Health Professional Competency Tests and Best Practices from Other Countries
The competency test for health workers was born from a noble intention: to protect the public from incompetent service practices. In the health sector, a professional error is not just a technical mistake. It can be directly linked to patient safety, quality of care, and even human life. Therefore, the state has a vested interest in ensuring that every health education graduate meets minimum competency standards before entering professional practice.
However, a policy born of good intentions must still be tested with fair questions. After years of implementation, has the competency test truly become a quality assurance instrument? Or has it gradually turned into an administrative barrier that delays graduates’ right to work, without sufficiently improving the quality of education from upstream?
This question is important to ask, not to reject the competency test. What needs to be reconsidered is its design, standing, transparency, and consequences. Especially when the competency test is positioned as a requirement for graduation from professional education, rather than merely a requirement for certification, registration, or a licence to practise. It is at this point that issues of fairness begin to emerge.
Many other professions also have a major impact on public life. Engineers build bridges, buildings, roads, dams, and infrastructure. Accountants safeguard financial trust. Teachers determine the quality of generations. Advocates engage with justice. Architects, psychologists, social workers, information technology analysts, and digital data managers are now also involved with safety, privacy, and the order of public life. Yet, not all professions are treated equally when it comes to competency tests as a graduation requirement.
The state can certainly set specific standards for health workers. This specificity is justifiable because health services deal directly with the human body, safety, and vulnerability. However, specificity must not turn into a disproportionate burden. If the basic principle is public protection, then the policy must be designed rationally, measurably, transparently, and must not produce new injustices for students.
A Large Volume of Health Professional Education
The scale of this problem is enormous. Health education is not a small sector. Higher education data shows that Indonesia has more than 4,400 higher education institutions, over 33,000 study programmes, and almost 10 million students. Within this, the health cluster has thousands of study programmes.
This means every competency test policy touches a vast national health education ecosystem, from medicine, nursing, midwifery, pharmacy, physiotherapy, nutrition, public health, medical laboratory technology, radiology, medical records, to sanitation.
In the field of medicine, the number of medical faculties has also grown rapidly. The government has previously stated the number has reached more than one hundred faculties, with a large quota for new medical students each year. The same applies to other health education programmes spread across faculties, higher schools, institutes, health polytechnics, and universities.
The question is, does the growth of institutions always align with the adequacy of clinical lecturers, practice venues, learning quality, field supervision, and graduate absorption capacity?
It is here that competency tests are often positioned as the final gatekeeper. Students have completed lectures, lab work, clinical practice, professional stases, academic assignments, and institutional assessments. However, if they do not pass the competency test, their graduation status can be delayed. Some must retake the exam repeatedly. As a result, study periods lengthen, family costs rise, psychological pressure increases, and opportunities to enter the workforce are also held back.
In such a situation, the competency test risks punishing students twice. Firstly, through failure in a single exam instrument. Secondly, through the delay of academic status and job access. Yet, failing a competency test is not always synonymous with overall professional inability. Many factors influence this: the quality of learning, institutional readiness, the quality of clinical guidance, variations in practice facilities, exam question design, test anxiety, digital literacy, the ability to read case-based questions, and resource disparities between higher education institutions.