Should I Do an International Elective?

Sarah Averill, MD

Disclosures

July 03, 2012

Question:

I'm considering an international elective. What are the risks and benefits of going abroad, and how can I get started planning?

Response from Sarah Averill, MD
Resident, University of Iowa Hospitals and Clinics, Iowa City, Iowa

If you are going into a medical profession in the United States, it is all but certain that your practice will include people from many parts of the world. Whether you practice in a big city on the East Coast or in a small town in the Midwest, you might encounter patients from Latin America, Africa, the Middle East, and Asia.

Recognizing this reality, medical schools offer opportunities for students to work with diverse patient populations, travel abroad, and learn about global health issues from a public health perspective.

You might wonder whether you should incorporate international experiences into your training and what the risk and benefits of such training might be.

The humanistic benefits of going abroad include gaining perspective on what works well (or not well) in your home medical system. An adventure outside the classroom with an idealistic practitioner might also give you a renewed sense of purpose when you are deep into the abstraction of biochemistry and pharmacology.

When considering whether and where to go, ask yourself what you hope to accomplish: Do you want to see a different model of primary care? Learn about different cultural practices such as acupuncture? Develop a relationship with a physician who can mentor you in your career? Do you want to learn a language? (So common is the need for Spanish-language interpreters; almost everyone I know wishes they spoke Spanish.)

Depending on your goals, you may find that you can accomplish them without wandering far from home. Demonstrating leadership and organizational skills on a project is more likely to impress residency program directors than a brief foray to an exotic location.

Worth the Cost?

Going abroad is expensive and involves potential risks to your health. Think about your risk tolerance when considering where you might want to go.

In addition to providing recommendations for vaccines and malaria prophylaxis, the Centers for Disease Control and Prevention (CDC) Website can help you gauge health and other travel risks, such as political instability. (The CDC has a wealth of travel-related information on topics ranging from getting insurance to signs and symptoms of scuba diving disorders.)

And why add to your mounting medical school debt? Debt is a legitimate consideration, and international programs vary in their associated travel costs. Even so, if you are serious about working internationally, it may be worth taking on some additional debt when you have the most time, which -- trust me -- is when you are a medical student.

Keep in mind that you may be able to solicit support for your travel or for the organization you hope to work with. Try to take into account any connection to your school and community when thinking about where you are going.

Local charities that support student activities might give in-kind donations or money to support a project. For example, I received travel funds and over-the-counter medicines from the Social Justice Committee at the Unitarian church in my city. 

Plan to Plan

Because medical school is more structured and has fewer blocks of free time than college does, taking time away for international study or volunteer work requires significant planning.

Unless you have a connection to the place you are interested in going, I would suggest looking into established programs at your home medical school.

If there are no established institutional ties, ask faculty and or fellow students if they know of trustworthy organizations that are coordinating projects. Finally, consider any local organizations or individuals in your community who have connections to international projects. For example, some students at State University of New York work with a local ER doctor who has ties to clinics in the Sudan.

If you have an inkling of what you might want to do for a career, you can tailor your travel experience to a long-term plan. To get a better idea of the range of potential careers in global health and the sorts of experiences you might want to have abroad, surf the Web and specific global health centers, such as Stanford University's Center for Innovation in Global Health, for ideas.

If you aren't sure what you are looking for, explore the American Medical Student Association's database for international health opportunities.

Your elective time in medical school is precious. No matter what you decide, investigate carefully.

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