4.5.

1 Kegiatan tenaga ahli/pakar sebagai pembicara dalam seminar/pelatihan, pembicara tamu, dsb, dari luar PT sendiri (tidak termasuk dosen di RS Pendidikan
Afiliasi dan Satelit).

JTA = Banyaknya tenaga ahli/pakar sebagai pembicara dalam seminar/pelatihan, pembicara tamu, dsb, dari luar PT sendiri (tidak termasuk dosendi RS
Pendidikan Afiliasi dan Satelit).

Catatan: Tenaga ahli dari luar perguruan tinggi dengan tujuan untuk pengayaan pengetahuan dan bukan untuk mengisi kekurangan dosen, tidak bekerja secara
rutin.

Jika JTA ≥ 12, maka skor = 4.

Kegiatan tenaga ahli/pakar/pembicara tamu dari luar PT sendiri dalam peningkatan mutu pendidikan.

N Nama Tenaga Bidang keahlian Nama dan Waktu Pelaksanaan

o. Ahli/Pakar Judul
Kegiatan
(1 (2) (3) (4) (5)
)
1. Riwanti Estiasari, dr., Neuroimunologi Teaching 19 Agustus 2016
Sp.S(K) Course
[UI] Multiple
Sclerosis (17th
CNE)
2. Amanda Tiksanadi, Neurorestorasi Managemem 19 Agustus 2016
dr., Sp.S(K) ent
[UI] dysphagia,
Prevention
pneumonia
aspiration &
breathing
exercise
[Workshop
Neurorestora
 tion in Stroke
(17th CNE)]
3. Prof. dr. Lucas Nyeri Chronic & 20 Agustus 2016
Meliala, Sp.KJ, Acute Pain
Sp.S(K) Synposium
[UGM] “Managemen
t of Chronic
pain: Focus
on
Ostheoarthri
tis
treatment”
(17th CNE)
4. Manfaluthy Hakim, Neurofisiologi Neurophysiol 20 Agustus 2016
dr., Sp.S(K) ogy
[UI] Symposium
“Managemen
t myastenia
crisis” (17th
CNE)
5. Yudiyanta, dr., Nyeri Pain 20 Agustus 2016
Sp.S(K) Symposium
“Understandi
ng the pain :
patophysiolo
gy of mixed 14 September 2019
pain and
chronificatio
n” (17th CNE)

KONAS 10th
PERDOSSI
 2019
6. M. Kurniawan, Neurovaskuler Thrombolysi 20 Agustus 2016
Sp.S(K), FICA s Symposium
[UI] “Thrombolys
is in Stroke :
Recent
clinical trials
and practical
aspect in
ASIAN
population.
(17th CNE)
7. Dr. Al Rasyid, dr., Neurovaskuler Stroke 20 Agustus 2016
Sp.S(K) Symposium
“Role of
Pentoxifyline 14 September 2019
on
cerebrovascu
lar disease
(17th CNE)

