Table 3 Recommendations for implementation by students undertaking medical electives

General

Participate in pre-departure training and post-return debriefing programs

[42, 47, 56, 59, 86]

Funding and Finances

Ensure adequate funds for airfares, accommodation, comprehensive travel insurance, daily living expenses, vaccinations and medications, visas, placement fees, recreational activities.

[4]

Establish the means by which HIV post-exposure prophylaxis (if required) will be prescribed and funded.

[22, 23, 27]

Clinical Routine

Establish contact with the designated supervisor and ascertain details of the elective program, clinical experience required and level of supervision.

[59, 63, 69]

Be aware of skills gaps that may be addressed prior to departure and that should be acknowledged as such during the elective.

[69, 70]

Become familiar with syndromic approaches to management of common and important conditions in host country.

[65, 89]

Accommodation and Personal Safety

Consider undertaking the elective with another student.

[27, 39]

Confirm the availability of secure and screened accommodation; determine whether guards and/or domestic help are provided.

[49]

Be streetwise when ‘out and about’; seek advice from hosts and inform supervisors of local travel plans. Undertake sufficient planning for and exercise caution when travelling by vehicle; avoid riding motorcycles.

[6, 23, 28]

Uphold high standards of clinical practice; seek advice and support from colleagues when dealing with ‘difficult’ patients.

[70]

Register with institutional and government travel registries prior to departure.

[29, 30, 33, 34, 74]

Ethical Behaviour and Social Accountability

Perceive the elective experience as that of a privileged visitor in a welcoming host community, value clinical cultures, respect social norms, work on language skills, and adapt attitudes and behaviour accordingly.

[17, 18, 23, 59, 76]

Dress modestly and respectfully; observe standards of clinical attire.

[23]

Undertake an institutional and/or on-line training program in global health ethics.

[64]

Health and Wellbeing

Ensure that adequate pre-travel health and safety advice, including necessary vaccines and medications, and appropriate preventative behaviour education (i.e. mosquito avoidance, safe sex) is obtained in a timely manner from a travel doctor. Pack a supply of non-sterile gloves, goggles and N-95 masks. Ensure that chronic medical conditions (including mental health conditions) are optimally controlled and that a management plan is in place for exacerbations. Arrange a pre-travel dental check-up.

[23, 25, 78]

Be competent in the self-management of minor illnesses and injuries, as well as recognition of symptoms of potentially serious illnesses.

[6]

Know how and where to access affordable local medical care, including services aimed specifically at foreigners. Keep all receipts and promptly notify travel insurance providers of all incidents and consultations.

[49]

In the event of significant illness or injury, seek the support and companionship of another student; notify the program coordinator or other faculty member.

[49]