In the past two decades, there has been a dramatic rise in the number of US medical students, residents, and fellows participating in overseas clinical and research activities. In 2008 alone, 27.5% of graduating medical students had an international elective experience, up from 22.5% in 2004. 1 Medical trainees, driven by altruism and interest, often choose to participate in international electives to expand upon their clinical training and broaden their understanding of health systems in resource‐poor countries. Medical institutions, in return, provide provisions and support these electives, as they allow trainees an opportunity to have greater involvement with primary care and to work with underserved populations. 2 Either through faculty guidance or institutional affiliations, electives are planned in areas with limited health care resources such as sub‐Saharan Africa, Latin America, or Southeastern/South Asia. In a review conducted by the Global Health Education Consortium (GHEC) in alliance with the Association of American Medical Colleges and the Foundation for Advancement of International Medical Education and Research, medical schools in America were surveyed regarding international opportunities available for medical trainees. 3 The study found that these opportunities were largely in the form of clinical electives, clinical research, or cultural/language immersion programs. Among the 103 institutions responding, 45% offered medical students preclinical research opportunities and 87% offered international clinical electives. Regarding resident opportunities, 59% of institutions had elective international rotations with an additional 11% describing a specific global health track. Trainees participating in international electives are at risk for exposure to locally endemic diseases such as malaria, dengue fever, traveler's diarrhea, and sexually transmitted infections as well as nosocomial transmission of blood‐ or body fluid‐borne pathogens such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). 4In these underserved settings, trainees may be faced with the increased responsibilities of managing patients with … Corresponding Author: Davidson H. Hamer, MD, Center for Global Health and Development, Crosstown 3rd floor, 801 Massachusetts Avenue, Boston, MA 02118, USA. E‐mail: dhamer{at}bu.edu