8. Dr. Retnaningsih, dr., Neurointensif Neurointensi 20 Agustus 2016

Sp.S(KIC) ve
[UNDIP] Symposium
“FASTHUG
: Supportif 14 September 2019
treatment in
Neurocritical
care (17th
CNE)
KONAS 10th
PERDOSSI
 2019
9. Fritz Sumantri Usman Neurointervensi Ischemic 21 Agustus 2016
Sr., dr., Sp.S., FINS Stroke &
[RS. Fatmawati] SAH
Symposium
“Hydrocepha 14 September 2019
lus &
Aneurysmal
SAH : when
the best time
to treat and
how ? (17th
CNE)
KONAS 10th
PERDOSSI
2019
10 Prof. Deok Hee Lee Neurology 18th CNE 5-7 Mei 2017
. [Asan Medical Center, Surabaya
Seoul]
11 Prof. Nijasri C. Neurology 18th CNE 5-7 Mei 2017
. Suwanwela Surabaya
[Comprehensive
Stroke Center,
Thailand]
12 Prof. Sarun Nunta- Neurology 18th CNE 5-7 Mei 2017
. aree Surabaya
[Siriraj Hospital
Mahidol University,
Bangkok]
13 Prof. dr. Clemens MF Neurosurgery Dutch 22-23 Maret 2018
. Dirven [Erasmus Foundation
 University Rotterdam] for
Postgraduate
Medical
Courses in
Indonesia :
Current
Comprehensi
ve
Management
of CNS
Tumors
14 Prof. dr. Max J Kros Neuropathology Dutch 22-23 Maret 2018
. [Erasmus University Foundation
Rotterdam] for
Postgraduate
Medical
Courses in
Indonesia :
Current
Comprehensi
ve
Management
of CNS
Tumors
15 Prof. dr. Rob JM Neurosurgery Dutch 22-23 Maret 2018
. Groen [Faculty of Foundation
Medical Sciences for
University of Postgraduate
Groningen] Medical
Courses in
Indonesia :
Current
 Comprehensi
ve
Management
of CNS
Tumors
16 Walter Taal Neurology Dutch 22-23 Maret 2018
. [Erasmus University Foundation
Rotterdam] for
Postgraduate
Medical
Courses in
Indonesia :
Current
Comprehensi
ve
Management
of CNS
Tumors
17 Dr. Amy May Lin Neurology 19th CNE 20 Juli 2018
. Quek [Singapore] Surabaya
18 Prof. Dr. Tan Chong Clinical Neurology 19th CNE 20 Juli 2018
. Tin MBBS FRCP MD Surabaya
FASc DSPN
[Malaysia]
19 Dr. Supoch Neurology / Internal 19th CNE 20 Juli 2018
. Tunlayadechanont Medicine Surabaya
[Thailand]
20 Prof. Dr. Khairul Biomedical Imaging 19th CNE 20 Juli 2018
. Azmi Bin Abd Kadir Surabaya
[Malaysia]
21 dr. Ahmad Rizal Neuroinfection 19th CNE 20 Juli 2018
. Ganiem, Sp.S(K), PhD. Surabaya 14 September 2019
KONAS 10th
PERDOSSI
2019
22 dr. Arthur H.P. Neuroinfection 19th CNE 20 Juli 2018
. Mawuntu, dr. Sp.S(K) Surabaya 14 September 2019
KONAS 10th
PERDOSSI
2019
23 dr. Kiking Ritarwan, Neuroinfection 19th CNE 20 Juli 2018
. Sp.S(K), MKT Surabaya 14 September 2019
KONAS 10th
PERDOSSI
2019ya
24 dr. Rivan Danuaji, 19th CNE 19 Juli 2018
. M.Kes, Sp.S Surabaya
25 DR.dr.DK Indrasari Sleep KONAS 10th 14 September 2019
Utami PERDOSSI
2019
26 dr. Zamroni Anif SpS Sleep KONAS 10th 14 September 2019
Biomed PERDOSSI
2019
27 DR.dr Desi R Emril Pain KONAS 10th 14 September 2019
SpS(K) PERDOSSI
2019
28 dr. Pagan Pambudi PAIN KONAS 10th 14 September 2019
SpS MSI PERDOSSI
2019
29 DR Thomas Eko PAIN KONAS 10th 14 September 2019
Purwata SpS(K) PERDOSSI
FAAN 2019
30 dr. M Kurniawan Neurointervention KONAS 10th 14 September 2019
SpS(K) FICA PERDOSSI
2019
31 dr.Suratno SpS (K) Neurootologi KONAS 10th 14 September 2019
PERDOSSI
2019
32 Eva Dewati SpS(K) Neurootologi KONAS 10th 14 September 2019
PERDOSSI
2019
33 DR.dr.Fitri Octaviana Epilepsy KONAS 10th 14 September 2019
SpS(K) MpdKed PERDOSSI
2019
34 dr.Endang Kustiowati Pain KONAS 10th 14 September 2019
SpS(K) PERDOSSI
2019
35 Prof.DR.dr Suroto Pain KONAS 10th 14 September 2019
SpS(K) FAAN PERDOSSI
2019
36 dr.Widodo Mardi Pain KONAS 10th 14 September 2019
Santoso SpS(K) PERDOSSI
2019
37 Prof Mon Ku Han KONAS 10th 14 September 2019
PERDOSSI
2019
38 Prof Andrew KONAS 10th 15 September 2019
S.C.Rice,MD.,FRCP.,F PERDOSSI
RCA, 2019
FFP,MRCA.,FFPMCA
I.
39 Prof. Harsono, KONAS 10th 15 September 2019
dr.,Sp.S(K) PERDOSSI
 2019
40 Dr. Aldy KONAS 10th 15 September 2019
S.Rambe,dr.,Sp.S(K) PERDOSSI
2019
41 Mursyd Bustami,dr., KONAS 10th 15 September 2019
Sp.S(K).,KIC.,MARS. PERDOSSI
2019
42 Abdul Muis, dr., Neuroinfection KONAS 10th 15 September 2019
Sp.S(K),Ph.D. PERDOSSI
2019

Hasil Jika JTA ≥ 12, maka skor = 4.

JTA 42, maka skor = 4.
4.5.2 Peningkatan kemampuan dosen di RS Pendidikan (Utama, Afiliasi dan Satelit) melalui program tugas belajar dalam bidang yang sesuai dengan bidang PS.

Perhitungan skor sebagai berikut:

N3 = Jumlah dosen yang mengikuti tugas belajar jenjang S-3/Sp.K pada bidang keahlian yang sesuai dengan PS dalam kurun waktu tiga tahun terakhir

Jika 10 % dari jumlah dosen, maka skor = 4.

Peningkatan kemampuan dosen (termasuk dosen di RS Pendidikan Afiliasi dan Satelit) melalui program tugas belajar dalam bidang yang
sesuai dengan bidang PS.

No Nama Dosen Jenjang Bidang Studi Perguruan Negara Tahun Mulai

. Pendidikan Tinggi Studi/Lama
Lanjut/Fellowship Fellowship
/Konsultan
(1) (2) (3) (4) (5) (6) (7)
1 DR. Hanik Badriyah Hidayati,dr. S3 Ilmu Uniersitas Surabaya, Indonesia 2016-sekarang
SpS(K) Nyeri Kedokteran Airlangga
2 A. Firdaus Sani, dr., Sp.S(K)., FINS S-3 Ilmu Universitas Surabaya 2016- sekarang
Neurointervensi Kedokteran Airlangga
3 Wardah R. Islamiyah, dr., Sp.S(K). S-3 Ilmu Universitas Surabaya 2016- sekarang
Epilepsi Kedokteran Airlangga April 2019
4 Moh. Saiful Ardhi, dr., Sp.S(K). S-3 Ilmu Universitas Surabaya 2016- sekarang
Neurovaskular Kedokteran Airlangga
5 DR.M Hamdan,Sp.S(K) S3 Ilmu Universitas Malang 2019
Kedokteran Brawijaya
6 Djohan Ardiansyah, dr., Sp.S(K). Fellowship Hospital Spanyol July – October
Neuroonkologi Universitario de 2018
Canarias September
2019

7 Devi Ariani Sudibyo , dr., Sp.S(K). Nyeri Kepala Indonesia September

2019
8 Abdulloh Machin dr., Sp.S(K). S3 Ilmu Indonesia September
Neuro-Intensif Kedokteran 2019

