This guide will support you during this exciting time, providing you with useful hints and tips and insightful first-hand experiences to aid you in your planning.

1. Pocket Guide
to Planning
your Elective
For medical students

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Soyou’regoing
onanelective?
Your elective is likely to be one of the most memorable
experiences you will have as a student. But, when it comes to
planning your trip, you may feel like you have a big challenge
ahead of you.
This guide will support you during this exciting time, providing
you with useful hints and tips and insightful first-hand
experiences to aid you in your planning.
As you read, remember to keep in mind what an elective can
offer you:
§§ The opportunity to get more experience in a particular
medical/surgical field
§§ Travel opportunities in the UK and around the world
§§ A flavour of healthcare in a developing/developed economy
§§ Help deciding on future career directions
§§ Development of important life skills.
Introduction

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Going on your elective is your first opportunity to really put into
practice the knowledge and skills you’ve learned over the last few
years. In doing so you’re bound to come across circumstances and
situations which are a medicolegal, as well as a clinical, challenge.
Medical Protection can offer you access to the best possible
professional protection.
Your elective protection
Medical Protection offers members access to free elective
protection in the majority of locations, including the USA and
Canada. Remember, even if you plan on staying in your home country
for your elective, you will still need to apply for elective protection.
As a member of Medical Protection, you have access to the full
benefits of membership, including emergency telephone advice
to help you tackle any medicolegal or ethical dilemmas you may
encounter whilst you are away.
Electives in Australia
The Australian Government stipulate that all healthcare
practitioners, including students, must be covered by an insurance
contract provided by a regulated insurer.
As Medical Protection is not an Australian regulated insurance
company, we have made arrangements with MIPS (Medical
Indemnity Protection Society), to cover our members’ electives
whilst in Australia.
If you are planning to travel to Australia for your elective, please
call us on 0800 561 9000 to ensure you have the correct
elective protection in place.
First things first…

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To qualify for free elective protection:
§§ Your elective must be authorised by the Dean of
your university
§§ Your elective work must be supervised by a qualified
medical practitioner and must not exceed the level of your
own qualifications or competence
§§ You must be a student member of Medical Protection in
one of the following countries: UK, Ireland, South Africa,
Hong Kong, Caribbean, New Zealand, Singapore or Malaysia.
Unfortunately we cannot offer elective protection to
medical students in other countries.
Apply for your FREE elective protection
Simply complete and return the elective
protection request form at the back of this
guide or call:
UK: 0800 561 9000
IRL: 1800 509 441
INT: +44 113 243 6436

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There are lots of different ways to approach the elective
and your medical school will have suggestions about when
you should start the process, as well as other useful advice.
Remember to make use of all the resources you have at
your disposal.
It’s best to start planning your elective as soon as possible –
particularly if you have something specific in mind.
Picking a project
The choice is yours, but we find there are two clear groups:
people who have a set idea of what they want to do, and people
who have a set idea of where they want to go. It’s best to work
around both these constructs and plan from there.
Approaching
your elective

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When the world is your oyster, it can be a challenge to choose
where you would like to go.
The following factors may help you to narrow it down:
§§ Budget
§§ Clinical interest
§§ Local or personal contacts (supervisor/medical school)
§§ One site/multi-site.
Picking a
destination

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Use your medical school
If you have been allocated a supervisor, use them. If you have a
clinician, use them as well. They will be aware of opportunities
linked to your university, projects that have gone well previously,
and destinations that haven’t. Remember, you’re not the first
person to be going through this.
Use the internet
The internet is a good place to start researching hospitals or
areas that you might like to visit. The Electives Network is a
particularly useful resource, providing hundreds of country
profiles, as well as information for those of you who want to do
something a little different.
Use FY doctors
The foundation year doctors in your trust may have some good
ideas and information about placements that have gone well.
Ask – most people enjoy talking about their electives.
Sources of
information

