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Department of Internal Medicine

History of Department of Internal Medicine

 

In 1950 until 1955, internal medicine was lead by Prof. Aulia (graduated from Stovia in 1913). At that time, the member of this department was still a few, among them were Prof. RD Asikin Widjajakusumah (professor), Dr. Oei Eng Tie (lektor), Dr. Lie Kioeng Foei (health ministry doctor), Dr. Bert Djauhar (then move to surgical dept.), Dr. Bahder Djohan, Dr. A. Ramali (head of infection policlinic), and doctors who works at clinic, which are Dr. Kusumasudjana (health ministry doctor), Dr. Sagaf (health ministry doctor), and Dr. R. Karmawan (health ministry doctor). At that time, internal medicine polyclinics were located at room 15, 16, and 17 (now being used for college student). In 1951-1953 there was additional staff such as Dr. Rasmin Rasjid (now professor), dr. ANS Kamarga, and dr. Utojo Sukaton (now professor). There were several rooms used as ward at that time. Barak A (ward A) with 48-bed capacity headed by dr. Bert Djauhar (then replaced by dr. Utojo Sukaton), while ward H3 headed by dr. Lie Kioeng Foei.

1950 was the year when Indonesia gains its sovereignty from Netherland. After that, the opportunity to develop internal medicine with our own power was open-wide. When Prof. Aulia being head of Internal Medicine Department, he was trying to show that doctor in Indonesia, even with simple equipment, were capable to develop themselves without being dependent to Netherland’s doctor. Health problem at that time differ than now, drug of choice wasn't as much as today, and laboratory examination and other equipment to support diagnosis was still very simple and limited, such as fluoroscopy (lung CB), electrograph, and equipment to calculate basal metabolism rate (BMR).

Even with limited staff and equipment, due to their strong intention to build this country, their achievements were quite high. Staffs of Internal Medicine summon up their power and time to build both of education side and health service. Even the field of research also went well.  Some research on the medicine in successfully published in international magazines such as JAMA (Journal of American Medical Association).

 

Development of Divisions

 

During Prof. Aulia became head of the department, there were several branches of internal medicine such as pulmonology, cardiology, infection, and psychosomatic which has been developed. Along with the development of science and the needs of the community service, thus forming the divisions as known today. The development of each division within the department is a core in advancing the science.

 

When the division of Cardiology established, cardiac care is still combined with other sufferers. There were availability of fluoroscopy and ECG as medical devices. Then, this division developed gradually. Through cooperation with the surgical department and radiological department, this division has successfully performed cardiac catheterization procedure. To improve emergency care of heart patients,dr. Lie Kioeng Foei pioneering ICCU establishment in 1971 and that was the first in Indonesia. Then, more and more equipment were completed such as treadmills, phonocardiography, and echocardiography.

 

In 1979, the pulmonology division was established, headed by Dr. Ahmad Dahlan. At the same time, RSCM successfully completed the medical equipment such as a pulmonary function tests, bronchoscopy, etc. At that time, cholera and other GED were one of the leading causes of death in the society. Faced with this problem, developed a way to assess the loss of body fluids based on clinical symptoms and signs, named a scoring system (1970). Besides the management of GED, there were also conducted various studies to improve the management of other infectious diseases such as typhoid fever, malaria, amoebiasis, and worm diseases. In 1984 dengue start to infecting adults so that division of tropical infection develop guideline for the management of DHF in adults in cooperation with the Division of Hematology.

 

When established in 1963, Division of Gastroenterology only has a few simple procedures such as businasi for achalasia, SB Tube stop upper gastrointestinal bleeding and rigid endoscope (rigid) used to anuscopy and proktosigmoidoscopy.

 

The discovery of hepatitis markers and ultrasound opens new horizons in the field of hepatology. Dr. RTL Pang pioneered liver biopsy since 1953. This method is useful to sharpen the diagnosis of liver disease. In 1975 ultrasound device was used, but in some types of liver disease, biopsy and peritoneoscopy were still required. Hepatitis B, cirrhosis, and liver cancer were a problem that being researched in the Division of Hepatology. Management of hematemesis and melena was then developed in conjunction with the Division of Gastroenterology.

 

Since 1966, there was the establishment of the division of Renal and Hypertension led by Dr. RP Sidabutar. One of the problems faced is kidney failure. To resolve this problem in 1969, the division started peritoneal dialysis. In 1970, thanks to the help of dialysis machines from abroad, we have been able to done hemodialysis. Chronic hemodialysis program started in 1971. In an effort to overcome the problem of kidney failure, kidney transplant program implemented in 1977.