9 Fidiana dr., Sp.S(K). Sleep Indonesia April 2019

10 Mudjiani Basuki dr., Sp.S(K). Neurofisiologi Indonesia September
2019
11 Yudhi dr., Sp.S. (K) Neuro-Intervensi Indonesia September
2019
12 Fadil, dr., Sp.S. Fellowship Hospital Spanyol July – October
Universitario de 2018
Canarias
13 Sita Setyowatie dr., SpS Fellowship Neurosonologi Universitas Indonesia 2 Februari –
(TCD-CD) Indonesia 29 Maret 2018
RSCM
14 Deby Wahyuninghadi dr.,SpS Fellowship Neurobehavior Universitas Indonesia 15 April 2019 –
Indonesia 15 September
RSCM 2019

Jika 10 % dari jumlah dosen, maka skor = 4.

Hasil 66,66 %, Skor 4

4.5.3 Kegiatan dosen PS dalam pertemuan ilmiah.

SP = [4 NA + 3 NB + 4 NC + 3 ND + 2 NE + NF] / NDT
Dengan:
 NA, NB, NC, ND, NE, NF dapat dilihat pada Tabel 4.5.3.
 NDT = Jumlah dosen PS.
Jika SP ≥ 9, maka skor = 4.

Nama Dosen di RS Bentuk Partisipasi dalam Penyajian Ilmiah

No.
Pendidikan Utama A B C D E F
(1) (2) (3) (4) (5) (6) (7) (8)
1 Prof. Dr. H. M. Hasan ● ASNA Siang Klinik
Machfoed, dr., Sp.S(K), Workshop RSUD Prof.
MS (Surabaya, 20 Dr. H. Aloei
Juli 2018) ● 2nd Cirebon Goron-talo
● Joint Meeting Neurological Meeting (2016)
2018 Mental and Symposium (2016)
Health & ● Semarang Trending
Neurology Topic of Neurology
Conference & (Semarang, Maret 2017)
2018 ● Mukernas PERDOSSI
Healthcare (Yogyakarta, Juli 2017)
and
● Bali Neurology Update
Cardiology
Conference (Bali, 2017)
(Bangkok, ● 18th CNE (Surabaya,
Sept 2018) Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
 September 2019)

2 J. Ekowahono R., dr.,

M.Kes., Sp.S.

● Chronic & Acute Pain

Sympo, 17th CNE
(2016)
● Vertigo & Epilepsy
Sympo, 17th CNE
(2016)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 19th CNE (Surabaya,
Juli 2018)

4 Dr. Kurnia Kusumastuti,

dr., Sp.S(K)

● Vertigo & Epilepsy

Sympo, 17th CNE
 (2016)
● Epilepsy & Migraine
Sympo, Movement
Disorders, 17th CNE
(2016)
● Semarang Trending
Topic of Neurology
(Semarang, Maret 2017)
● Mukernas PERDOSSI
(Yogyakarta, Juli 2017)
● Medan Neurology
Update (Medan,
Agustus 2017)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

5 Dr. Paulus Sugianto, dr., ● ASNA

Sp.S(K) Workshop
(Surabaya, 20
Juli 2018) - Neuro-Infection
 Sympo, 17th CNE
(2016)
- Mukernas PERDOSSI
(Yogyakarta, Juli 2017)
- 18th CNE (Surabaya,
Mei 2017)
- 19th CNE (Surabaya,
Juli 2018)
- KONAS 10th
Surabaya (Surabaya,
September 2019)

6 Mudjiani Basuki, dr., Neuropain

Sp.S(K). Interventional
(Nerve-1)
International ● Neuro-physiology - Myasthenia
Scientific Sympo, 17th CNE Gravis Sympo,
Meeting In (2016) 17th CNE
Conjunction ● Mukernas PERDOSSI (2016)
With Continuing (Yogyakarta, Juli 2017)
Neurological ● 18th CNE (Surabaya,
Education VII Mei 2017)
Malang ● 19th CNE (Surabaya,
Juli 2018)
● PIN Bogor, April 2018 - National
● KONAS 10th Scientific
Surabaya (Surabaya,
September 2019)
 meeting Banten 1st
CNE (2016)

- 18th CNE
(Surabaya, Mei
2017)

7 Muhammad Hamdan, 18th CNE

DR.dr., Sp.S(K) (Surabaya, Mei
2017)
● Movement Disorders,
17th CNE (2016)
● Mukernas PERDOSSI
(Yogyakarta, Juli 2017)
● 18th CNE (Surabaya,
Mei 2017)
● KONAS 10th
Surabaya (Surabaya,
September 2019)
8 Isti Suharjanti, dr., Internatio-nal
Sp.S(K) Headache
Society (Canada,
● Chronic & Acute Pain September 2017)
Sympo, 17th CNE
(2016)
● Pain Sympo, 17th CNE
(2016)
● Epilepsy & Migraine
Sympo, Movement
Disorders, 17th CNE
(2016)
● Mukernas PERDOSSI
(Yogyakarta, Juli 2017)
● 18th CNE (Surabaya,
Mei 2017)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 19th CNE (Surabaya,
Juli 2018)
● PIN Bogor, April 2018
● KONAS 10th
Surabaya (Surabaya,
September 2019)

9 Yudha Haryono, dr.,

Sp.S(K).

