The curriculum of the Undip Faculty of Medicine’s Anesthesiology and Intensive Care Specialist Doctor Program contains competencies that must be possessed by students, with reference to national requirements (in accordance with KKNI standards), professional standards (Anesthesiology and Intensive Care College), and local requirements (institutional and regional standards) that continue to develop by meeting international standards (World Federation Society of Anesthesiologists – WFSA) in both core and supporting competencies. The breadth, depth, and coherence of the curriculum are outlined in the Guidebook for the Anesthesiology and Intensive Care Specialist Doctor Education Program at the Faculty of Medicine, Diponegoro University. The Anesthesiology and Intensive Care Specialist Doctor Education Program at FK Undip is completed in 8 semesters.

In accordance with Ministry of Education and Culture Regulation No. 49 of 2014 on National Standards for Higher Education, KATI has formulated learning outcomes for specialist education in line with the three competency domains of Anesthesiology and Intensive Care Specialists, as detailed below:

a. Attitude Formulation
1. Being devoted to God Almighty and able to demonstrate religious attitudes;
2. Upholding human values in carrying out duties based on religion, morals, and ethics;
3. Contributing to the improvement of the quality of life in society, nation, state, and the advancement of civilization based on Pancasila;
4. Acting as a proud citizen who loves the homeland, possesses nationalism and a sense of responsibility to the state and nation;
5. Respecting cultural diversity, views, religions, and beliefs, as well as the opinions or original findings of others;
6. Cooperating and possessing social sensitivity and concern for the community and environment;
7. Obey the law and maintain discipline in social and state life;
8. Internalize academic values, norms, and ethics;
9. Demonstrate a responsible attitude towards work in the field of Anesthesiology and Intensive Care independently;
10. Internalize the spirit of independence, struggle, and entrepreneurship;
11. Professional ethics of Anesthesiology and Intensive Care Specialists that are good and beneficial to the community, with good attitudes towards patients, educators and colleagues, paramedics and non-paramedics, discipline and responsibility, compliance in filling out medical documents, compliance in carrying out assigned tasks, and compliance in implementing guidelines for the use of drugs and equipment;
12. Communicating with colleagues, patients and their families, paramedics, and teaching staff in an honest, open, and friendly manner;
13. Good cooperation between colleagues, doctors, nurses, health workers, patients, and patients’ families, and the ability to work together harmoniously as a team to provide optimal service; and
14. Following Patient Safety guidelines, including: IPSG 1-6 (Identification, hand washing, timeout, effective communication, infection prevention, and medication administration).

b. General Knowledge Formulation

1. Basic Medical Science
a) Understanding the physiology of bodily functions in normal conditions, the relationship between these functions and changes in function that may arise in anesthetic practice, particularly the physiology of pain, respiration, circulation, the central and peripheral nervous systems, hemostasis, the neuromuscular junction, the kidneys, metabolism, and endocrinology;
b) Understanding pharmacology, including general pharmacology principles, pharmacokinetics, and pharmacodynamics of anesthetic drugs, analgesics, sedatives (central nervous system depressants and stimulants), muscle relaxants, emergency drugs, and other supportive drugs;
c) Understand the principles of physical and chemical properties in the application of Anesthesiology and Intensive Care;
d) Be able to explain the application of basic medical science in the field of Anesthesiology and Intensive Care.

2. Basic Specialist Clinical Medicine in Anesthesiology and Intensive Care
a. Able to understand the working principles of anesthesia equipment or machines, as well as invasive and non-invasive monitoring devices, ECG, pulse oximetry, capnography, nerve stimulators, BIS, ultrasound, x-ray imaging, and C-arms;
b. Able to understand/interpret laboratory test results, chest X-rays, head scans, ECG, echocardiography, and other necessary tests;
c. Able to understand how to position patients safely after surgery and know the adverse effects;
d. Understand the suitability of anesthesia machines and ventilators as well as other supporting equipment;
e. Knowledge of the pathophysiology of diseases/comorbidities associated with the patient’s condition and related to anesthesia;
f. Understanding of the physiology and pathophysiology of diseases and comorbidities in pediatric and neonatal patients;
g. Understanding of anesthesia theory in surgery, both for adult and pediatric patients;
h. Understand the theory of regional anesthesia, including peripheral nerves, subarachnoid, and epidural;
i. Understand the theory of premedication, induction, maintenance of anesthesia, and post-anesthesia/surgical management;
j. Understanding the specific problems of anesthesia in general surgery, ENT surgery, eye surgery, and obstetric and gynecological surgery
k. Understand the signs of anesthesia complications and be able to quickly overcome these problems;
l. Understand early on life-threatening emergencies, whether during induction, during anesthesia, or after anesthesia, and in critical situations, and know how to overcome them;
m. Understand the theory of cardiopulmonary resuscitation (CPR);
n. Understanding the management of trauma patients in life-threatening emergencies and/or with disabilities;
o. Understanding the theory of acute and chronic pain.

