HOW TO PLAN YOUR ELECTIVE

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I took this picture at the top of Table Mountain. What you see on the left is Lion's Head (the mountain I climbed the the following day) and Signal Hill (another one, the day after). In the distance is Robben Island, the famous location for Nelson Mandela's prison. 

 Looks like its elective season! I can't believe mine was almost two years ago.. How time flies! I thought it'd be useful to write something for anyone who is planning an elective either for this year (although you're probably too late if you haven'T planned already!) or the upcoming years. Electives are fun, whatever you do. If you're interested in finding out what I did for my elective, click here! Otherwise, here are some tips on how to plan your elective. 

When to start planning 

As early as possible basically. Even if you're in first year of medical school (I know the elective period is in year 4 or 5 for most people), planning early means you are more likely to get a placement that you want. There are certain areas in the world that are oversubscribed and there are also certain elective types that are also oversubscribed (e.g. trauma at Tygerberg hospital in South Africa).

Where to go 

This is entirely dependent on the sort of experience you want to gain (plus your budget). Do you want to put your medical skills to the test and actually get involved in patient management (like I did) - if so, then your best bet is a developing country in Africa or Asia. On the other hand, do you want to experience cutting edge medical technology or get involved in medical research - if so then a developing country is your best bet. From all the research I did, the USA, Canada and the UK will take elective students as observers. You won't get very involved in actually doing anything practical. This is useful if you just want to get an idea about something for example a field that you're interested in. I spent some of my elective at the Birmingham Women's Hospital in the UK, basically learning about all the different specialities that are affiliated with obstetrics and gynaecology. I been got the chance to participate in some IVF and Embryology as well as semen analysis which was pretty awesome!

Who to go with 

Again, this depends on the sort of person you are (and also if you really want to go with someone else). I went on my elective by myself (I can't tell you how much I had to bargain with my family to be allowed to travel solo as a female to South Africa). I wanted to go by myself because I would be forced to socialise and make friends. At the time, I was the sort of person that would let someone else have the experience instead of me because I was cripplingly shy and very socially awkward (thankfully things are starting to change!). By going solo, I had exposure to every opportunity that was presented. I was always first assistant in any surgery, always the first to clerk or see interesting signs. It gave me a lot of confident as a budding medical practitioner because ultimately, when you are a doctor, you are solo at least some of the time. 
On the other hand, going with someone else means you're not lonely because you have someone to be around if all else fails. Also handy because that person doubles up as a photographer! Some of my friends went with their boyfriends, some went with family...
So I say definitely think about the kind of person you are and what you'd like.

What to sort out in advance 

Basically, all the important stuff need to be sorted out early on: 

  • Travel Visa - does the country you are planning to visit need you to have a visa? 
  • Letter of recommendation - this is usually provided by your medical school 
  • Vaccinations - some counties need you to have some vaccinations that are not routine like Yellow Fever. Get more detail on the CDC website here
  • Indemnity insurance - I got mine free from the Medical Defence Union here
  • Travel insurance 
  • Travel money - its cheaper to change your money before you travel and also to change it anywhere else but the airport. The post office or your own bank can have competitive rates - look at the value of your currency regularly and go change your money when the exchange rate is good 
  • Passport and other ID- make sure your passport is valid for the duration of your elective. Some countries expect your passport to have at least 6 months left on it before they allow you in. If you need to apply for a new passport, do so well in advance because sometimes it takes a long time to get one through.

What to pack - basic items 


  • Camera - you are going to see some of the most beautiful places on earth. Don't let a poor quality camera ruin this!
  • Clothes for winter and clothes for summer REGARDLESS of which country you're going to - I made the mistake of packing only summer clothes when I went to South Africa and boy did I learn! Some of the nights where bitterly cold and my pyjama shorts didn't help matters. Thankfully I went out and stocked up on water clothes! 
  • Laptop - this was handy because it allowed me to catch up on TV shows and also to Skype people back home 
  • First aid kit - not a full blown affair but something with basic things like antihistamines, analgesia, plasters, oral rehydration solution, etc 
  • HIV Post Exposurre Prophylaxis - This is mandatory in some places. I had to buy some to go to South Africa. My advice is to check with the place you're going - some hospitals include PEP in their registration fee so you won;t have to spend £300 for nothing. 
  • Driver's licence - if you plan to rent a car wherever you're going, you may need to show proof of your ability to drive
  • Sunscreen 
  • Unlocked mobile phone 
  • Other comfort items you need - I took photographs, iPod
  • (Food) - this is in brackets because you OBVIOUSLY want to experience the cuisine in the country that you've visited. However, if you have something that you absolutely must have, like lactose free milk for me, then its best to take enough for the first couple of days. After this, you'll know your way to the shops! 

What to pack - medical items 

  • Stethoscope (obviously) 
  • Box of gloves 
  • Goggles (if you plan on doing trauma surgery) 
  • Scrubs 
  • Crocs or Trainers 
  • Torch (for night shifts)
  • Clinical handbooks - I took my oxford handbook for easy referral 

Last minute tips 

  • As well as taking a photocopy of your ID documents, save them on your dropbox account or email them to yourself so that in emergencies, you have something 
  • On the first day you arrive, do the following 
    • Go get registered with the organisation you are doing your elective with 
    • Get a local sim card for your phone and contact your family to let them know you're safe 
    • Make friends with people that are already there - handy because they know their way around 
  • Do you best to learn the language - it makes having medical conversations easier and also allows you to keep up with ward rounds if they are conducted in different languages 
  • Arrange pick up from the airport in advance - if possible, arrange for someone within the organisation you're visiting to pick you up. This is way easier, safer and often cheaper than getting into any taxi from the airport

Hope that's useful guys! Remember, these lists are not comprehensive, rather they are the basic of what you need to think about when you're planning your elective. If you have any specific questions, let me know and i'll do my best to answer! 

Sam 

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