● WS Neuro-oncology, 18th CNE (Surabaya,

17th CNE (2016) Mei 2017)
 ● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)
● 20 KONAS 10th
Surabaya (Surabaya,
September 2019)th
CNE (Surabaya,
September 2019

10 Abdulloh Machin, dr., ● Neuro-intensive Sympo, World Congress 18th CNE

Sp.S(K). 17th CNE (2016) Neurologi (Kyoto (Surabaya, Mei
● 18th CNE (Surabaya, Japan, 2017)
● The Korean Mei 2017) September 2017)
Neurocritical ● 19th CNE (Surabaya,
Care Society Juli 2018)
(Korea, Maret ● PIN Bogor, April 2018
2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

11 Achmad Firdaus Sani, dr., Seminar

Sp.S. (K)FINS Compre-
hensive
- Annual ● WS SAINS (2016) Thrombolysis Sympo, Stroke
Convention ● Ischemic Stroke & SAH 17th CNE (2016) Management 
Philippine Sympo, 17th CNE : to Acute
Prevention
(2016)
Conti-nuing
 Medical
Education of
Neurology (2016)
Neurologi-cal (2016)
Associaton ● 18th CNE (Surabaya,
(Manila, Mei 2017)
November ● 19th CNE (Surabaya,
2017) Juli 2018)
- Stroke Live ● KONAS 10th
Course Surabaya (Surabaya,
(Prancis, September 2019)
Oktober 2017)
- Asia Pacific
Stroke
Conference
(Jakarta, Sept
2018)

12 Wardah Rahmatul
Islamiyah, dr., Sp.S(K)
● How to refer
Neurological cases for
GP, 17th CNE (2016)
● Epilepsy & Migraine
Sympo, Movement
Disorders, 17th CNE
(2016)
● 1st INA SLEEP meeting
(Bandung 2016)
● 18th CNE (Surabaya,
 Mei 2017)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 19th CNE (Surabaya,
Juli 2018)
● PIN Bogor, April 2018
● KONAS 10th
Surabaya (Surabaya,
September 2019)

15 Djohan Ardiansyah, dr., Asia Oceanian Continuing

Sp.S(K). Neuroon-cology Medical
(Japan, Oktober Education of
● WS Neuro-oncology, 2017) Neurolo-gy
17th CNE (2016) (2016)
● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)
13 Hanik Badriyah Hidayati, Continuing
dr., Sp.S(K). Medical
Education of
● How to refer Neurology
Neurological cases for (2016)
GP, 17th CNE (2016)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 18th CNE (Surabaya,
Mei 2017)
● Interventional Pain
Management
Ultrasound-Guided
Injection Beginning-
Intermediate Level
Course Injection
Workshop, Amos Cozy
Hotel Jakarta, 24-25
March 2017
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

14 Mohammad Saiful Ardhi, Seminar

dr., Sp.S(K). Compre-
hensive
● WS Neuro-Restoration Stroke
in Stroke, 17th CNE Management 
: to Acute
Prevention
(2016)
 (2016)
● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)

15 Fidiana, dr., Sp.S(K)

● How to refer ● Continuing

Neurological cases for Medical
GP, 17th CNE (2016) Education of
● 1st INA SLEEP meeting Neurology
(Bandung 2016) (2016)
● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018)
● PIN Bogor, April 2018
● 18th CNE
(Suraba-ya,
Mei 2017)
16 Devi Ariani Sudibyo, dr., Second Indonesi International Workshop
Sp.S(K). Interventional Headache Keperawatan
Pain Physician Society (Canada, Manajemen
Symposium (2nd ● Teaching Course September 2017) Nyeri RS Mitra
Ina-IPPS) Multiple Sclerosis, 17th Keluar-ga
[Jakarta, Juni CNE (2016) Waru (2016)
2018 ] ● How to refer
Neurological cases for
GP, 17th CNE (2016)
● Neuro-Infection Sympo,
17th CNE (2016)
● 18th CNE (Surabaya,
Mei 2017)
● PIN PERDOSSI
(Pekanbaru, Oktober
2017)
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

17 Yudhi Adrianto, dr.,

Sp.S(K).
● How to refer
Neurological cases for
GP, 17th CNE (2016)
 ● 18th CNE (Surabaya,
Mei 2017)
● 19th CNE (Surabaya,
Juli 2018) 20th CNE
(Surabaya, September
2019)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

18 Fadil, dr., Sp.S 18th CNE

(Surabaya, Mei
2017)
● How to refer
Neurological cases for
GP, 17th CNE (2016)
● 19th CNE (Surabaya,
Juli 2018)
● KONAS 10th
Surabaya (Surabaya,
September 2019)

19 Priya Nugraha, dr., Sp.S

20 Sita Setyowatie, dr., Sp.S
21 Deby Wahyuning Hadi,
dr., Sp.S.
Total NA= 7 NB= 100 NC= 4 ND= 12 NE= 2 NF= 2
Keterangan:
 1. Pembicara tamu (invited speaker) pada pertemuan ilmiah Dokter Spesialis Internasional
2. Pembicara tamu (invited speaker) pada pertemuan ilmiah Ilmu Dokter Spesialis nasional
3. Penyaji makalah (free paper/poster presentation) pada pertemuan Dokter Spesialis internasional
4. Penyaji makalah pada pertemuan ilmiah Dokter Spesialis nasional
5. Penyaji makalah pada pertemuan ilmiah kedokteran non Dokter Spesialis
6. Penyaji makalah pada seminar populer tentang kesehatan Dokter Spesialis

Jika SP ≥ 9, maka skor = 4.

SP = 17,8 maka skor = 4
4.5.4 Media publikasi karya ilmiah dosen PS.

SP = [4 NA + 3 NB + 3 NC + 2 ND + NE + NF] / NDT
Dengan:
 NA, NB, NC, ND, NE, NF dapat dilihat pada Tabel 4.5.4.
NDT = Jumlah dosen PS.

