POLRI DAERAH JAWA TIMUR

BIDANG KEDOKTERAN DAN KESEHATAN

RUMAH SAKIT BHAYANGKARA TK III TULUNGAGUNG

REKOMENDASI RINCIAN KEWENANGAN KLINIS

DOKTER UMUM

Nama :
NRP / NIP / NIK :
Tempat/Tanggal Lahir :
Pendidikan / Jabatan : Dokter Umum

Kewenangan Klinis Yang Diminta Yang Disetujui

DAFTAR PENYAKIT
Jenis Pelayanan :
1. Basic of Cardiovascular √ √
2. Basic of Respiratory √ √
3. Basic of Gastrointestinal √ √
4. Basic of Nephro-urology √ √
5. Basic of Hematology √ √
6. Basic of Immunology √ √
7. Basic of Genetics / newborn / chromosomal disorders √ √
8. Basic of Endocrine, metabolic disorders and nutrition √ √
9. Basic of Central and peripheral neural system √ √
10. Basic of Ear, nose and throat √ √
11. Basic of Eye √ √
12. Basic of Infectious and tropical medicine √ √
13. Basic of Neoplasm √ √
14. Basic of Psychiatry and mental health √ √
15. Basic of Musculoskeletal system √ √
16. Basic of Traumatology √ √
17. Basic of Reproduction system √ √
DAFTAR KETRAMPILAN KLINIS
Jenis Pelayanan :
Internal Medicine
1. Physical examination
- General survey
- Head and neck
- The spine
- Thorax
√ √
- Abdomen
- Perineal
- Female genitalia
- Male genitalia
- Extremities
2. Diagnostic procedures √ √
 3. Therapeutic skills √ √
Neurology
Physical examination
- Cranial nerve function
- The motor system
- Coordination
- The sensory system √ √
- Radicular sensation disorders
- Higher functions
- Reflexes
- Others ….
Additional diagnostic investigations √ √
Therapeutic skills √ √
The spine √ √
Psychiatry
Diagnostic skill
- History taking
- Psychiatric examination √ √
- Identifying problems
- Additional examination
Therapy √ √
Paediatrics
History taking √ √
Physical examination
- General
√ √
- Newborn and infant
- All ages
Therapeutic skills, examinations and operation of the child √ √
Surgery
Diagnostic skill
- Physical examination
- Orthopedic examination
- Varicose veins
√ √
- Arterial vascular disorders
- Abdominal hernia
- Male genitalia
- Accident and emergency
Additional examinations √ √
Therapeutic skills √ √
Operative surgery
Gynecology
Physical examination
- General, including breast
- External genitalia
- Speculum examination √ √
- Bimanual examination
- Rectal examination
- Combined recto-vaginal septum
Additional diagnostic examination
Additional diagnostic for sub fertility
Therapy and prevention
Contraception / sterilization
Obstetry
Selection of high risk pregnancy √ √
Pregnancy
Normal delivery
Puerperium
Dermatology
Diagnostic skill
- Physical examination
- Terminology of skin lesions √ √
- Additional examinations

Therapy √ √
Prevention √ √
Otolaryngology (ENT)
Diagnostic skill
- Ears, hearing, equilibrium
√ √
- Nose, sinuses
- Mouth, throat, speech, esophagus, neck
Therapeutic skill √ √
ENT surgery
Ophthalmology
General ophthalmologic examination
- Vision
- Refraction
- Visual fields
- External inspection
√ √
- Position of eyes
- Pupils
- Media
- Fundi
- Intraocular pressure
Additional general ophthalmologic examination
Special ophthalmologis examination
Therapeutic skill
Surgical therapy
General practice – skill list
Eye √ √
Ear √ √
External and internal genitalia √ √
Arm √ √
Leg √ √
Skin, mucosa and subcutaneous tissue √ √
Laboratory investigation, blood √ √
Laboratory investigation, urine √ √
DAFTAR KETRAMPILAN UNIT TERTENTU
1. Sistim TRIAGE √ √
2. Sistim Rujukan √ √
3. Melakukan tindakan medis preventif, kuratif dan
√ √
rehabilitatif
4. Melakukan edukasi dan konseling √ √
5. Melakukan promosi kesehatan √ √
6. Menentukan indikasi rujuk √ √
7. Membuat diagnosis klinik dan memberikan terapi
pendahuluan pada keadaan gawat darurat demi
√ √
menyelamatkan nyawa atau mencegah keparahan
dan atau kecacatan pada pasien
8. Resusitasi jantung, paru pada keadaan gawat
√ √
darurat
9. Pemasangan ETT √ √
10. Pemasangan Ventilator √ √
11. Menentukan rujukan tepat bagi penanganan
pasien selanjutnya bila diperlukan dan
menindaklanjuti sesudah kembali dari rujukan √ √
berdasarkan Standar Kompetensi Dokter
Indonesia
12. Melaksanakan universal precaution √ √
Rekomendasi DISETUJUI DISETUJUI DENGAN TIDAK DISETUJUI
CATATAN
Tanggal :

Catatan :

Ketua Komite Medik, Ketua Sub Komite Kredensial,