FIRST AID, atau cari video GOLJAN dll. Juga bisa berlangganan soal ujian dari USMLE World.

Ada baiknya ujian step 1 & step 2 diambil ketika kita masih tingkat 4 - 6. Ujian ini mungkin bisa dilakukan di Indonesia (sama spt ujian TOEFL). Biaya per ujian $800. Untuk ujian step 2 cs, hanya bisa dilakukan di beberapa kota di Amerika, e.g., Chicago, Philadephia, Houston. Biaya untuk yg ini adalah $1200.

Kalau kita mau benar2 ingin melanjutkan ke US, ada baiknya kalau mungkin kita melakukan salah satu rotasi kita di US. Dgn demikian kita akan terekspose dgn system di sini dan mungkin bisa mendapatkan kontak di sini. Selain itu beberapa program spesialisasi menyaratkan kita mempunyai US clinical experiences. Nah, dgn melakukan rotasi di US, maka kita bisa dapat clinical experience ini.

Langkah berikutnya adalah pendaftaran. Hal ini dilakukan secara serentak setiap thn, mulai tgl 1 september. Ini dilakukan online melalui ERAS. Untuk lebih lengkapnya lihat di website mereka:

http://www.aamc.org/students/eras/guideline/start.htm

Document yg diperlukan biasanya adalah:
1. Surat rekomendasi dari dokter (3 buah): kalau bisa dapat dari dokter amerika akan sangat bagus sekali;
2. USMLE transcripts;
3. Personal statement;
4. Ijazah kedokteran;
5. Surat dekan;
6. Pas photo.
Sangat dianjukan untuk mengirimkan dokumen tsb ke ERAS (via pos/courier) sekitar bln Agustus, karena mereka akan perlu waktu untuk meng-upload dokumen tsb. Jadi pas tgl 1 september kita sudah siap untuk mengirim lamaran ke program yg kita tuju. Tiap program mempunyai persyaratan berbeda-beda (e.g. USMLE scores, US experience, visa sponsorship, graduation date). Jadi sebaiknya kontak program2 tsb sebelum kita melamar untuk mencari tahu persyaratannya. Untuk mencari program yg ada, silahkan lihat di FREIDA:

https://freida.ama-assn.org/Freida/user/viewProgramSearch.do

Nah, mulai tgl 1 september kita bisa mengirim lamaran via ERAS ke program yg kita tuju. Tentunya ada biaya lamaran disini. Untuk 10 program pertama per jurusan, biayanya $60. Selebihnya diitung satu per satu:
Number of Programs Per Specialty-------ERAS Fees Up to

10------------------------------------------------$6 each

11-20--------------------------------------------$8 each
21-30--------------------------------------------$15 each
31 or more--------------------------------------$25 each

jadi makin banyak ngelamar, makin besar biayanya. Mungkin orang asing biasanya melamar sekitar 30-40 program per jurusan.

Setelah melamar, kita hanya akan menunggu. Kalau credential kita bagus, maka beberapa program akan mengundang kita untuk interview. Kalau tidak bagus, mungkin tidak ada yg mengundang kita interview. Tapi kalau kita bisa dapat 5-8 interview, itu sudah sangat bagus sekali.

Langkah selanjutnya adalah, kita merangking program yg kita minati. Berdasarkan interview kita (kalau kita dapat interview), kira2 program mana yg kita prioritaskan. Demikian juga si Program, dia akan merangking calon2 mana saja yg dia prioritaskan (Mungkin mereka mengundang 100 orang untuk interview, sementara mereka hanya akan menerima 10 orang). Hal ini dilakukan paling lambat tgl 27 Februari. Untuk info lebih lanjut silahkan lihat NRMP:

http://www.nrmp.org/res_match/yearly.html

Kalau kita bernasib baik maka kita akan tahu apa kita akan dapat tempat atau tidak tgl 17 Maret. Tapi kita masih belum tahu akan dapat tempat dimana.
Baru pada tanggal 20 Maret (Match day) kita akan tahu dimana kita akan diterima. Mungkin kita masuk pilihan nomor 1 kita atau mungkin pilihan nomor bontot.

