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

Tropical Diseases, Travel Medicine and Vaccines

Table 3 Recommendations for implementation by students undertaking medical electives

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

Issue	Responsibility	Reference
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]
Funding and Finances	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]

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