 

In the internal medicine ward, diabetes mellitus cases were often. Metabolism and endocrine clinic was also one of the clinics that had been visited by many people. Division of metabolic and endocrine was initiated by dr. Utojo Sukaton. Since 1971 he conducted counseling in group of DM patients and their families on a regular basis in collaboration with clinical nutrition RSCM. Various studies conducted to treat the complications of diabetes such as diabetic gangrene in non-surgical. Similarly, ketoacidosis protocol that use insulin infusion was developed in order to guide the management of ketoacidosis. Thanks to advances in medical technology such as ultrasound, thyroid scan, and fine needle biopsy so that the diagnosis of thyroid disease can be sharpened, whereas in the medical field this division can do aspiration and treatment for sclerosing thyroid cyst.

 

At the time of its establishment, division of hematology can only do peripheral blood smear and bone marrow biopsy. Then, cytology for various malignancies in blood began to be developed. Similarly, researches in the field of non-Hodgkin lymphoma were also begun to develop. Progress in the field of immunology resulted monoclonal antibody use since 1983 and HIV serology testing since 1985.

 

Division of allergy and immunology started activities in 1971 and have been able to perform skin tests for a variety of allergens as well as intracutaneous desensitization treatment. In 1978, provocation tests can be performed to assess bronchial hyper reactivity. Furthermore, assessment of the immune status in vivo and in vitro, as well as the identification of allergen, was being developed.

 

The establishment of division of rheumatology was expected to improve the quality of life of patients with rheumatic diseases. Assessment of the disease such as joint fluid examination, rheumatic factor, and double stranded DNA for SLE began to be developed. Rehabilitation efforts initiated by dr. Remy Nasution, who was then serving as head of division as well as head of Medical Rehabilitation Unit RSCM.

 

Development in the Field of Education

 

In addition, Department of Internal Medicine, as part of the Faculty of Medicine, University of Indonesia, also serves as an educational area for medical student as well as specialist program. Department of Internal Medicine developing a system for both inpatient and outpatient care by putting supervisor (specialist). Specialist based care while assistant experts work as support. The presence of the assistant expert can support care and research program that prioritizes health services which hope can improve the quality of service, so the RSCM-FKUI cooperation will be beneficial for both parties. In the past, specialists of Medicine who was educated in the Department of Internal Medicine parted in a variety role in Faculty of Medicine within Indonesia. Among them are Prof. Kadri (USU), Prof. Hanif (UNAND), dr. Tondobala (UNSRI), Prof. MZ Hazman (UNPAD), Prof. Budi Darmojo (UNDIP), Prof. Soekono (Airlangga University) and Dr. Handono Kalim (UNBRA).

 

Since its inception, the Department of Internal Medicine in conjunction with RSCM and FKUI has been developed in an effort to solve health problems in the community. If comparing the initial state to the state stands now, it has been a lot of progress made by the Department of Internal Medicine. Until now, Department of Internal Medicine is still trying to develop to actualize the vision and mission as well as trying to be the best in terms of health service, education, and research.

 

Vision and Mission

 

VISION & MISSION

“To become an international centre of internal medicine health services, education and research with an excellent quality, in order to provide  infinite experiences for important stakeholders”

Strategic aims:
1.Providing an excellent satisfaction for stakeholders.
2.Providing excellent quality of health services, education and research.
3.Creating cost- containment health services, education and research.
4.Interationally accredited.
5.To establish a network of health services and education systems in order to make “Cipto Mangunkusumo Hospital-University of Indonesia” as an acute tertiary care hospital.
6.To become an integrated centre of research, health services and education with excellent quality.
7.To establish excellent management system dan quality control at working units.
8.Creating Cipto Mangunkusumo Hospital-University of Indonesia to be the best place to work.
9.Creating a culture of hardworking and a willingness to help others.

 

Service

 

Services
 
1) Diabetic Foot Clinic
2) Digestive Endoscopy Service Centre (PESC)
3) National Geriatric Center
4) Therapeutic Apheresis
5) Autologous Bone Marrow Transplantation
6) Adult Thalassemia Clinic
7) Integrated Kidney Center
8) Palliative Care Services
9) Integrated Services Center for Tropical and Infectious Diseases
10) High-Dose Chemotherapy Service Center
11) Radiofrequency Ablation for Hepatoma
12) Services for Drug Allergies and Anaphylactic
13) Service Center for Peripheral Blood Vessels
14) Endobroncial Bronchoscopy Ultrasonography (EBUS) Services
15) Musculoskeletal Ultrasound Services
16) Integrated Cardiac Care
17) Integrated Procedure Facilities