Jika SP ≥ 9, maka skor = 4.

Media publikasi karya ilmiah dosen (termasuk dosen di RS Pendidikan Afiliasi dan Satelit).

Nama Dosen di RS Jenis Media Publikasi

No.
Pendidikan Utama A B C D E F
(1) (2) (3) (4) (5) (6) (7) (8)
1. Prof. Dr. H. M. Hasan Majalah
Machfoed, dr., Sp.S(K), Neurona vol 36
MS no 2 edisi
● Buku The New Era : maret 2019
● AKTUALN Towards curative (Bekam
NEUROL 2016, Neurology, 2017 (New sebagai terapi
16 (2), p. 71– Era and Paradigm in alternative
78DOI: Neurology: From untuk nyeri)
10.15557/AN.201 Nihilistic to Optimistic
6.0009 and Therapeutic
(Duchenne Aspects)
Muscular ● Buku The New Era :
Dystrophy : Towards curative
Overview and Neurology, 2017
Future (Understanding
Challenges) Chronic Pain :
● Neurology. 2017 Approaching From
April 18; 88 (16 Neurobiology to
Supplement) : Therapeutic Aspects)
P3.263
● Open Neurology
Journal. 2017
Dec 19 ; 17 : 74-
83 doi:
10.2174/1874205
X01711010074
(Clinical
Outcomes of
Repeated
Intraventricular
Trasplantation
of Autologous
Bone Marrow
Mesenchymal
Stem Cells In
Chronic
Haemorrhagic
Stroke. A One-
Year Follow Up)
● American Academy
of Neurology, April
18, 2017:88(16
Supleme)
(Hypertension Is
The Most Risk
Factor Stroke In
Indonesia Stroke
Registry)
● Macedonian
Journal of
Medical Science
2017, Mar
15;5(1):54-57.
 https://doi.org/10.38
89/oamjms.2017.02
(Tumour
Necrosis Factor-
A, Interleukin-1
and Interleukin-
6 and Serum
Levels and Its
Correlation
With Pain
Severity in
Chronic
Tension-Type
Headache
Patients :
Analysing Effect
of
Dexketoprofen
Administration)

2. J. Ekowahono R., dr.,

M.Kes., Sp.S.
● Buku The New Era :
Towards curative
 Neurology,
2017(Understanding
Evidence in Neurology)

3. Dr. Kurnia
Kusumastuti, dr.,
Sp.S(K)
● Buku The New Era :
Towards curative
Neurology, 2017
(Tinitus)
● Buku : Pedoman
Tatalaksana Vertigo
(Tinjauan Umum
Mengenai Gangguan
Keseimbangan)

4. Dr. Paulus Sugianto, Neurona

dr., Sp.S(K) Buku : Majalah
Kedokteran
Neuro-
Sains
● The New Era : Perhimpun
Towards Curative an Dokter
Neurology (Recent Spesialis
Management of Saraf
Hypertensive Indonesia
Emergency in Stroke : Vol. 35 No.
What We Learn From 3 Juni 2018
The Newest Evidence) ISSN: 0216-
6402(Penguk
uran Tingkah
 Laku Pada
Model Nyeri
Neuropatik
● Buku: Joint Meeting Perifer:
On ASNA Tikus dengan
Neuroinfection and CCI (Chronic
The 19th CNE 2018 Constriction
“The Holistic Injury)
Approach In
Neuroinfection”( Lumb
rokinase in Ischemic
Stroke)
● Buku: Joint Meeting
On ASNA
Neuroinfection and
The 19th CNE 2018
“The Holistic
Approach In
Neuroinfection”
(Toxoplasma
Encephalitis)
● Buku: Joint Meeting
On ASNA
Neuroinfection and
The 19th CNE 2018
“The Holistic
Approach In
Neuroinfection”
(Multiple Sclerosis
Overview)
5. Mudjiani Basuki, dr., Actualn Neurol.
Sp.S(K). 2017 November
2017, 17 (3), p.
144-149. DOI : ● Buku The New Era :
10.15557/AN.2017. Towards curative
0015 Neurology, 2017 (CIDP
 Anasthesia : Update Management
Pain and and Prognosis)
Intensive Care ● Buku: The New Era :
(Apicare), Vol Towards Curative
22 (October Neurology
2018) S54-S57 (Management of
(Updates in Spasticity in Cerebral
Management Palsy)
of Guillain
Barre
Syndrome)
6. Muhammad Hamdan,
dr., Sp.S(K)
● Buku The New Era :
Towards curative
Neurology, 2017 (The
Current Management
Advance Parkinson’s
Disease Focus on DBS)
7. Isti Suharjanti, dr., 16th Oceanian
Sp.S(K) Congress of
Neurology Korea
(20 miligram of ● Buku The New Era :
Intramuscular Towards curative
Tremeinolon Neurology, 2017
Injection for
Piriformis
Syndrom Case
report)
8. Yudha Haryono, dr.,
Sp.S(K)
● Buku The New Era :
Towards curative
Neurology, 2017