Skills
a. Able to assess the preoperative condition of patients;
b. Able to optimize the condition of patients before surgery;
c. Able to perform techniques and interpret monitoring of vital functions, ECG, pulse oximetry, capnography, neuromuscular monitoring;
d. Able to operate an anesthesia table;
e. Able to operate various anesthesia machines;
f. Able to perform several techniques of inhalation, intravenous, and rectal anesthesia induction;
g. Able to use face masks, laryngeal masks, tracheal intubation, and perform anesthesia maintenance safely;
h. Able to manage the airway using the methods mentioned above;
i. Able to provide assisted ventilation and manual controlled ventilation
j. Able to perform extubation and monitor post-extubation and post-anesthesia problems and complications;
k. Able to perform spinal, epidural, and peripheral nerve block anesthesia/analgesia techniques and able to manage acute complications that may occur;
l. Able to perform cardiopulmonary resuscitation (CPR), basic life support, and advanced life support;
m. Able to manage patients in life-threatening and/or disabling emergencies;
n. Able to manage post-anesthesia patients, both in the recovery room (Post Anesthesia Care Unit / PACU) and in the ICU;
o. Able to administer anesthesia for digestive surgery;
p. Able to administer anesthesia for orthopedic surgery;
q. Able to administer anesthesia for trauma;
r. Able to administer anesthesia for plastic surgery;
s. Able to administer anesthesia for oncology surgery;
t. Able to administer anesthesia for eye surgery;
u. Able to administer anesthesia for ENT and oral surgery;
v. Able to administer anesthesia for urological surgery;
w. Able to administer anesthesia for pediatric surgery;
x. Able to administer anesthesia for geriatric surgery;
y. Able to perform outpatient anesthesia;
z. Able to perform anesthesia outside the operating room.

3. Advanced Clinical Medicine Specialization in Anesthesiology and Intensive Care
Knowledge
a. Understanding the problems and techniques of anesthesia in brain surgery, heart surgery, lung surgery, and transplant surgery;
b. Understanding critical care theory in cases in the Intensive Care Unit;
c. Understanding how to perform clinical procedures and their use, invasive procedures such as central venous catheter placement, intra-arterial catheter placement, Swan Ganz catheter placement, cricothyrotomy, pleural puncture in pneumothorax, and others;
d. Mastering the important principles of critical patient management;
e. Understanding how to manage an ICU unit;
f. Understand disaster management systems.

Skills
a. Able to assess ICU patients, both post-surgical and non-post-surgical, and perform initial actions for life-threatening conditions;
b. Able to administer anesthesia for neurosurgery;
c. Able to assist in open heart surgery anesthesia;
d. Able to administer anesthesia for lung, vascular, and closed heart surgery;
e. Able to administer anesthesia for special conditions;
f. Able to perform difficult intubation
g. Able to manage PACU/RR, High Care Unit (HCU), and ICU patients;
h. Able to perform invasive procedures: central venous catheterization, intra-arterial catheterization, cricothyrotomy, intrapleural puncture;
i. Able to respond to consultations in the field of anesthesia, ICU cases, and pain management;
j. Able to perform and coordinate disaster management.

4. ICU / Intensive Care Management

Knowledge
a. Understand the general principles of emergency and critical care medicine, RJPO which includes Basic Life Support, Advanced Life Support, and Prolonged Life Support;
b. Able to explain the indications for admission to and discharge from the ICU;
c. Able to explain the indications and management of invasive procedures, such as central venous catheter placement, Swan-Ganz catheter placement, intra-arterial catheter placement, Continuous Renal Replacement Therapy (CRRT), pericardiocentesis, and tracheostomy;
d. Able to explain airway management and respiratory support with/without mechanical ventilation;
e. Recognize signs and symptoms that threaten the patient’s life due to respiratory, cardiovascular, central nervous system disorders, fluid balance disorders, acid-base and electrolyte imbalances, severe infections, hemostasis disorders, metabolic and endocrine crises, kidney and liver function disorders;
f. Able to explain the management of nutrition, sedation, analgesia, and thermoregulation in critically ill patients;
g. Able to determine classic death and brain stem death;
h. Able to explain end-of-life care: withdrawing and withholding life support.

