Electives and self-care: do your global health thing but do yourself first.
I’ve been thinking a lot about medical electives recently. Not least because this is an opportunity fast approaching for me, and I’ve been wrestling with that dilemma that seems to confront us when we first think about the elective: do I go for a two-month holiday, or a two-month aid effort? Do I use my elective as an eye-opening, perhaps more meaningful addition to my education or do I use those precious two months as a bit of time to explore my favourite specialty or city? Do I spend eight weeks wrapped up in scarves and bathing my ears in the luxury of Scottish accents, or do I push myself to assist primary care workers with our refugees on Christmas Island?
Do I use my elective as an eye-opening, perhaps more meaningful addition to my education or do I use those precious two months as a bit of time to explore my favourite specialty or city?
Of course, these two immediate choices undergo permutations as we approach final decisions about our perfect elective, and I’ve heard many baby docs do a neat little combination of the two. But it left me wondering – for those of us looking for something to fulfil a need to help people less advantaged than ourselves, what is the best way to achieve that and also cope with the mental/cultural shock of working in a poorer country?
An increasing proportion of medical students in Australia have centred their electives on a desire to give back and to help people in places that need international aid. This broadening of medical student focus to the outside world is directly parallel to the call for more global health teaching and opportunities within medical curricula – a voice that I hope continues to grow in volume as we head for our medical futures. But as Law et al pointed out in the MJA in 2013, we are often underprepared before departure, and under-supported upon return from electives in countries that present significant cultural and psychological stress.1 The shock to the system of working in low-resource areas is an experience not to be undervalued, perhaps even an experience that should be encouraged; so how do we ensure our own health and safety when embarking on an inherently risky endeavour?
We are often underprepared before departure, and under-supported upon return from electives in countries that present significant cultural and psychological stress.
The article doesn’t offer a great deal in terms of solutions to supporting students. Perhaps this is something we need to take up ourselves? We all understand the importance of mental health and self-care – you can’t give from an empty vessel – so perhaps it should be taken upon ourselves to ensure we each care for each other when undertaking rotations in difficult circumstances. Networking with other students heading to the same area could help in preparing for what you expect from the elective, and debriefing with mentors and seniors is a brilliant way to cope with confronting issues and difficult patient experiences.2
Please don’t let this deter you though – go on those big adventures to those far-off places, but make sure you care for yourself while you’re out saving the world.
Side note – here are some really cool places to organise global health-focused electives, in case you’re interested/you’re like me and have left it to the last minute.
Lots of love,
Article – Emily Earnshaw
Photo – Monica Leung
- Law I, Worley P, Langham F. International medical electives undertaken by Australian medical students: current trends and future directions. Med J Aust [Internet]. 2013 [cited 2015 Mar 26];198(6):324-6. Available from: MJA.
- Kelly E, Nisker J. Medical students’ first experience of death. Medical Education [Internet]. 2010 [cited 2015 Mar 26];44(4):421-8. Available from: Medline.