9. Abdulloh Machin, dr., Anasthesia Pain

Sp.S(K). and Intensive Care
(Apicare), Vol 22
(Oktober 2018)
(Management of
Super refractory
Status Epilepticus)
10. Achmad Firdaus Sani, ● Journal
dr., Sp.S(K). Cerebrovac
Dis 2018,46
(suppll)1-49 ● Buku The New Era :
DOI Towards curative
101159/000493 Neurology, 2017
155
(Corelation
between high
blood pressure
and bleeding
volume with
 degree of
consciousness
and mortality
in
intracerebral
hemorrhage
patients in the
neurologic
Section of
RSUD Dr.
Soetomo in
2014)
● Abstract book
KCR Korea
2018 (Cortical
intracerebral
hemorrhage
due to rupture
of intracranial
peripheral
aneurysm
treated by glue
embolization)
● Journal
Cerebrovac
Dis 2018,46
(suppll)1-49
DOI
(Intractable
Headache
diagnosed as
indirect
carotid
caverbous
fistula
successfully
treated with
embolization)
11. Wardah Rahmatul Anasthesia Pain
Islamiyah, dr., Sp.S(K) and Intensive Care
(Apicare), Vol 22
(Oktober 2018) ● Buku The New Era :
(Management of Towards curative
Super refractory Neurology, 2017
Status Epilepticus) ● Buku Joint Meeting on
ASNA Neuroinfection
and the 19th CNE 2018
(Relationship between
klein Levin syndrome
and upper respiratory
infection)

12. Djohan Ardiansyah,  Differences of

dr., Sp.S(K). Temozolamid
e therapy ● Buku The New Era : ● ●
Response Towards curative
After Neurology, 2017
● Buku Joint Meeting on
Radiochemoth ASNA Neuroinfection
erapy and and the 19th CNE 2018
Surgery in (Neurotoxicuty
Glioblastoma : associated with cancer
Report of Two theraphy)
● Buku Joint Meeting on
Cases ASNA Neuroinfection
Dipresentasik and the 19th CNE 2018
an pada Asian (HIV Infection and
Society For cancer risk, types and
Neuro- treatment option)
oncology
Jepang
 Dutch
Foundation
 for
postgraduate
medical
courses in
Indonesia
Courses on
current
comperhensiv
e management
of CNS
Tumors
(Epidemology
of brain tumor
in Dr.
Soetomo
General
Hospital
Surabaya
13. DR.Hanik Badriyah  Anasthesia Pain ● Majalah
Hidayati, dr., Sp.S(K). and Intensive Neurona
Care (Apicare), vol 36 no
Vol 22 (October  Buku Workshop CNE ● Malang 2 edisi ● Majalah Amal,
2018) Halaman Headache and facial pain Neurology maret Edisi 84, April
S164-S169 (The (Headache and facial Journal. July 2019 2018
Role pain, pratical aspect of 2017; 3(2) : (Bekam ● Majalah Amal,
Neuromuscular occipital nerve blocks 78-87 (Design sebagai Edisi 84, Mei 2018
Electrical third occipital nerve) of Expert terapi ● Majalah Amal,
Stimulation for  Buku Workshop CNE system as a alternativ Edisi 84, Juli 2018
rehabilitation in Headache and facial pain support tool e untuk
ICU Acquired (Optimizing diagnosis for early nyeri)
weakness) and treatment of primary
temporal arteritis) headache)
 Anasthesia Pain
and Intensive
Care (Apicare),
 Vol 22 (Oktober
2018)
(Management of
Super refractory ● Buku The New Era : ● Neurona Vol.
Status Towards curative 34 No. 3 Juni
Epilepticus) Neurology, 2017 2017
 Anasthesia Pain (Recent Guideline For
and Intensive Neurorestoration:
Care (Apicare), What Neurologist
Vol 22 (October Should Know?)
2018) S58-S66 ● 18th Continuing
(Management Neurological Education
Cerebral (CNE) 2nd Scientific
Vasospasm in Meeting Indonesian
Subarachnoid Pain Society (IPS)
Hemorrhage) 2017(Guidelines for
Adult Stroke
 Book of
Rehabilitation and
Abstract
Recovery)
INTERNATION
● Buku The New Era :
AL
Towards Curative
GRADUATE
Neurology(Practical
STUDENTS
Aspect of Occipital
Conference on
Nerve Blocks: Greater
pharmaticeutica
Occipital Nerve)
l science 2018
● Proceeding book INA-
(Review article
TIME 2019 Indonesia
paracetamol,
Tuberculossis
migraine and
International Meeting
medication
2019 (Cerebral
overuse
vasculitis in patients
headache
with tuberculosis)
(MOH))
 Anasthesia Pain
and Intensive
Care (Apicare),
Vol 22 (October
2018) S54-S57
(Updates in
 Management of
Guillain Barre
Syndrome)
 Proceeding Book
AOCN 2018
(Significant
Reduction on
Pain Intensity
with Azatriopine
in Refractory
Tolosal-Hunt
Syndrome Case
Report)
 16th Oceanian
Congress of
Neurology
Korea (20
miligram of
Intramuscular
Tremeinolon
Injection for
Piriformis
Syndrom Case
report)
 Anasthesia Pain
and Intensive
Care (Apicare),
Fourth (March
2019)
(Increasein the
glutamate
transporter 1
and time
withdrawal
latency following
wet cupping
therapy in
chronic
  Asian J pharm
Clin Res
(Atheroprotectiv
e effect of
solanium
betaceum on rat
exposed to
cigarette smoke)
 Asian J pharm
Clin Res
(Solanum
betaceum
improves
cognitive
function by
decreasing n
methyl-d-
aspartate on
Alzheimer rats
model)
14. Mohammad Saiful  Journal
Ardhi, dr., Sp.S(K). Cerebrovac
Dis 2018,46
(suppll)1-49 ● Buku The New Era :
DOI Towards curative
101159/000493 Neurology, 2017
155(Corelation ● Buku Joint Meeting on
between ASNA Neuroinfection
Framingham and the 19th CNE 2018
Point Score (Stroke Pathway
and Cognitive Intracerebral
in primary Haemorrhage)
Health Care) ● Buku Joint Meeting on
ASNA Neuroinfection
 Journal
and the 19th CNE 2018
Cerebrovac
Dis 2018,46
(suppll)1-49
DOI
 101159/000493
155
(Corelation
between high (Posterior Cerebral
blood pressure Review of Vascular
and bleeding anatomy and clinisal)
volume with ● Proceeding book INA-
degree of TIME 2019 Indonesia
consciousness Tuberculossis
and mortality International Meeting
in 2019 (Cerebral
intracerebral vasculitis in patients
hemorrhage with tuberculosis)
patients in the
neurologic
Section of
RSUD Dr.
Soetomo in
2014)
 Proceeding
Book AOCN
2018
(Significant
Reduction on
Pain Intensity
with
Azatriopine in
Refractory
Tolosal-Hunt
Syndrome
Case Report)
15. Fidiana, dr., Sp.S(K)  Anasthesia
Pain and
Intensive Care
(Apicare), Vol ● Buku The New Era :
22 (October
2018) S58-S66
(Management
 Cerebral
Vasospasm in
Subarachnoid
Hemorrhage) Towards curative
Neurology, 2017
● Buku Panduan
Tatalaksana gangguan
tidur (Gangguan
Tidur-Bangun Irama
Sirkadian)

