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LETTERS: Jane Zuckerman, Heather Harris, and James K Torrens Medical students' electives abroad BMJ 1998; 317: 1528 [Full text]

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Medical students' electives

Robin Greenwood   (18 December 1998)

Medical students' electives 18 December 1998
Robin Greenwood Send response to journal: Re: Medical students' electives	Dear Sir or Madam I am writing to follow up some issues which Heather Harris raised in her letter of 28 November (BMJ 317). I do not propose to contribute anything more to the debate on the value of electives. But I hope at least to bring your readers up to date on Action Health. Since 1992 Action Health (we have dropped the "2000") has taken a policy decision no longer to make use of electives. We now require a minimum of two years' post-qualification experience. The usual period of service with us is between one and two years. The main reason behind this shift comes from our partner organisations in developing countries: they prefer the people we send to have more experience and to come for longer. The health professionals (we call them "Trainers") who we now send benefit from more thorough preparation and closer support than Heather had in 1992. We have fewer partner organisations than we did then and we select new partners through a process which culminates in a three-day visit by Action Health to the partner. The only purpose of this visit is to assess the organisations' mutual compatibility and the partner's capacity to work with a Trainer. Among other things the visit covers practical points such as making sure that the partner can offer the Trainer accommodation which is clean, secure and affords privacy. The design of the project itself comes only later, during a second, longer visit by Action Health to the partner. Prior to new Trainers' departures we prepare them by means of a three -day Orientation Course in the UK. This covers non-technical aspects of the posting such as cultural differences, staying healthy and communication. In addition to this each Trainer has a specific briefing day to cover the technical aspects. The facilitators of the Orientation Course are themselves Returned Action Health Trainers. The support from Returned Trainers is continued through the posting. Action Health allocates a "correspondent" to each new Trainer. Correspondents have the same professional background as the Trainers and have worked with Action Health in a broadly similar situation. While in post Trainers receive support from Action Health staff. Programme Managers visit each project twice a year. With the move to longer postings each Trainer is guaranteed face-to-face contact with the person who recruited them. This year we have taken an important step which provides further support to Trainers in post in India: we now have a full-time staff member based in the country. This person is able to provide a quicker and more direct response to the needs of our partners and Trainers. I hope that these points will demonstrate to Heather that we have learnt from her experiences and assure (non-elective) doctors and other health professionals that Action Health offers them a strong network of support. Yours faithfully Robin Greenwood Director