Healthy, safe and effective international medical student electives: a systematic review and recommendations for program coordinators

D Ashley Watson,Nicholas Cooling,Ian J Woolley

doi:10.1186/s40794-019-0081-0

Abstract

BackgroundThousands of medical students undertake international medical electives each year. These students face potentially substantial health and safety risks as well as educational and ethical challenges and therefore should undertake their electives within well-structured and coordinated programs.MethodsWe conducted a qualitative systematic review based on a pre-determined protocol. Relevant publications and guidelines relating to international medical electives were identified through a review of the literature using on-line search engines, principally PubMed. We then conducted a systematic qualitative synthesis to extract relevant publications. Finally, the literature was organized according to themes, with the aim of developing a structured set of Recommendations for Implementation for program coordinators.ResultsA wide range of important issues were identified which were categorized into seven themes upon which recommendations were made principally for the benefit of program coordinators: Responsibilities; General policies; Travel advisories; Occupational risk assessment; Funding & finances, Pre-departure training programs; and Post-return debriefing and screening.ConclusionsRecommendations for program coordinators on the health and safety of medical students while on international medical electives have been sourced from existing guidelines and relevant publications. There was considerable consensus from the literature and as such these synthesised recommendations could form the basis for internationally accepted standards for elective placement program coordinators.

Highlights

A significant proportion of medical students from high-income countries around the world participate in enriching, usually self organised, clinical electives outside their home country - often known as international medical electives or global health electives [1]
Whilst standard pre-travel health advice covers some of the issues relevant to electives, there are typically a number of additional issues that need to be considered, including occupational hazards, professional standards, emotional wellbeing, and ethical challenges
The 12 comprehensive guideline papers and the 89 supporting literature publications were subjected to a systematic qualitative synthesis process

Summary

Introduction

A significant proportion of medical students from high-income countries around the world participate in enriching, usually self organised, clinical electives outside their home country - often known as international medical electives or global health electives [1]. This is becoming increasingly popular in low- and middle-income countries - the motivations of students from different regions may be dissimilar [2]. Thousands of medical students undertake international medical electives each year These students face potentially substantial health and safety risks as well as educational and ethical challenges and should undertake their electives within well-structured and coordinated programs

Objectives

Methods

Results

Conclusion