16. Devi Ariani Sudibyo,

dr., Sp.S(K).
● Cephalalgia ● Buku The New Era :
2017. Vol. 37(IS) Towards curative
209-303. Neurology, 2017
● Cephalalgia (Challengs in The Definition
2017. Vol. 37(IS) and Classification of
52-171 refractory headache)
● Proceeding Book ● Indonesia Pain Society
AOCN 2018 Surabaya (Comperhensive
(Significant Management of pain)
Reduction on ● Migraine Expert Academy
Pain Intensity 1,0 (Redefining Migraine
with Azatriopine Management)
in Refractory ● Konsensus Nasional V:
Tolosal-Hunt Diagnosis dan
Syndrome Case penatalaksanaan Nyeri
Report) Kepala kelompok Studi
Nyeri kepala PERDOSSI
(Diagnosis dan
penatalaksanaan nyeri
 kepala kelompok studi
Nyeri kepala PERDOSSI)
● Buku Joint Meeting in
ASNA Neuroinfection and
the 19th CNE 2018 (Acute
Migraine:Current treatment
and Emerging Therapies)
● Proceeding book INA-
TIME 2019 Indonesia
Tuberculossis
International Meeting
2019 (Cerebral
vasculitis in patients
with tuberculosis)

17. Yudhi Adrianto, dr., Bali Medical

Sp.S. (K) Journal 2017 Vol
6 : 1 ; P. 130-134
● J NeuroInter- ● Buku The New
vent Era : Towards
Surg doi:10.1136 curative Neurology,
/neurintsurg- 2017
2016-012267 ● Buku :The
● Journal of Challanges of
NeuroInterventi Neurological
onal Surgery. Development in 4.0
Vol. 9 ; 4. April Generation of
2017. P. 405-410. Industrial
http://dx.doi.org Revolutionary Era
/10.1136/neurint (Gambaran Carotid
Intima Media
Thickness Pada
Penderita Stroke
 Iskemik Akut di
RSUD Dr. Soetomo)
● Buku : Manajemen
surg-2016- HIV/AIDS (Stroke
012267 Pada Pasien
● Abstract book HIV/AIDS)
KCR Korea
2018 (Cortical
intracerebral
hemorrhage due
to rupture of
intracranial
peripheral
aneurysm
treated by glue
embolization)

18. Fadil, dr., Sp.S  Anasthesia ● Aksona Vol ● The 7th

Pain and 1 No. 4 BALI
Intensive Care September- NEURO
(Apicare), Vol ● Buku The New Desember LOGY
22 (October Era : Towards 2019 UPDAT
2018) S54-S57 curative Neurology, (Hubungan E
(Updates in 2017 Lama (BANU)
Management ● Buku Joint Meeting Kerja (Hubung
of Guillain on ASNA Penggunaa an
Barre Neuroinfection and n Kadar
Syndrome) the 19th CNE 2018 Komputer Gamma-
“The Holistic Dengan GT
 Diabetes
Approach in Kejadian Serum
Mellitus 2018,
Neuroinfection Carpal Dengan
21(4) 277-282.
(Early Detection of Tunnel Kecepata
(Correlaton
Tuberculous Syndrome n Hantar
Between High
Spondylitis) Petugas Saraf
Serum Uric
● Buku : Administra Motorik
Acid Levels
The Challanges of si RSUD Pada
With
Neurological Dr. Saraf
 Occurence Of Development in 4.0 Soetomo Peroneus
Diabetic Generation of Industrial Surabaya) Pasien
Peripheral Revolutionary Era Polineur
Neuropathy In (Repetitive Nerve opati
Patients With Stimulation) Diabetik)
Type 2 ● The New
Diabetes Era :
Mellitus In Towards
Soetomo Curative
General Neurolog
Hospital) y(Clinica
l
Predictor
of
Immuno
modulati
on in
Myasthe
nia
Gravis :
Buku)
19. Priya Nugraha, dr., ● Buku :
Sp.S The Challanges of
Neurological
Development in 4.0
Generation of Industrial
Revolutionary Era
(Peningkatan Berat
Badan Pasien Parkinson
Disease Pasca Deep
Brain Stimulation pada
nucleus Subthalmikus)
20. Sita Setyowatie, dr., ● Buku :
Sp.S The Challanges of
Neurological
Development in 4.0
Generation of Industrial
Revolutionary Era
 (Gambaran Carotid
Intima Media Thickness
Pada Penderita Stroke
Iskemik Akut di RSUD
Dr. Soetomo)
24. Deby Wahyuning Hadi,
dr., Sp.S
Total NA= 37 NB= 46 N C= 3 ND= 2 NE=4 NF= 3
Keterangan:

A. Jurnal internasional E. Dokumentasi pada perpustakaan lokal

B. Buku teks ISBN F. Majalah Populer/surat kabar
C. Jurnal nasional terakreditasi

D. Jurnal nasional tidak terakreditasi

Jika SP ≥ 9, maka skor = 4.

