DR. MAULINA SARI Puskesmas Pangalengan, Jalan Raya Pangalengan no. 1, Pangalengan , Kabupaten Bandung, Jawa Barat, Indonesia +62-81252936862 [email protected] Service Record for Application as Medical Doctor Specialty Area: General Practicioner/ER Physician/Primary Health Care/Occupational Medicine Physician 1. Formal Education Background Year Formal Education Course Award Educational Institution 01.05.2000 Bachelor of Medical Science Graduated (2nd Class) National Education Department, University Syiah Kuala, Banda Aceh, Indonesia. 01.11.2002 Doctor (dr.) Degree Graduated National Education Department, University Syiah Kuala, Banda Aceh, Indonesia. 27.4.2012 Certified Competency as General Physician for Primary Health Care Services Certified Collegium of Indonesian Physician, Indonesia 7.11./2016 Certified Competency as General Physician for Primary Health Care Services Validity: 7.11.2016 – 26.2.2021 Certified Collegium of Indonesian Physician, Indonesia 1|P a g e 2. Professional Practice Registration/ License & Competency Certification No 1 2 Details Date Certified (D-M-Y)/ Validity Puskesmas Pangalengan DTP, Jalan Raya Pangalengan No. 1, Kabupaten Bandung, Jawa Barat Klinik Prima Medika Salatiga Green Valley Residence #21 Jalan Arjuno, Karangalit, Dukuh, Salatiga, Central Java 50722, Indonesia 01.03.2018 - Sekarang 27.3.2017-26.2.2022 3 Registration Certificate of Doctor The Indonesian Medical Council, Indonesia 4 Certified Competency as General Physician for Primary Health Care & Services Collegium of the Indonesian Physicians, Indonesia 7.11.2016 – 26.2.2021 5 Registered Doctor at RSUD Dr. Soetomo General Hospital Public Health Care & Service, Surabaya, Indonesia 20.11.2011-20.11.2016 6 Certificate of Doctor Registration The Indonesian Medical Association, Indonesia 20.11.2011-20.11.2016 7 Registered Doctor at Pondok Pesantren Al-Amien Prenduan Public Health Care & Service, Madura, Sumenep, Indonesia 5.8.2011-20.11.2011 8 Certificate of Doctor Registration The Indonesian Medical Association, Medan, Indonesia 5.8.2011-20.11.2011 9 Licensed General Physician Ministry of Health, Indonesia 10 27.3.2017-26.2.2022 5 years Certificate of Doctor Registration Public Health Service, Aceh, Indonesia 2002 ***Copies of Certificates as Attached in (2) MD Competency & Registered License folder 3. Academic Training/ Courses No. Training & Courses Host/ Institution Date Certified 1 Women’s Security Awareness – Safe Travel, Survival as Hostage, Violence Amongst Women United Nations Dept. of Safety & Security, UN House, Port of Spain – Trinidad &Tobago 6.10.2015 2 Basic Security in the Field II United Nations Dept. of Safety & Security, UN House, Port of Spain – Trinidad &Tobago 14.8.2014 3 ASITF English Language United Nations Dept. of Safety & Security, UN House, Port of Spain – Trinidad &Tobago 14.9.2014 2|P a g e 4 HSE Disaster Management & Humanitarian Settings - Infectious Tropical Diseases Short Course Griffith Univ. in assoc. IFEH, EHSA & University Airlangga, Surabaya, Indonesia 28-29.4.2014 5 NLS Neonatal Life Support RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia 27-28.4.2013 6 Improving Services to Public RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia 10-12.7.2012 7 GELS General Emergency Life Support, RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia 1-3.5.2012 8 TOEFL Course Language Center of Universitas Sumatra Utara, Indonesia 12.8.2010 9 Basic Trauma & Cardiac Life Support Department of Research for Nursing Care Aceh, Indonesia 10 Earthquake, Tsunami & Volcano Safety Training UNDSS-I United Nations Dept. of Safety & Security Field Office (West), Banda Aceh, Indonesia 11 Occupational Medicine Faculty of Medicine, University Indonesia, Jakarta, Indonesia 12 Microsoft Office (Full Package) 13 Advanced Trauma Life Support IKABI Association of Specialists Surgeons Indonesia & The American College of Surgeons on Trauma SCC Computer Center Medan, North Sumatera, Indonesia RSU Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia 21-24.7.2009 13.10.2009 17-28.4.2006 16.08.2007 30.5.20031.6.2003 ***Copies of Certificates as Attached (5) CME Training & Short Courses folder 4. Career Progression Record A. Work History Employment Period Start End