Your elective is one of the highlights of your 5–6 years of medical school: the opportunity to go anywhere in the world for 4–12 weeks. It’s a big decision. Choose wisely, and don’t leave the planning to the last minute!
Medical electives are a wonderful opportunity to develop skills and widen medical interests in a new and unfamiliar location. You don’t have to travel far – there are many exciting opportunities within the UK, for example with helicopter emergency crews. On the other hand, research or careers-focused electives (eg at a renowned oncology centre) should greatly help your career aspirations in an increasingly competitive job market.
If you are certain that you want to venture abroad, choose carefully. Yes, you will have plenty of opportunities to travel abroad for holidays when you are a doctor, but it may not be so easy in the future to work in a rural village in Uganda for 8 weeks; for example, you will have more bills to pay, you might have a house, and you might have a family to support. If you are intent on travelling abroad for your elective, be sure to pick a unique, enjoyable opportunity that you will probably never have the chance to do again.
Aims of the elective
It is important to decide what you want to get out of the elective. Do you want to get a general overview of the medical system/hospitals/conditions in the developed or less developed world? Or are you looking for something more specific? Do you want to publish research papers? Do you want to teach? Do you want to become an expert in haematology by working in a specialist haematology centre? Do you want to witness unusual medical conditions that you have read about in textbooks? Do you want to become competent at medical procedures, eg putting in chest drains by working at a trauma centre?
The best resource will be past medical students who have been on their elective. They will have good ideas, contact details and may be able to put you in touch with colleagues who have experienced other electives. Ask your foundation year 1 doctors (FY1s), specialty registrars (StRs), registrars and consultants – everyone should have some good ideas and will be willing to share experiences of their elective.
Most medical schools keep details of past medical electives, which may include contact details as well as reviews. Some royal colleges may also be able to help you with ideas or contact details for careers orientated destinations.
The Medic’s guide to work and electives around the world gives detailed information on countries and hospitals, including contact information. The Electives Network website gives useful information and student reviews of electives. While both give valuable information, they are not exhaustive. Therefore, if you feel that you are getting nowhere, arrange a meeting with your hospital dean or careers lead.
Types of elective
There are many types of elective, so you have an almost endless choice. Do you wish to work in the developed world such as Australia or Europe? Or how about doing cutting-edge research in modern hospitals in the USA? Would you like to see the provision of medical care in the developing world in rural parts of Africa or India? Or are you even more adventurous? If so, try electives primarily based at high altitude – such as working with mountaineers or in ski resorts. How about working with helicopter emergency crews or even NASA? Alternatively, past medical students have worked at ‘low’ altitude with scuba diving / hyperbaric centres.
Do you want to brush up on your language or survival skills at the same time? Do you want to do research, or to develop your clinical/surgical skills? Or how about doing all of these, while residing on a tropical island in the Caribbean?
Start thinking about your elective about 18 months ahead of time. Popular elective destinations, hospitals and schemes will be booked up 6–12 months ahead, so book early wherever possible. If you plan to embark on your elective with medical school colleagues, you may need to book even earlier to guarantee a place.
There are a number of commercial companies that will organise every aspect of your elective. While they are typically efficient and successful, they can be pricey.
Medical electives can give an unparalleled opportunity to experience healthcare and life in a different part of the world. However, in less familiar territory, heed travel advice and warnings, and always check the Foreign and Commonwealth Office website before booking, and again prior to travelling.
Electives are typically expensive, and the costs quickly mount up: flights, accommodation, vaccinations, deposits, processing fees, insurance, travel, spending money etc. Work out your rough budget before you organise the elective; for example, it is not worth travelling to New Zealand for 2 months if your budget is less than £1,000. For electives with a specialty, research or humanitarian focus, funding is often available in the form of awards or grants; check the websites of the royal colleges, specialist societies or other medical associations for details. A Google search is probably a good starting place – search and apply early.
In the midst of preparing for final exams and applying for FY1, remember to leave plenty of time for final preparations, including vaccinations, tests, health checks and visa applications – visas for the USA and Canada can take many weeks, or even months.
Don’t forget indemnity cover as well as a good travel insurance package. Post-exposure prophylaxis (PEP) is worth taking with you if it is not readily available at your destination hospital – hopefully you won’t need it. Contact your local infectious disease / occupational health department for details.
Finally, if necessary, visit your GP for travel advice including the need for malaria prophylaxis and medical travel packs, which can include emergency antibiotics (for diarrhoea, eye/ear infections etc) as well as some basic medical equipment.
Finally – enjoy yourself.
Dr James Goodman
BSc (Hons) MBChB