Medical Elective Planning – where to start!

The Elective is probably the best, most exciting part of the medical degree. It involves 6 weeks spent doing medicine anywhere in the world in any setting or speciality that interests you. You can go anywhere and do anything, which is fantastic but makes it really hard to know where to start! I am currently in the middle of planning mine, so I thought I’d write a few tips that might make the journey smoother!

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Do you want to go in a group, or alone?
Going in a group has its advantages, you have someone else to split the admin, to help find bursaries, to explore with on weekends and days off. It also makes travelling safer and easier as you can split the cost of transport and accommodation. But you also have to take into account their hopes and expectations for the elective, so if you do want to go together chose people with a similar idea of what the elective is, and what you want to get from it. If your ideas aren’t compatible you could always arrange to meet up for some post-elective travel afterwards.

What specialty do you want to experience?
This might be because you’re dead set on a certain field and want to amp up your CV, or because you want to experience a field you didn’t get to in medicine. You should also think about the kind of procedures you want to be involved in and how hands on you want to be. You also need to consider the effect of a speciality on you, for example, Obstetrics in a developing country will be extremely different to in the UK, and you will need to be prepared for the possibility of seeing deaths and morbidity from conditions and emergencies considered easily preventable with UK resources.

Where do you want to go?
If you already have a country or even city in mind this is easy! However, myself and my friends wanted to go just about everywhere. Narrow down the list by each deciding what kind of medicine you want to see (excellent resources or under resourced? Developed or developing country?) and then consider what you will want to do in your down time. I really wanted to go somewhere we could spend our weekends on beaches and learning to surf, while my friend was really keen to do safaris and see some jungle environment.

If you have a boyfriend/girlfriend who may join you at some point or after (to sweeten the blow of abandoning them for six weeks) consider what may entice them out there too!

Consider what else you want to do during your elective.
Do you want to fit in some volunteer work on your days off? Are there any projects you’d like to get involved with, like community education, building wells or teaching English? Or do you want to try and include an audit or some research into your time, or try and find rare cases to write up for publication?

Consider what level of risk is acceptable to you
No UK medical schools will let you go anywhere on the no go list provided by the British Embassy. Other considerations though are the political and religious culture of any area you may visit, and how respectful you are willing to be. This is particularly important for women, to may be expected to have a chaperone or cover their heads/bodies in certain parts of the world, although I think this is rarely an issue.
There is also the factor of safety, which is even more important if you are travelling alone. Unfortunately some of the places with the most exciting emergency and trauma cases are also the most dangerous in terms of general street safety.
Finally of course you must consider your own health, and what vaccinations are needed in different areas. Bear in mind that this can significantly add to the cost of your elective!

Funding Search
Google is your friend here. I spent an evening putting various combinations of specialties, countries and ‘medical Elective bursary’ into Google to see where and what attracted funding and when I’d need to apply. I created a little word table of all the bursaries that might possibly be useful. I think it is important to do this at this stage because you may find that something you’re interested in doesn’t attract much funding, meaning you may need to do it cheaply or search for funding in more inventive places. For example, I want to do a Paediatric elective but there is very little funding for Paeds, there are however several bursaries for neonatal placements.

Decide what is most important to you
Consider each of the following points and make a list, 3-5 specialities you would consider, the countries or the type of environment or experiences you want (hot, beach, safari etc), any extra activities like research or volunteering. If you are going with friends I suggest you each do this alone first. Then decide, of all of these things, what is most important to you, and which you are willing to compromise on. For me, it was most important that I go with my friends, I wanted to do Paediatrics or Neonates if possible and I was willing to go anywhere warm that I hadn’t been before. It was also important to try and get as many bursaries as possible (to minimise disruption to the wedding fund!), so Neonates is probably what I’ll apply for. For my friend it was most important that she did psychiatry, she wanted to go together and she didn’t mind about anything else. At this stage if you find you are incompatible with the friends you wanted to travel with, it is time to consider alternatives. Could you all go to different places in South America and meet up for a long weekend or final week in Cancun? Or is anybody willing to compromise to keep the group together? Either way it’s best to be honest about what you really want than waste this opportunity doing something that doesn’t quite satisfy you.
Another great way to get around varying expectations is to split your elective. We are intending to do three weeks somewhere like Ethiopia and then three weeks somewhere beachy, like the Seychelles or the Philippines. Flights between the two aren’t hugely expensive, and we get double the experiences!

Make your short list!

Once you have decided and agreed upon your non negotiable features, it’s time to start looking for electives.
For those of you who are signed up with the MDU, you get free access to the electives network, which has a wealth of information about different countries, which hospitals do which specialties and how to apply. A lot of the hospitals also have reviews from students that have been before but always remember to check the date as things will change over time! There is a Q&A section too although mostly people just ask if the email address given is current!
Google is also a good idea, lots of people blog about electives and reports are often available online from real students. Your medical school will probably have these available in the library too.
Another place to look is on trip advisor, as a lot of people mention that they are on elective when visiting attractions/staying in places.

This is the stage that I am up to at the moment. At this point we are emailing every hospital that has all of our pre-requisites, and seeing who gets back to us first. Some hospitals take a month to reply, others get back to you in a day or two. Most require a medical CV and letter of recommendation from your university, so it’s a good idea to get these sorted asap so they are ready to go when you know what you’re aiming for.
I also recommend sending one email from the whole group if there are several of you going together, even if you want to do different specialities. This makes it easier to co-ordinate for the hospital, and makes you seem much more organised. It also means you will be told straight away if there aren’t enough places for all of you.

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