Setelah itu.kalau matched maka bisa  mengurus surat2 yg diperlukan, (e.g., kontrak, visa dll)
Untuk program spesialisasinya sendiri akan mulai serentak tgl 1 Juli.
Untuk lihat forum lain yg mendiskusikan tentang lamaran, interview, dan match prosess, persiapan ujian USMLE step 1 & step 2 silahkan lihat : 

http://www.prep4usmle.com/forum/11/

Nah.jadi buat Teman sejawat yang minat PPDS di Amerika Serikat, mungkin bisa dipersiapkan dari sekarang mulai dari biaya dan persiapan.

USMLE step1,step2,step2CS sama step3 pada dasarnya sangat sulit.
Bahkan  di forum studentdoctor.net mereka bahkan  punya bimbel untuk itu.
Untuk persiapan, silahkan baca buku-buku persiapan untuk ujian USMLE step 1. Ini ada beberapa yg saya upload filenya online.

Step 1 - Anatomy: http://www.mediafire.com/?3n92uneydmg
Step 1 - Biochemistry: http://www.mediafire.com/?22mtxexntdm
Step 1 - Physiology: http://www.mediafire.com/?5g1y0dnhfz7
Step 1 - Microbiology & Immunology: http://www.mediafire.com/?dzdjsxvi3y3
Step 1 - Pathology: http://www.mediafire.com/?3yamd51z4xt
Step 1 - Pharmacology: http://www.mediafire.com/?ewy1m1j1ljd
Step 1 - Question BOOK: http://www.mediafire.com/?8yygla2jirt
Step 2 - Question Book: http://www.mediafire.com/?bydomdezmg1

Tapi tenang. USMLE step1,step2 bisa dilakukan di jakarta sehingga lebih mudah untuk kita melakukan tes..
dan hampir semua FK di Indonesia di recognized sama pihak USMLE jadi gak masalah mengenai administrasi.

Yang memberatkan itu sebenarnya biaya tesnya

Bayangkan saja biaya USMLE step 1+step2+step3 aja 800+800+1200=US$2800!!!!(berarti sekitar 30 jutaan). 

Iya kalo langsung tinggi nilainya. Kalo gak sama aja.terus belum lagi USMLE step 2 CS yg harus di USA. Perlu pertimbangan juga biaya visa-nya. Tapi memang jika lulus bukan kita yang membayar ke mereka tapi malah kita yang dibayar (500 juta setahun, berarti sebulan gaji kita 40 juta..)
belum lagi kesempatan kita untuk kerja di negara2 lain yg mengenal USMLE seperti singapore,HK,aussie.

jadi mungkin bwt Teman Sejawat yg bisa menghandle biaya yg sya sebutin tadi serta mau bekerja keras untuk USMLEnya, PPDS ke USA bisa menjadi alternatif selain mengikuti PPDS di Indonesia..

Terlepas dari semua kesulitsan itu, pasti ada jalan kalau kita mau bersungguh-sungguh kawan. 

Forum Diskusi Dokter Dunia:

http://forums.studentdoctor.net/

source: electroplated with some adjustment from http://pendproismkiwilsatu.blogspot.com

Naming of "Medical Doctor"

Bachelor of Medicine, Bachelor of Surgery, atau dalam bahasa latin Medicinae Baccalaureus, Baccalaureus Chirurgiae (disingkat dalam berbagai ragam cara, MBBS or MBChB, MB BS, MB BChir, BM BCh, MB BCh, MB ChB, BM BS, BM, BMed etc.) adalah dua glar profesional yang diberikan kepada lulusan sekolah kedokteran dalam bidang pengobatan dan bedah di berbagai negara yang mengikuti tradisi di UK. Pemegang gelar MBBS merujuk kepada gelar "Dokter" dengan prefix "dr"

Berikut adalah ulasan tentang penamaan dokter di berbagai negara.

NAMING OF "DOCTOR"

The specific names and abbreviations given to these degrees depend on the particular institution, awarding body or country, and vary widely; this is mostly for reasons of tradition rather than to indicate any particular difference between the relative levels of the degrees, and they are considered equivalent.

