Revisiting Subspecialty Training in Cardiology in Indonesia: Structural, Regulatory, and Global Perspectives

Muhammad Munawar; Anggia Chairuddin Lubis; Budi Yuli Setianto; Yudi Her Octaviono; Andina Munawar; Sodiqur Rifqi; Sasmojo Widito

doi:10.30701/ijc.1971

Muhammad Munawar Binawaluya Cardiac Center; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia https://orcid.org/0000-0002-0351-4432
Anggia Chairuddin Lubis RS Adam Malik; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0002-2743-658X
Budi Yuli Setianto RS Dr. Sardjito; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
Yudi Her Octaviono RS Dr. Sutomo, Department of Cardiology and Vascular, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
Andina Munawar Lyell McEwin Hospital, Adelaide, South Australia, Australia
Sodiqur Rifqi RS Karyadi; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
Sasmojo Widito Department of Cardiology and Vascular Medicine, Saiful Anwar Teaching Hospital; School of Medicine, Universitas Brawijaya, Malang, Indonesia

DOI: https://doi.org/10.30701/ijc.1971

Keywords: cardiology subspecialty; fellowship; medical education; hospital-based training; Indonesia

Abstract

The rapid expansion of cardiology as a discipline has prompted the emergence of numerous subspecialties that require structured, competency-based training. In Indonesia, however, the development of subspecialty education remains inconsistent, divided between university-based programs known as Spesialis-2 (Sp-2) and hospital-based fellowships. The interchangeable use of the terms “fellowship” and “subspecialty” has generated conceptual ambiguity and regulatory uncertainty. Globally, subspecialty training in cardiology follows a hospital-based apprenticeship model, led by accredited teaching hospitals and closely regulated by professional boards such as ACGME, ACC, or ESC. Indonesia’s deviation from these international norms has implications not only for the quality of advanced cardiovascular training but also for the nation’s ability to attract international fellows—a marker of global academic recognition. This review examines the current landscape of cardiology subspecialty education in Indonesia, contrasting it with global frameworks, and discusses structural, academic, and legal challenges, including those concerning foreign trainees. The article concludes by proposing a policy framework to harmonize Indonesia’s subspecialty education with global standards, thereby strengthening both national capacity and international credibility.

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