Most students complete their medical elective during their fourth or fifth year at medical school. They can be undertaken in the UK or overseas.
It is up to the individual where they want to go. Medical students might have a desired destination, or a specific specialty they want to gain experience of, or certain goals such as a project.
A medical student may wish to travel somewhere where the health system is as advanced, such as much of Europe, America or Canada. In this setting it’s relatively easy to undertake an audit or research project, if this is one of the medical student’s goals.
The cultural experience will be more profound in the developing world but, due to the limited resources in such places, it may be harder to perform a project or get as much specialty specific experience.
The medical student needs to decide on their elective priorities and, whichever country they choose, approval of the medical school’s dean is often required.
Start planning early. There is often a lot of red tape to plough through. Popular destinations often book up over 12 months in advance, so you need to make contact up to 18 months prior to intended start date. And it is worth having a second choice.
There are sources of funding available for medical electives but they need to be tracked down and applied for properly.
Overseas electives offer a great opportunity to experience healthcare in different cultures.
It can be a lonely experience though, particularly if the student goes to a country which speaks a different language. Medical students can arrange to go on elective with others in their year.
Ask other medical students and FY1s about their electives - it will help determine whether the destination will be a developed or developing country.
The medical school should have contacts with schools abroad and have lists of last year’s students who will be able to provide a good idea what the places they visited are like. Most students are required to complete an elective report. These often provide insight and useful contact names and addresses for placements all over the world.
Electives can be organised through private companies, such as Work the World, with many other options available (just search on google).
If there is a particular specialty the medical student is interested, it’s worth meeting the relevant professor or consultant at their medical school. They can provide advice and potentially contacts.
If the elective is organised properly, and well supervised, it will be a rewarding experience, but remember professional and ethical boundaries. It is both illegal and unethical for unregistered students to work as if they were qualified doctors, even in the developing world.
All medical students should ensure their standards of professional conduct are in keeping with the standards laid down by the GMC. In Good Medical Practice, the GMC states that ‘you must work within the limits of your competence’. You must not diagnose, prescribe or administer treatment without close clinical supervision.
Medical electives in the UK
Electives in the UK provide the opportunity to gain insight into a particular field with an acclaimed specialist department or clinician. Medical students can also make contacts that might be useful to career development.
Making the approach
The initial approach should be to a named contact. The email or letter should contain the dates of the proposed elective and the plans. Medical students should provide details about their medical education so far and include a CV.
Funding a medical elective
It is important that students budget for an elective - it can be a significant constraint on choice. There are a number of national and local awards for medical electives and the medical school will have a list available.
An application for an award should be clear about where a student wants to go and what they want to achieve. It needs to cover any intended research or projects, potential benefits for experience and career development, and include confirmation of the destination, a good reference, accommodation costs and a CV (see a list of sources below).
Going on medical elective - issues to consider
1. Travel and health insurance
Certain companies, such as Wesleyan Medical Sickness, provide cover specifically for medical electives so the student in question is covered for any medical costs and needle stick injuries as well as lost luggage. If visiting an EU country apply for the free European Health Insurance Card, which offers you access to reduced-cost medical treatment.
2. Appropriate vaccinations
The Department of Health provides more information. Take certificates with you.
3. International student card
It can provide useful discounts transport and accommodation, and NUS cards are not accepted abroad.
4. Medical kit
If going overseas, make sure it contains insect repellent, malaria tablets and rehydration sachets for diarrhoea.
5. Access to emergency funds
6. Medical indemnity (if required)
7. Medical school/hospital letter
Carry a letter from the medical school/hospital being visited - on headed note paper - mentioning the details of the elective and the medical student’s name. It can help with bureaucracy.
If the student is going to the developing world, consider taking some gifts. Spare, portable equipment from the hospital might be well received. Pharmacies and GPs may also donate left-over or sample medications. Also consider some fundraising for the hospital being visited in advance - local businesses or hospital staff may be able to help. Check it’s wanted or needed first.
Copies of the British National Formulary are often appreciated. Also, remember to take your own stethoscope, handbooks and plastic gloves.
Further sources of advice:
BMA Elective Toolkit
Relevant article in MJM
A thread on The Student Room
Sourcing destinations and visas:
List of embassies and high commissions
Global list of medical schools
Commonwealth Universities Yearbook
American Medical College Applications Service
Directory of Grant Making
Medics’ Guide to Work and Electives Around the World: A Guide to Travelling and Working Abroad, Mark Wilson, Hodder Arnold