Intended for healthcare professionals

Student Life

Rethinking your elective

BMJ 2005; 330 doi: (Published 01 February 2005) Cite this as: BMJ 2005;330:050274
  1. J Jaime Miranda, Wellcome Trust research training fellow1,
  2. Sarah Finer, senior house officer in medicine2
  1. 1London School of Hygiene and Tropical Medicine
  2. 2Newham General Hospital, London

Your elective can be an exciting experience. But have you ever considered it from an ethical perspective? J Jaime Miranda and Sarah Finer offer some tips on making your elective a productive and beneficial experience for all

For many medical students, the elective is a long awaited part of medical school. Scheduled in the final year in nearly all UK medical schools for an average of six to eight weeks,1 it is a chance to get away before house jobs and provides freedom from other ties.

Most literature about electives has focussed on health safety and personal problems,213 with little focus on the ethics of this experience. Only few people--and worse, few teachers and students--have thought about electives in a broader ethical context. But your responsibilities on elective are possibly more significant; you are ambassadors overseas.

One way process

It is well known, and surprisingly accepted, that most UK medical students do their electives abroad with a significant number going to developing countries in resource-poor settings.

Students who go abroad use the host countries' facilities and teaching resources. In the United Kingdom, people recognise that resources are scarce and that hospitals and universities are functioning under constant constraints--the lack of tutors and teachers is particularly apparent. This is also the case for institutions in poorer countries. But, under the current situation, the elective period is a one-way process, with its benefits and balanced towards those who can afford to go to a foreign institution - namely students from wealthy nations.

Elective costs highlight this imbalance between students from different countries. Student loans and debts do add financial stress. However, students in developed countries are almost certain that they will get a job, and a well paid salary as soon as they finish their training. On the contrary, students from the …

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