Developing Equitable Policies for Task-Shifting from Supervisors to Resident Doctors in Indonesian Teaching Hospitals: A Legal and Ethical Framework

Background: Task-shifting from supervisors to resident doctors is critical to specialist medical education in Indonesia. While broadly regulated under Law No. 17 of 2023, the absence of specific derivative regulations creates significant challenges, including role ambiguity, increased risk of medical errors, and inequities in supervision. Aims: This study aims to critically evaluate the proposed implementation of international best practices within Indonesia’s unique healthcare system and formulate a legal and ethical framework for equitable task delegation. Methods: Employing an empirical juridical approach, the study integrates in-depth interviews, document analysis, and legal doctrinal reviews across multiple teaching hospitals. Result: Findings indicate that the absence of derivative regulations leads to ambiguity in authority, inconsistent supervision practices, and heightened medical risks. International models such as the ACGME and EU directives offer useful insights but require contextual adaptation. This study further highlights systemic barriers in Indonesia, including resource constraints, logistical challenges, and political inertia. The critical role of supervisors is emphasised, necessitating clear training, certification, and accountability standards. Conclusion: There is an urgent need for a structured and localised task-shifting policy framework that integrates global standards while addressing Indonesia's practical realities. The proposed model outlines legal clarity, equitable delegation mechanisms, competency-based assignments, and institutional accountability.