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Australia/New Zealand
A modern healthcare system, sun, sea, sand and beautiful
scenery… it’s no wonder that Australia and New Zealand are
two of the most popular elective locations. If this is your
destination of choice, you may want to consider getting a flight
deal that covers a few stops around the area. Remember the
scale of Australia. The east coast is often popular, and you can
incorporate a trip to the north and/or south or New Zealand
fairly cheaply.
United States of America/Canada
These modern healthcare environments are similar to Australia
and New Zealand. If you are interested in a specific area of
medicine, it could be an excellent addition to your CV and,
perhaps more importantly, provide an opportunity to visit a
world-leading healthcare institution. Plan your travel itinerary
very carefully and book ahead for any internal flights you may
wish to take.
Popular
destinations
We saved a bit of cash by taking a a bus from Cairns on the
North East Coast to Brisbane. Having a bit of spare cash for
the East Coast was perfect: yacht trips, Fraser Island and
The Whitsundays were all unforgettable.
Medical student, Birmingham University

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Middle East
The Middle East has a lot to offer medical students. Again,
planning is essential to get the most out of your trip, as is
researching the locality of your placement destination.
South Africa
For every potential risk of undertaking an elective in a diverse
area such as South Africa, there is an upside. You need to
consider and plan this trip carefully, and pay particular attention
to your own personal health and safety. Placements with an
internationally-recognised body (for example, Médecins Sans
Frontières and international charities, such as the Red Cross),
large hospitals or an established aid organisation give added
peace of mind.
We ended up as a group in Beirut, Lebanon. It was a
fantastic trip, and the culture of a different health care
system and the ethical issues that were raised really
were an eye opener. We saw HIV-infected patients who
had been exposed to contaminated blood products in the
1980s (our project was on haemophiliacs). Incredible visit.
GP, West Midlands

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India/South East Asia
Like Africa, there are parts of the region that are politically
sensitive, but if you research well, India can be incredibly
worthwhile. Make sure you research the potential health threats
and receive the right vaccinations and protection.
Staying at Home
If travelling doesn’t appeal to you, or you are unable to travel
due to health or financial reasons, your home country has a
lot to give.
One of the most important advantages of spending your
elective at home is the sort of placement you can arrange
to go on. Want to shadow a forensic team, an organ retrieval
and donation team, or a placement in a cardiac transplant
centre? What about a project on left ventricular assist devices
(mechanical hearts) in a cardiac transplant centre? It is easier
to arrange these in your home country than anywhere else
in the world.
Amazing elective, taking it all in sat in an old colonial
coffee plantation with a beer looking down over a
rainforest is one of the best memories of my medical
school days. Remember to check your change, don’t have
ice in your drinks, don’t eat salad, you can stay vegetarian if
needed, and don’t eat roadside food. You’ll still get ill!
Paul, elective in South East Asia/Australia

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When making contact with institutions that you are interested
in, make sure you use your university email address. This
professional approach helps reassure institutions who will be
receiving all kinds of correspondence.
Use this email address as your single point of contact – you
could also ‘cc’ in a supervisor or a personal tutor to help
facilitate the process.
Make sure you keep a record of all correspondence about your
elective. This will be helpful should you be asked to provide
proof of your placement (for example, if you are applying for
funding). Like everything, the sooner this happens, the better.
Making the move

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Most medical schools will have a list of funding opportunities
available. These are competitive, and many are specific to a
particular school or a specific area of study (for example, child
health in South East Asia). Other organisations (for example, the
BMA) and national specialty bodies (such as the British
Societies of the various major specialties) have advertisements
on their websites.
It’s also worth being proactive – speak to your peers, ask
foundation doctors, talk to your supervisor and search the
internet – you might be surprised what funding is on offer.
Applying for funding

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Top tips when applying for funding
§§ Make a list of the requirements of the funding grant and
make sure you address them. You can put these in a
covering letter to the organisation to make it absolutely
clear that you have addressed each point. You may not
get the award, but at least you will have satisfied all of
the criteria.
§§ Don’t leave any bits out! Bursary forms can often be
complicated. Take your time.
§§ Make sure you have a structured costing for the approach:
this means having an estimate of exactly what things
will cost, for example, you could try getting a cheap
accommodation quote. This way the funding body knows
what to expect.
It turned out that there was a bursary scheme organised
by the university. No one really knew about it, and it was
only at the last second that I actually got something
down on paper. In the end, after a short interview, me and
a partner got funded to the tune of £500 each, from a
bursary we’d never heard of. We were most grateful, and
pleased to provide the funder with information relating to
our elective report. It was good for the CV too! Remember,
most elective placements won’t charge for a student to be
trained there, but it’s worth checking.
4th year student, Birmingham University