If the awarding body titles the degrees in Latin, the degrees are commonly named Medicinae Baccalaureus, Chirurgiae Baccalaureus,Medicinae Baccalaureus et Chirurgiae Baccalaureus, or Baccalaureus in Medicina et in Chirurgia, abbreviated as MB ChB, MB BCh or otherwise. If titled in English, they are named Bachelor of Medicine, Bachelor of Surgery, Bachelor of Medicine and Bachelor of Surgery, or Bachelor of Medicine and Surgery, usually abbreviated as MB BS, and sometimes as BM BS, even though most MB BS-awarding institutions do not use Latin to name their degrees.

Below are described the specific names used, arranged by country.

Australia

See also: Medical education in Australia

Most Australian medical schools confer MBBS degrees. However, the University of Newcastle confers BMed. This degree is equivalent to MBBS and any BMed graduate may practice in any field of Medicine of their own choice including surgery. In Australia, the Doctor of Medicine (MD) is an advanced research degree requiring two years of full-time enrolment, compared to a PhD, which requires three years of full-time enrolment. The University of Melbourne will award a Doctor of Medicine to their MBBS equivalent graduates as will several others including the University of Western Australia, located in Perth.

Bahrain

The Medical University of Bahrain or RCSI-Bahrain, is a constituent university of the Royal College of Surgeons in Ireland (RCSI) and awards its graduates the MB/BCh BAO, the same degree awarded to graduates at RCSI.

Bangladesh

All medical schools in Bangladesh award MBBS. The MD is awarded as a postgraduate research degree in select medical colleges, following the medical tradition of Commonwealth countries. In Bangladesh, Allopathic and Alternative Medicine related medical education at the undergraduate and graduate level is provided by medical colleges. The colleges are under the jurisdiction of the Ministry of Health, and are affiliated with a university in the respective region. Until the early 1990s, all medical colleges were established by the government. Since then, several private medical colleges have been set up.

Egypt

All Egyptian medical schools, public and private, award an MBBCh as the basic medical degree after completion of 6 academic years. Contrary to the US and Canada, an MD is awarded as an advanced research degree, comparable to a PhD.

England and Northern Ireland

Various abbreviations are used for these degrees in these areas:

• MB ChB are used at the universities of Birmingham, Bristol, Lancaster, Leeds, Leicester, Liverpool, Keele, Manchester, Sheffield, and Warwick.
• MB, BCh, BAO are used at the Queen's University, Belfast.
• MB BS are used at all medical schools currently or previously part of the University of London (Imperial College School of Medicine,UCL Medical School, King's College London School of Medicine, Barts and The London School of Medicine and St George's, University of London), University of East Anglia, Hull York Medical School, and Newcastle University.
• BM BCh are used at the University of Oxford and Swansea University.
• BM BS are used at the University of Nottingham, Peninsula College of Medicine and Dentistry (Exeter Medical School and Plymouth University Peninsula Schools of Medicine and Dentistry), and Brighton and Sussex Medical School
• BM is awarded at the University of Southampton. Although no degree in surgery is formally awarded by Southampton, this degree is equivalent to the MB ChB, and students may go on to a career in surgery the same as any other graduates in medicine and surgery.
• MB BChir are awarded by the University of Cambridge.

At the University of St Andrews, pre-clinical study leads to the award of a BSc (Hons) degree. Students then progress to other institutions to complete their MBChB. At the Universities of Oxford and Cambridge, the preclinical course leads to an additionalBachelor of Arts (BA), degree (upgradable after three or four years to Master of Arts), after which most students used to go elsewhere (but usually to one of the London teaching hospitals) to complete clinical training. They could then take the degrees of their new university: they used to have the options of returning to their old university to take the clinical examinations, or taking one of the old non-university qualifying examinations.

The Conjoint diplomas: LRCP, MRCS, and the alternative diploma LMSSA were non-university qualifying examinations in medicine and surgery awarded jointly by the Royal College of Physicians of London, Royal College of Surgeons of England and Society of Apothecaries through the United Examining Board from 1994 until 1999, when the General Medical Council withdrew permission. Prior to 1994, the English Conjoint diploma of LRCP, MRCS was awarded for 110 years, and the LMSSA was a distinct and sometimes less-esteemed qualification. These diplomas slowly became less popular among British medical students, but as recently as 1938 only a half of them qualified with university degrees.^[3] The diplomas came to be taken mostly by those who had already qualified in medicine overseas.