Job Title Specialty Employer/ Place of Work Reasons For Leaving 23rd Dec 2002 26th Dec 2004 - Doctor - Rapid Response Disaster Physician 1. Emergency/ Trauma Unit 2. Natural disasters Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia - Government Affected by natural disaster – tsunami 2005 7th Jan 2005 30th June 2005 Tsunami Disaster Team 1. Emergency/ Trauma Unit Dr. Zainoel Abidin General Hospital, End of Contract 3|P a g e 2. Natural disasters Banda Aceh, Indonesia - Government PT. Arun LNG (Liquified Natural Gas) Company Hospital, PERTAMINA, Banda Aceh, Indonesia - Government 1st July 2005 31st Dec 2006 Occupational Medicine 1. Emergency/ Trauma Unit 2. Clinic duties 3. On Call 1st Nov 2011 31st Oct 2009 DOKTER PTT Primary Health Care Physician KAJEUNG Public Health Center, West Aceh, Indonesia - Government End of Contract 11th Oct 2007 31st Mar 2010 1. Post tsunami recovery for UN Staffs 2. Referral United Nations UNDP, Banda Aceh, Indonesia - International World Organization End of Contract End of Contract UNDP Physician 19th Apr 2010 19th Apr 2011 Homeopathy Assistant Homeopathy medicine Prof. Dr. M. Simanjuntak MD.Hom, Medan, Indonesia - Private End of Contract 1st Aug 2011 31st Dec 2011 Doctor (Nonfixed Term, subcontract) Primary Health Care Physician GAPURA Public Health Center, Madura, Indonesia - Government End of Contract 5th Aug 2011 30th Apr 2012 General Practitioner (GP) 1. Emergency/ Trauma Unit 2. Clinic duties 3. On Call PONDOK PESANTREN AL-AMIEN, Madura, Indonesia - Government End of Contract 2nd Apr 2012 30th Mar 2015 - Physician - Rapid Response Disaster Physician DR. SOETOMO General Hospital, Surabaya, Indonesia - Government End of Contract 30th Sept 2014 31st Dec 2016 1. Triage at Trauma Unit 2. Natural disaster 3. Ambulance On Call 4. CPR trainer General Physician Baraka Foundation, United Nations UNDP Trinidad & Tobago – Caribbean Islands End of Contract (evidence of service presented as Salary Slip from UNDP/ refer to testimonial) UNDP International Volunteer Doctor ***Copies of Certificates as Attached (3) Appointment Letters folder 4|P a g e B. Record of Formal Appointments Year Appointing Body/ Host Designation Brief Description 9.9.201719.11.2017 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Doctor Hajj Pilgrimage Health Check 29.8.2014 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Ambulance Medic Duty RSUD Dr. Soetomo - Harahap Hospital, Jakarta 23-24.1.2014 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Trainer/ Facilitator Nursing & Mid-Wives Courses for new graduates of nurses and midwives Competing Team Organizational Resuscitation Competition at 1st Emergency Medicine Conference 27.9.2013 1.9.2013 Port Health Office, Office of Director General Environmental Health, Surabaya – Indonesia Doctor Hajj Pilgrimage Health Check 1-31.7.2013 Airlangga University, Surabaya, Indonesia RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Trainer/ Facilitator Trainer/ Facilitator Managing Trauma, Accident & Emergency Cases Trauma, Accident & Emergency At 1st Annual Scientific Meeting on Emergency Medicine 28.1.201313.2.2013 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Trainer/ Facilitator BLS Basic Life Support 28-29.1.2013 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Trainer/ Facilitator GELS for Nurses & Mid-Wives 3-5.12.2012 RSUD Dr. Soetomo General Hospital, Surabaya, Indonesia Trainer/ Facilitator GELS General Life Support 7-30.1.2005 National Disaster Management, MOH - Medan, Indonesia Flying Doctor Providing relief services to areas affected by natural disasters 19-28.2.2013 ***Copies of Certificates as Attached (3) Appointment Letters folder 5|P a g e 5. Professional Development and Growth – Continuing Medical Education Date / Year Brief Description Programs / Role Participant 9.3.2015 Addressing Insulin Challenges Airlangga University, Surabaya, Indonesia 17.5.2014 Symposium: Prevention & Management of Tetanus The Indonesian Medical Association Surabaya, Indonesia Participant 2224.8.2014 Symposium: Dignity & Happiness in Golden Age Regional Scientific Conference VI, East Java, Indonesia Participant 8.11.2014 22nd AHML International Homeopathic Conference Kuala Lumpur, Malaysia Participant Dec. 