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Royal Society of Medicine
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Electives are seen as an important opportunity for medical students to experience healthcare delivery in an unfamiliar setting and improve their cultural competency. It’s estimated that 40% of students in the UK and Canada go on their elective to a low or middle income country (LMIC).

The Royal Society of Medicine is involved in research exploring initiatives to improve electives. It is important that student voices are heard in this discussion. Share your views and get a free one month trial of RSM membership.

We want to know:
  • What are your expectations of your elective?
  • What issues do you anticipate?
  • How are you planning your elective?
  • What relevant education and/or support have you received from your home medical school?
  • For anyone who has already been on their elective, how did it influence you?
  • What influence do you think visiting students had on the host community?


The RSM provides access to relevant and unique services to help you throughout your medical careers. But don’t just take our word for it, try it for yourself by signing up to our free one month trial. Sign up here.

Plus if you are planning an elective the RSM can help, offering bursaries to help fund your elective.

More about electives


Alongside the potential benefits of electives, there has been growing concern about harms for both students and the hosts. Students may find their personal safety compromised or experience negative psychological impacts of finding themselves in situations for which they are ill-equipped without sufficient support. They may also feel learning outcomes are inadequate.

To help students prepare for this, King’s College London and St George’s have published a free Massive Open Online Course (MOOC), Preparing for an International Health Elective: Training in Global Health, Ethics and Safety. This course can be accessed via the Future Learn platform.

For hosts there is the problem of visiting students using scarce resources. Also they have to consider potential harms to patients due to visiting students practising outside their competency, and assumptions of visiting students’ superiority in skills and knowledge, based on global power dynamics rather than actual expertise.

So whether you are about to take your elective or have completed it, there are always stories to tell. Will you share your views and tell us how electives can be improved?

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Angury
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My elective experience was pretty negative compared to what I had expected (being told it will be the best part of med school etc). I went to a low income country, and the main difference I was expecting was a lack of resources and rationed healthcare. It was therefore a big shock to come across a hospital that was well-equipped, but with a completely different working environment, in which there was a strict form of hierarchy (you generally didn't speak to the consultant unless spoken to) and patients who were terrified of their doctors.

What I least appreciated was how the role of the doctor was very much tied to the views and beliefs of a society. For example, in the place where I did my elective, doctors were seen as Gods, and doctors would often abuse their position both within the hospital and out in the community. It was the psychological impact of seeing patients being treated so badly that stayed with me more than anything else.

If I were to organise my elective again, I think I would go through a company like Work the World rather than do it alone like I did. I found that the doctors on my elective didn't really appreciate or even care about my training while there, and I was just left to my own devices, whereas if I had gone through a company, perhaps there would have been a bit more organisation and responsibility taken on by the host institution.

I have to say though, my medical school were fantastic in helping us organising our electives. They gave us a lot of resources in terms of funding and bursaries, and offered support in terms of safety and what to do if things went wrong etc.
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nexttime
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My elective was undoubtedly my most useful placement during which i learned the most. So much pathology you never see in the UK, both in type and severity, and so many seriously unwell patients. Very frequently i had to frantically look things up so that we could them implement that treatment on a real, unwell patient. So many cultural differences too, such as those highlighted above - provides real context for how you view the patient-doctor interaction.

Large elective fees asked for by hospitals are a real shame. Especially as it tends to be the developed, rich countries who charge the fees, and extremely poor developing countries who do not.
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