Where to go?

Deciding where to go can initially feel daunting, since you basically have the whole world to choose from! However, there are a few considerations that can help you start to narrow it down.

The first thing to think about is what you want from your elective experience. It can feel like there's pressure to have a sun-soaked, adventure-filled 8 weeks, but what really matters is having an experience that is special for you. Therefore, I wouldn’t stress about making it Instagram-worthy, but focus on exploring something you might not get to do otherwise.

Home or abroad?

Lots of people stay in the UK for their elective and there are many advantages to doing so: you can save lots of money, spend some valuable time at home, or see how a particular speciality is done elsewhere in the UK, perhaps in a leading specialist centre. The UK is more varied than people give it credit for, so there are plenty of options if going abroad is unappealing or unaffordable for you.

If you want to go abroad, there are factors that might help you decide where. Would you prefer somewhere English-speaking, are you happy to go somewhere where communication might be a struggle, or are you willing to put time into learning a new language?

English-speaking places:

Australia and New Zealand – both are attractive countries for obvious reasons, and easy options in terms of language. The downside is the cost of flights and accommodation. You also need to apply early for these (at least 12 months in advance).
Canada – not as expensive, but costs will still be considerable. Most applications open 6 months in advance. 
America – definitely an option, and good for research electives, but bear in mind that you have to pay just to apply to many places, and some also require the USMLE. 

If you're interested in applying to any of these places, I'd really recommend trying to find someone who's been, and talking to them about it.

Many other countries, such as India and Kenya, have English as an official language. However, whilst the doctors you work alongside may speak English, patients often speak a different local language, which can have implications for history taking. It's always useful to learn some basic phrases which will help you inside and outside the hospital, and you could consider doing a specialty which doesn't rely so heavily on history taking, such as radiology or surgery.

Some people want to go somewhere relaxing before starting 5th year, whereas others want to encounter medicine in a developing country. This can be an eye-opening experience, giving you an opportunity to observe how medicine is practised in a resource-poor setting. It's really important to ensure that your elective is ethical – you should be well-supported by your seniors and always work within the limits of your competency. Make sure you research the hospital before going, ideally by speaking to someone who has been there, or by reading reviews on somewhere like The Electives Network. People have a tendency to think that the more challenging experiences are the most rewarding, but it's worth thinking carefully about how much inconvenience you are willing to put up with!

Flying Solo?

Another question people puzzle over is whether to go alone or in a group. If you have firm ideas about where you want to go and what you want to do, being part of a group might involve compromises that you're not willing to make. Eight weeks is a long time flying solo, so you need to be comfortable with the thought of making friends once you're out there and spending time in your own company. On the other hand, if you're happy not having control over every aspect of the elective, going away as a group can be an amazing experience. By fourth year you probably know your peers well enough to know whether they will drive you crazy if you live in a hut together for 8 weeks!

Organisiation

The best ways to find a hospital are to use the internet and ask other people. Websites such as The Electives Network and the University Elective Search are useful. When you have found somewhere you might be interested in, send an email. In fact, send lots of emails, and be persistent, as it's likely that you won't get a reply from some people. Most people start doing this around a year to 9 months before the elective. Having things organised well in advance does have benefits such as getting cheaper flights and having plenty of time to apply for bursaries. However, don’t stress if your friends are all sorted and you're not – once you get the go-ahead from your prospective hospital, the details can all be arranged pretty quickly.

Some people choose to go with a company – some medical schools discourage this, but it can make life easier if you're going alone. Although they can be expensive, they are still worth considering – just make sure that you research the company and the elective.

There are lots of checklists and websites to help you with the details of your elective such as accommodation, insurance etc. The BMA have one, as do The Electives Network. If you have an assessment or assignment for your elective, read the brief before you go, so you have an idea of what things to make notes on whilst you are there.

Lastly, remember that while the elective is a great opportunity, it's not your only chance to travel or experience medicine abroad – you could take an F3 year or do part of your training abroad in the future. Do what feels best for you, and try not to compare your experience to anyone else’s, as everyone has their own priorities. Enjoy your elective experience for what it is. Happy planning!

Here at Medisense we know that keeping the cost of your elective down can be a worry – stay tuned for another blog post full of tips on how to do it.

If you’d like to contribute to the Medisense blog, we’d love to hear from you – send us an email at blog@medisense.org.uk.