Muhammad Munawar, Anggia Chairuddin Lubis, Budi Yuli Setianto, Yudi Her Oktaviono, Dian Andina Munawar, Sodiqur Rifqi, Sasmojo Widito
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 clinical fellowships. The interchangeable use of the terms “fellowship” and “subspecialty” has generated conceptual ambiguity and regulatory uncertainty. Globally, cardiology subspecialty training follows a hospital-based apprenticeship model led by accredited teaching hospitals and regulated by national or regional professional boards such as the Accreditation Council for Graduate Medical Education (ACGME), the American College of Cardiology (ACC), or the European Society of Cardiology (ESC). Indonesia’s deviation from these international norms has implications for both the quality of advanced cardiovascular training and the nation’s potential to attract international fellows—a marker of global academic recognition. This review examines the current landscape of cardiology subspecialty training in Indonesia, compares it with global frameworks, and discusses academic, structural, and legal challenges, including those related to foreign trainees. A policy framework is proposed to harmonize Indonesia’s subspecialty education with global standards, thereby strengthening national capacity and international credibility. © 2025 Indonesian Heart Association. All rights reserved.
Binawaluya Cardiac Center, Jakarta, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; RS Adam Malik, Medan, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia; RS Dr. Sardjito, Yogyakarta, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia; RS Dr. Sutomo, Surabaya, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Lyell McEwin Hospital, Adelaide, SA, Australia; RS Karyadi, Semarang, Indonesia; Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia; Department of Cardiology and Vascular Medicine, Saiful Anwar Teaching Hospital of Jawa Timur, Malang, Indonesia; School of Medicine, Universitas Brawijaya, Malang, Indonesia