SP = 12,7 maka skor = 4.
4.5.5 Keikutsertaan dosen dalam organisasi keilmuan atau organisasi profesi tingkat internasional.

PDNI = Persentase dosen yang menjadi anggota organisasi keilmuan atau organisasi profesi tingkat
internasional.

Jika PDNI≥ 80% maka skor = 4.

Sebutkan keikutsertaan dosen (termasuk dosen di RS Pendidikan Afiliasi dan Satelit) dalam
organisasi keilmuan atau organisasi profesi tingkat nasional dan internasional.

No. Nama Dosen Nama Organisasi Keilmuan atau Organisasi

Profesi
(1) (2) (3)
Nasional Internasional
[Kurun Waktu] [Kurun Waktu]
1 Prof. Dr. H. M. Hasan - PERDOSSI - ASNA
Machfoed, dr., Sp.S(K), [1982-sekarang]
MS - ASNS (Airlangga
Soetomo
Neuroscience
Society)
- INA (Indonesian
Neurological
Association)

2 J. Ekowahono R., dr., PERDOSSI [1990- - World

M.Kes., Sp.S. sekarang] Stroke
Organization

3 Dr. Kurnia 1.PERDOSSI ILAE 2009 –

Kusumastuti, dr., [1997-sekarang] Sekarang
Sp.S(K) 2.ASNS (Airlangga
Soetomo
Neuroscience
Society)
3.MNI
(Masyarakat
Neuroscience
Indonesia)
4 Dr. Paulus Sugianto, PERDOSSI [1999- ● World Stroke
dr., Sp.S(K) sekarang] Organization
● AAN (American
Academy of
Neurology) 2014 -
sekarang
5 Mudjiani Basuki, dr., PERDOSSI [2000- ● International
Sp.S(K). sekarang] Parkinson and
Movement
Disoder Society
(MDS) [2016-
sekarang]
● American
Academy of
Neurology (AAN)
● ASEAN Sleep
Federation 2019
6 DR.Muhammad ● PERDOSS International
Hamdan, dr., Sp.S(K) I [2001- Parkinson and
sekarang] Movement Disoder
● ASNS Society (MDS)
(Airlangga [2006-sekarang]
Soetomo
Neuroscience
Society)
7 Isti Suharjanti, dr., PERDOSSI [2001- International
Sp.S(K) sekarang] Headache Society
IPS (Indonesia [2005-sekarang]
Pain Society)
-IASP 2016 –
sekarang
8 Yudha Haryono, dr., ● PERDOSSI - World
Sp.S. [2002-sekarang] Stroke
● API (Asosiasi Organization
Psikogeriatri
Indonesia)
9 Abdulloh Machin, dr., ● PERDOSSI -
Sp.S(K). [2008-sekarang]
● ASNS (Airlangga
Soetomo
Neuroscience
Society)
● MNI
(Masyarakat
Neuroscience
Indonesia)
10 Achmad Firdaus Sani, 1. PERDOSS - Wold
dr., Sp.S(K)., FINS I [2009- Federation
sekarang] International
2. KNI and
(Kolegium Therapeutic
Neurologi
 Indonesia) [2015- Neurradiology
2019]
2017-Sekarang
- Society of
vascular
Interventional
Neurology
2016 -
sekarang
- ASEAN
Neurointerventi
on Asociation
2018 - 2023

11 Wardah Rahmatul 3. PERDOSS ILAE 2016 - Sekarang

Islamiyah, dr., Sp.S(K) I [2009-
sekarang] ASEAN Sleep
4. KNI Federation 2019 -
(Kolegium sekarang
Neurologi
Indonesia) [2011-
2015 ; 2015-
2019]
12 Djohan Ardiansyah, dr., PERDOSSI [2009- International
Sp.S(K). sekarang] Parkinson and
Movement Disorder
society 2019 –
Sekarang

13 DR. Hanik Badriyah PERDOSSI [2011- CBEES 2018 –

Hidayati, dr., Sp.S. sekarang] Sekarang
14 Mohammad Saiful PERDOSSI [2012- World Stroke
Ardhi, dr., Sp.S(K). sekarang] Organization 2018
15 Fidiana, dr., Sp.S(K) PERDOSSI [2012- ●ASF (Asean Sleep
sekarang] Federation) 2019
●International
Parkinson and
Movement
Disoder Society
(MDS) [2016-
sekarang]
16 Devi Ariani Sudibyo, PERDOSSI [2013- IASP-PAIN
dr., Sp.S(K). sekarang] IHS 2018 -2019
17 Yudhi Adrianto, dr., PERDOSSI [2013- KSR (Korean
Sp.S(K). sekarang] Society of
Radiology) [2015-
sekarang]

18 Fadil, dr.,SpS PERDOSSI [2013-

sekarang]
19 Priya Nugraha dr., PERDOSSI [2015- Movement
Sp.S. sekarang] Disoreder Society
2016 – Sekarang
20 Sita Setyowatie dr., SpS PERDOSSI [2015-
sekarang]
21 Deby Wahyuning Hadi PERDOSSI [2016-
sekarang]