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Remember that your university will have already checked your
vaccination status for your career path, so you’re probably
already halfway there. The rest may feel like a minefield, but
your health on the trip is the most important thing – both
mental and physical.
Some of the key things to look out for are risks of:
a. Malaria prophylaxis (remember to take the tablet out of
its packet and swallow to activate, don’t just leave them
in your bag)
b. Hepatitis A vaccination
c. Hepatitis B vaccination (you should have had this)
Other vaccines
Fortunately, as a medical student you will already have had
a fairly rigorous vaccination schedule, so this is the perfect
time to check your tetanus, Hep B, DTP and MMR status. We
recommend you seek advice on the following, as each of these
depends on the areas you plan to visit:
§§ Typhoid
§§ Yellow fever
§§ Meningococcus
§§ Japanese encephalitis
§§ Rabies
Your health matters

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I have taken highly active antiretroviral therapy (HAART)
personally following a practical procedure (and been
OK!). It’s a stressful situation, even at home. If you are
worried, one port of call would be the Infectious Diseases
department at a University Hospital, or again seeing your
GP. In practice you may have to pay for the tablets, and
in the end it’s a personal decision on taking them, and
depends on the circumstances.
Experiences as a CT1, Birmingham Hospital
HIV and hepatitis C
These conditions are very prevalent, but the good news is that
there are now excellent treatments available.
Accidents happen so try your best to minimise them. If you do
get a needle stick injury, it’s not the end of the world, but you do
need to do everything you can. This means serious consideration
about visits to sub-Saharan Africa, especially in the context of
situations where you may be exposed to high-risk procedures.
The situation is constantly evolving; your university may have
policy documents on this topic.

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TB (I don’t need to worry about TB, do I?)
It’s important to keep it in mind, as one student found out…
We rocked up to the specialist TB ward at the large
government hospital in Bangalore. The day before we
started the placement, we read a document from the
WHO which contained some estimations of the protection
given by the BCG. From memory, its best estimate was
30% - 98%. Bit of a shock! We decided not to visit the
multi-drug resistant TB ward. Be vigilant when it comes
to TB; remember that masks need to be custom fitted to
each individual to give proper protection from open TB.
Foundation doctor, elective in Karnataka, India
Remember to be vigilant against patients who have open
tuberculosis. Try and take as many precautions as possible.

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I did tell my bank, they calmly explained that
international counter fraud policies mean I could still
be blocked from withdrawing money. This did happen,
but only for 24 hours, and I managed to sort it out in a
bank branch, during working hours.
Anaesthetist, London
Money, money, money
If you are planning to use your debit or credit card when you
are travelling round the world, your bank needs to know.
Unfortunately, even if you do tell your bank, it doesn’t guarantee
you will still be able to withdraw money – every bank has
different policies, so it is worth understanding what they are
(and how to contact them if your card does get declined) before
you set off on your travels.
Take some medical kit
Along with the basics, you may want to take a travel health
pack if you are visiting a developing country. Think sensibly
about what you might need. This could include plasters,
bandages and an IV line and drip tubing. Oral rehydration
sachets are absolutely critical and it is worth buying
these separately.
Remember, travelling in a group is not only a great way to get to
know people, it can also make things a lot easier and safer.
Travel notes

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We were travelling in a group of three and one of the lads
we were travelling with had inflammatory bowel disease.
He ended up fairly unwell, and the antibiotic that we
took seemed to be fairly useful in the context of what we
labelled as ‘traveller’s diarrhoea’.
Anaesthetist, GP, Cumbria
I got sent back en route for my elective in Nepal from
Delhi airport. The airline flying me out from Heathrow
apparently should not have let me on the flight: I was
misinformed by a travel agent that I did not need a
visa for my connecting flight through India to Nepal
from Heathrow. I did, due to the flights being from
different terminals, and my luggage not being checked
all the way through to Kathmandu. It was my first (and
only) first class flight (I was in floods of tears and the
airline took pity on me and took me back to Heathrow
in luxury). I had to buy a new ticket, delaying the start
by several days, and at some cost.
FY2, Nottingham
Visas
We suggest you check your need for a visa for every country
you are visiting, including those with connecting flights that may
leave from different terminals. See the experience below.
Other basics
It’s important to remember the basics! If you are travelling
somewhere exotic, remember to get some up-to-date literature
on the area – The Rough Guide books are a good starting point.
Understanding the culture of a particular area can help you
avoid some potentially tricky situations.