2013 Drug Use in Elderly Patients KALBE Medical Online Portal – CDK Online Sept. 2013 Thyroid Hormones & Effects on the Heart KALBE Medical Online Portal – CDK Online Aug. 2013 Intra Hepatic Cholestasis KALBE Medical Online Portal – CDK Online Aug. 2013 Lymphoma Diagnosis & Intervention KALBE Medical Online Portal – CDK Online May 2013 Management of Diabetes Mellitus in Fasting Month KALBE Medical Online Portal – CDK Online May 2013 Endometriosis Management & Practical Pathology KALBE Medical Online Portal – CDK Online 20.4.2013 Conference - Nutrition & Body Fluid in Children 10th POCARI Sweat Conference, Sheraton Surabaya, Indonesia Participant Jan.2013 The Pleura Anatomy & Physiology KALBE Medical Online Portal – CDK Online Nov.2012 Managing Subarachnoid Bleeding KALBE Medical Online Portal – CDK Online Aug. 2012 Dyspepsia KALBE Medical Online Portal – CDK Online Aug. 2012 Anemia & Issues with Pregnancy KALBE Medical Online Portal – CDK Online July 2012 Periodic Familial Hypokalemic Paralysis Online 6|P a g e KALBE Medical Online Portal – CDK 8.1.2012 Strategy to Control the Threat of Bug Infection Airlangga University, Surabaya, Indonesia Participant Sept. 2011 Pioglitazone Metformin Therapy KALBE Medical Online Portal – CDK Online Jan. 2011 Signs & Management of Stroke KALBE Medical Online Portal – CDK Online 28.4.2007 Symposium: Managing Snoring Diponegoro University, Semarang, Indonesia Participant 17.2.2007 Seminar: Managing Hearing Loss & Deafness Diponegoro University, Semarang, Indonesia Participant 26.4.2004 Symposium: Managing Severe Infections Association of Indonesian Surgeons Participant 31.32003 Symposium: Parenteral Therapy for Admitted Patients Syiah Kuala University, Aceh, Indonesia Participant 27.5.2002 Seminar: Smart Children - EQ, IQ & SQ Sallimah Muslimah Sisterhood, Banda Aceh, Indonesia Participant 2.5.1999 Hepatitis - The Unforgiving Threat RSU Dr. Zainoel Abidin General Hospital Banda Aceh, Indonesia Participant 14.12.1997 Dialogue: Marriage & Reproductive Health Syiah Kuala University, Aceh, Indonesia Participant 15.6.1997 Seminar: Early Detection of Cervical & Breast Cancer Indonesia Cancer Foundation Participant 9.6.1996 Dialogue: IVF Babies - An Islamic Perspective Syiah Kuala University, Aceh, Indonesia Participant 20.12.1995 Symposium: Aspirations vs. Reality - Islamic Medicine Services Syiah Kuala University, Aceh, Indonesia Participant ***Copies of Certificates as Attached (4) CME Online, Seminars, Symposium folder 6. Record of Achievements A. Community Services Programme Description 1 7|P a g e GELS General Emergency Life Support Bhayangkara Kediri General Hospital Surabaya, Indonesia Role Speaker/ Trainer Date/ Duration 6-9.9.2012 2 Disaster Relief Contingencies Plan for Cities & Provinces, Public Health Care & Service for East Java, Ministry of Health, Indonesia Trainer/ Facilitator 3 Women's Reproductive Health Pondok Pesantren Al-Amien Prenduan Public Health Care & Service, Madura, Sumenep, Indonesia Speaker 23.12.2011 4 Gastrointestinal & Kidney Disease Aceh, Indonesia Facilitator 18.4.2004 5 Sucralfate Suspension & LESI Therapy in Acute Gastro Intestinal Issues Association of Internal Medicine Specialists Doctors Aceh, Indonesia Speaker, Moderator, Facilitator 9.3.2003 6 Scientific Writing Competition Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia Coordinator 29.5.1999 7 Health Movie Screening Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia Coordinator 12-14.9.1997 8 Visum Et Repertum & Autopsy Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia Coordinator 7.4.1996 9 Bakti Sosial (Undergraduate Social Welfare Programme) Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia Social Worker 10.9.1995 Role of Women in Raising Healthy, Independent & Devout Generation Faculty of Medicine, Syiah Kuala University, Aceh, Indonesia Coordinator 10 21-25.5.2012 1995 ***Copies of Certificates as Attached (7) Service Appreciation folder Note: All the records detailed above are verified correct. Track Record of Testimonials ***Copies as Attached (8) Service Testimonials folder All copies of personal papers, certificates, formal appointments and testimonials are as attached; available upon request in hard copy. 8|P a g e