Ghana

All Ghanaian medical schools award an MBChB as the basic medical degree after 6 academic years. These medical schools areKwame Nkrumah University of Science and Technology,^[4] University of Ghana, University for Development Studies and University of Cape Coast

Guyana

The University of Guyana awards MB BS. Other "offshore" United-States-linked schools in the country award the North American MD. Recently, the University of Guyana acquired accreditation by CAAM-HP, establishing itself as a credible institute and teaching standards in comparison with University of West Indies.

Hong Kong

The awarding of qualifications in Hong Kong follows the British tradition. The dual degree is awarded as:

• MBBS at The University of Hong Kong; and
• MBChB at The Chinese University of Hong Kong.

India

Medical colleges in India, accredited by the Medical Council of India, all title the degrees as MBBS.

Indonesia

In Indonesia, medicine is an undergraduate study. The Bachelor of Medicine program is completed in 3.5 up to 4 years and graduating students are awarded the degree of S.Ked (Sarjana Kedokteran / Bachelor of Medicine). At this point, the graduate is not yet a doctor, but he or she may choose to work directly as a scientist or other non-clinician professions (usually still health-related). However, most S.Ked graduates will pursue the conventional path, which is to enroll in the clerkship program for another 1.5 up to 2 years. This makes the total duration of medical school 5 or 6 years. After they finish clerkship, they will take their Hippocratic Oath and be awarded the title of dr. (medical doctor, equivalent to M.D. in United States). Graduates who hold this title are licensed and may now practice medicine. Note that this title is written in lowercase "d", as opposed to uppercase "D", Dr., which in Indonesia refers to a Ph.D.

Iran

In Iran, the primary medical (postgraduate) degree is completed in 7 years. Medical graduates are awarded a postgraduate certificate in general medicine and referred to as general doctors. They may subsequently specialize in a specific medical field at medical school offering the necessary qualification, and upon graduation apply for specialist training posts.

Iraq

All medical schools in Iraq award MB ChB.

Ireland

The medical schools in both the Republic of Ireland and Northern Ireland—namely Queen's University Belfast, University of Dublin(Trinity College), some constituent institutions of the National University of Ireland (University College Dublin, University College Corkand National University of Ireland, Galway), and the Royal College of Surgeons in Ireland—award the degrees of MB BCh BAO. The letters BAO stand for Baccalaureus in Arte Obstetricia (Bachelor of Obstetrics), a degree unique to Ireland which the Irish universities added in the 19th century as the legislation at the time insisted on a final examination in obstetrics. This third degree is an anachronism which is not registerable with the Irish Medical Council nor the British General Medical Council (GMC). The only exception is theUniversity of Limerick graduate school of medicine which awards BM BS for Bachelor of Medicine and Bachelor of Surgery.

LRCPI LRCSI, or simply LRCP&SI, denotes a holder of the historical non-university qualifying licenciates awarded jointly by the Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland to students of the RCSI's medical school under the Irish Conjoint Scheme. Unlike the corresponding licentiates awarded by the Royal Colleges in Scotland and England (which were external qualifications), these qualifications are still registerable with the Irish Medical Council, but not with the British GMC. Students at RCSI still receive these licenciates but now also receive the degrees MB BCh BAO, due to RCSI's status as a recognised college of theNational University of Ireland. The RCSI students also received a Licence in Midwifery (LM) from each college, in the same way that the Irish universities granted BAO degrees, so their qualifications were sometimes expressed as L & LM, RCPI, L & LM, RCSI or more misleadingly as LLM, RCP&SI.

LAH formerly denoted a licentiate of the now-defunct Apothecaries' Hall, Dublin, and is no longer awarded.

Jordan

The Bachelor of Medicine and Surgery (MBBS) degree is awarded in Jordan after completion of six years comprising three years ofmedical sciences and three clinical years. 

Kenya

The national universities with medical faculties in Kenya, namely Egerton University, University of Nairobi, Kenyatta University, Moi University, and Maseno University award MB ChB.