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Here’s our list of the top 10 things to consider before and
during your trip.
1. Make sure you take out elective indemnity: most host
institutions will ask for proof of this. Remember, it is free,
but you do need to contact us so that we have all the
relevant details on record.
2. Tell your bank you are going away, including the dates
and times.
3. Take copies of your passport, health insurance, visas and
other travel documents. Store them somewhere safely.
4. Take a mobile phone that will work in the destination.
Check with your provider that you won’t be charged
extortionate rates. If you have a smartphone, make sure
you turn data roaming off.
5. Avoid taxis that don’t have a license and agree a fare to
your destination before getting in the cab. If your taxi driver
won’t agree a fare, we suggest getting another taxi.
6. Use your GP, occupational health department and, where
necessary, other practitioners to help advise on the
health aspects.
7. If you have a medical condition, chat to your specialist
about it (you may require documentation about different
medicines, in particular if you use insulin).
8. Be organised! Keep a record of all your documents and tell
family and relatives of your planned itinerary.
9. Have a budget, and plan in some leeway for unexpected
financial costs.
10. Consider travelling in a group and remember, don’t do
anything on your elective that you wouldn’t do in the UK.
Top 10 elective tips

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We have put together the following basic checklist for you to
refer to. This is by no means exhaustive, but there are some
useful ideas.
Take the originals and copies of:
§§ Passport
§§ Travel insurance and contact number (including
embassy contacts)
§§ Flight tickets and contact number for the sales office
§§ Indemnity documentation from Medical Protection
§§ Driving licence – if applicable
§§ Letter from medical school contact
§§ Copy of correspondence with accepting institution
§§ Document with contact details for: next of kin,
medical school contact, destinations, accommodation,
local organisations.
General kit
§§ Student ID card and holder
§§ Travel adaptors
§§ Mobile phone and charger
§§ A ‘yellow book’ (the pocket guides and the BNF are
excellent, plus anything else relevant to study)
§§ Other items may include a stethoscope, gloves, hand wash,
antibiotics and a post-exposure pack.
Your basic checklist

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General health
§§ Malaria tablets
§§ Medical pack (all in ones are good, available from high
street chemists). Make sure they are sealed to aid you
through customs.
§§ Post exposure HIV prophylaxis (PEP) kit
§§ Antibiotics (after discussion with GP)
§§ Plenty of oral rehydration sachets (buy them from
your chemist)
§§ Paracetamol.

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Travelling on an elective is a great opportunity to see the world
while enhancing your clinical skills.
We hope you enjoy it and good luck for the trip!
Good luck and
have fun!

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28. HOW TO CONTACT US
Medical Protection
33 Cavendish Square
London W1G 0PS
United Kingdom
Tel 0800 561 9000
IRL 1800 509 441
Int +44 113 243 6436
Fax +44 (0)113 241 0500
elective@medicalprotection.org
The Medical Protection Society Limited (MPS)
is a company limited by guarantee registered
in England with company number 36142 at 33
Cavendish Square, London, W1G 0PS.
MPS is not an insurance company. All the
benefits of membership of MPS are discretionary
as set out in the Memorandum and Articles of
Association. MPS is a registered trademark and
‘Medical Protection’ is a trading name of MPS.

29. Elective protection request form
MPS membership number
Full Name
Date of Birth Qualification Year
Email address
Address
Medical School
Current year of study
Country you will be going to
State (only applicable in the USA)
Elective Start Date Elective End Date
Date Signature
I confirm that the above information is correct to the best of my knowledge and belief, and
where information is different to that which MPS currently holds I authorise MPS to update
my records. I acknowledge that MPS will process the above information in accordance with
the data privacy statement I made when I applied for membership.

30. To apply for your FREE elective protection today, simply
complete the form overleaf and return in an envelope to:
Freepost RTBT-CZAY-BBKJ,
The Marketing Department,
Medical Protection Society,
Victoria House,
2 Victoria Place,
Leeds
LS11 5AE
Alternatively, call us on:
UK: 0800 561 9000
IRL: 1800 509 441
INT: +44 113 243 6436
Elective protection request form