Skills
Mastering skills in clinical procedures, both for monitoring, diagnosis, and therapy
a. Central venous catheter placement, intra-arterial;
b. Pleural puncture placement for ventil pneumothorax, and cricothyrotomy;
c. Managing life-threatening conditions in patients due to respiratory, cardiovascular, central nervous system disorders, fluid, acid-base and electrolyte imbalances, severe infections, hemostasis disorders, metabolic and endocrine crises, and kidney and liver dysfunction;
d. Able to manage nutrition, sedation, analgesia, and thermoregulation in critical patients;
e. Consulting with other medical disciplines at the appropriate time;
f. Responding to consultations from patients in other wards or hospitals who will be treated in the ICU;
g. Communicating with colleagues from several related disciplines as part of a team;
h. Providing guidance to program participants or other residents, medical students, and nurses
i. Able to manage and care for infants in the ICU/NICU;
j. Able to manage and care for children in the ICU/PICU;
k. Able to manage and care for adults in the ICU.

c. Skill Formulation
1. General Skill Formulation
Graduates of the PPDS program must possess the following general skills:
a) Ability to work in the field of Anesthesiology and Intensive Care and possess professional competencies that are at least equivalent to nationally/internationally recognized professional standards;
b) Ability to make independent decisions in performing professional duties based on logical, critical, systematic, creative, and comprehensive thinking;
c) Able to compile study reports equivalent to a thesis, the results of which are published in nationally/internationally accredited professional scientific journals, or produce specific design works and their descriptions based on design methods or rules and professional codes of ethics recognized by the professional community at the national and international levels;
d) Able to communicate the results of studies, critiques, appreciations, arguments, or innovative works that are beneficial to professional development, entrepreneurship, and human welfare, which are scientifically and professionally ethical, to the general public through various forms of media;
e) Able to critically evaluate the work results and decisions made in carrying out their professional work, whether by themselves, their peers, or their institutional system;
f) Able to improve their professional skills in the field of Anesthesiology and Intensive Care through training and work experience, taking into account the latest developments in Anesthesiology and Intensive Care at the national, regional, and international levels;
g) Able to improve the quality of resources for the development of strategic organizational programs;
h) Able to lead a work team to solve problems, both in the field of Anesthesiology and Intensive Care, as well as problems that are broader than their field;
i) Able to collaborate with other professionals in the same field or other fields in solving complex work problems related to the field of Anesthesiology and Intensive Care;
j) Able to develop and maintain a network with the medical profession and clients;
k) Able to take responsibility for work in the field of Anesthesiology and Intensive Care in accordance with the Indonesian medical code of ethics;
l) Able to improve the learning capacity of themselves and the team under their responsibility;
m) Able to contribute to the evaluation or development of national policies in order to improve the quality of education in Anesthesiology and Intensive Care or the development of national policies in the health sector;
n) Able to document, store, audit, secure, and retrieve data and information for the purposes of developing the results of their professional work.

2. Anesthesiology and Intensive Care Skills
a) Provide comprehensive anesthesia services in accordance with Standard Operating Procedures, medical ethics, and law;
b) Able to provide comprehensive or advanced life support services in emergencies in accordance with Standard Operating Procedures, medical ethics, and law;
c) Providing comprehensive intensive care services in accordance with Standard Operating Procedures, medical ethics, and laws;
d) Providing comprehensive pain management services in accordance with Standard Operating Procedures, medical ethics, and laws;
e) Producing scientific works that comply with national and international scientific standards.

Assessment of learning outcomes is carried out through competency achievement, namely the achievement of a minimum number of cases that have been handled or worked on during the education period of Anesthesiology and Intensive Care Specialist Doctors, whether worked on independently or under supervision/guidance in accordance with the competency level specified in the KATI Competency Standards.
Competency levels are the levels of ability that must be achieved, which are divided into 4 levels of ability, namely:
➢ Competency Level 1 (Knows): knows and is able to explain a clinical skill or clinical picture of a disease, and is able to master the theoretical knowledge, including the biomedical and psychosocial aspects of the skill, so that they can explain the principles, indications, and possible complications to patients/clients and their families, colleagues, and other professionals;
➢ Competency Level 2 (Knows how): has seen or been demonstrated a clinical skill, has mastered the theoretical knowledge of this skill with an emphasis on clinical reasoning and problem solving, and has had the opportunity to see and observe the skill in the form of a demonstration or direct implementation on a patient
➢ Competency Level 3 (Shows): has performed or applied a clinical skill under supervision on a mannequin and/or patient, has mastered the basic theoretical and scientific knowledge of the skill, including its background and clinical and psychosocial impact.
➢ Competency Level 4 (Does): able to perform independently, namely able to diagnose, perform management independently and thoroughly, and demonstrate their skills by mastering all theories, principles, indications, steps, complications, and complication control.