Mount Kenya University awards a different degree, the Bachelor of Clinical Medicine and Community Health

Libya

There are two major medical universities in Libya, University of Tripoli (Tripoli) and Garyounis University (Benghazi). Both schools awardMBBCh. There is also a credited private university called Libyan International Medical University.

Malaysia

The MBBS is awarded by 5 Public & 14 Private Universities:

Myanmar

All five medical schools (UM1, UM 2, DSMA, UMDY, UMG) in Myanmar award MB BS.

Nepal

There are 18 Medical Schools in Nepal that award MBBS degree. Nepal Medical Council (NMC) is the regulatory board in Nepal that give recognition to medical institutions for providing formal studies in medical science and training.

New Zealand

The two New Zealand medical schools, Auckland and Otago, style their degrees as MB ChB.

Pakistan

All sixty-nine medical colleges award MBBS, including famous colleges The Aga Khan University, King Edward Medical University,Services Institute of Medical Sciences, and Allama Iqbal Medical College. See medical colleges and schools in Pakistan.^[5]

People's Republic Of China

In the People's Republic of China, medical graduates are traditionally awarded a Bachelor of Medicine (BMed) for a course of study lasting five or six years. However, as of 2011, 49 universities, including its frequently top-ranked medical schools, have been authorized by the government to award the MBBS degree as an equivalent to the BMed.

Saudi Arabia

Medical schools in Saudi Arabia award MBBS.

Somalia

Medical schools in Somalia award the MBBS degree.

Scotland

All medical schools in Scotland (Aberdeen, Dundee, Edinburgh and Glasgow) award MB ChB.

The University of St Andrews School of Medicine awarded MB ChB until the early 1970s, but since the incorporation of its clinical medical school into the University of Dundee, St Andrews now only awards a pre-clinical BSc or BSc (Hons), and students go to a Partner Medical School (Aberdeen, Dundee, Edinburgh, Glasgow, or Manchester where they are awarded an MB ChB after a further three years' study.

The Scottish Triple Conjoint Diploma of LRCPE, LRCSE, LRCPSG (earlier LRCPE, LRCSE, LRFPSG) is an old non-university qualifying examination in medicine and surgery awarded jointly by the Royal College of Physicians of Edinburgh, Royal College of Surgeons of Edinburgh and Royal College of Physicians and Surgeons of Glasgow, previously through a Conjoint Board and from 1994 through theUnited Examining Board. These qualifications are still registrable with the GMC, but permission to award them was withdrawn by the Privy Council of the UK in 1999.

South Africa

The University of Pretoria, University of Cape Town, University of the Free State, University of Stellenbosch, University of KwaZulu-Nataland MEDUNSA all award MBChB, whereas the University of the Witwatersrand styles its degree as MBBCh. See Medical education in South Africa.

Singapore

The Yong Loo Lin School of Medicine at the National University of Singapore confers MB BS. The American Duke University also has a medical programme based in Singapore (Duke-NUS Graduate Medical School), but it follows the North-American model of styling its degree Doctor of Medicine.

Sri Lanka

The University of Colombo, University of Peradeniya, University of Kelaniya (Ragama), University of Ruhuna, University of Sri Jayewardenepura, Rajarata University, University of Jaffna, General Sir John Kotelawala Defence University and Eastern University of Sri Lanka all award MBBS.

Sudan

All Sudanese medical schools award BMBCh. The University of Juba in South Sudan awards the MBBS degree after the successful completion of six academic years.

United States

The Wisconsin Medical Society defends the use of the MD title by physicians who graduated with an MBBS and are licensed to practice medicine in Wisconsin.

Uganda

The five universities in Uganda which have medical schools that teach undergraduate courses, namely Makerere University, Mbarara University, Gulu University, Kampala International University and Busitema University, all award the MBChB degree.

Wales

Both universities in Wales that have medical schools, namely Cardiff University and Swansea University, award MB BCh.

West Indies

All constituent countries of the University of the West Indies (UWI) confer MB BS, due to the historical affiliation of UWI to the University of London. There are other medical schools in the West Indies, but these follow the North-American system leading to MD

Source: electroplated from wikipedia