In most medical schools, especially during the fourth year, it's possible to arrange a clinical elective overseas. There are many benefits to studying overseas as a medical student, even if you plan on ultimately establishing your career in the United States.
Many medical schools recognize the increasing importance of global health training; a 2009 survey found that approximately 25 percent of U.S. medical students graduated with some type of international medical experience.
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What are the benefits of international clinical experiences?
• Exposure to a wider variety of illnesses: Whether you're a medical student or a resident, you will likely see illnesses and unusual clinical presentations of conditions you would probably not see at your school or hospital. You will probably also have more latitude in clinical planning and get to perform more procedures.
A 2009 survey published in Academic Medicine noted the benefits of an international clinical rotation, which can give physicians the opportunity to treat patients with illnesses they would not typically encounter. The survey found that 18 percent of patients observed by pediatric residents who rotated in Peru and Guatemala had diseases they have never encountered, and 6 percent had diseases with which the residents were familiar, but not in such advanced stages.
• Learning about different health systems:
Rotating abroad, either as a medical student or as a resident, you learn a considerable amount of information about patients' experiences under different legal healthcare structures. Given possible upcoming changes in the American healthcare system, it could be additionally helpful to have experiences in practical clinical work overseas to better understand the context of the changes.
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• Broadening your horizons: It sounds simple, but doing a clinical clerkship overseas can provide a unique cultural understanding that affects your subsequent training. Residents surveyed in the above study stated that two years after completing an international clinical rotation, the experience continued to positively impact their awareness of cultural and socioeconomic factors and clinical and language skills. Additionally, the survey found that experience with different medical systems can help participants gain better cultural understanding of medical care.
The 2009 Academic Medicine study also concluded that medical students and residents who took advantage of international clinical opportunities were more likely to work with underserved populations. It noted that trainees who rotated internationally felt more confident with physical examinations and other clinical procedures. The authors speculate that the inability to rely on expensive tests forced medical students and residents to use clinical judgment over expensive studies.
As a medical student, how can you get involved?
There are some schools that allow medical students from a variety of institutions to participate in their programs; typically medical schools spend years cultivating relationships with clinics and/or hospitals abroad to open up these opportunities to their own students as well as others.
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The School of Medicine at Yale University traditionally has had the widest range of electives available internationally, and the Perelman School of Medicine at University of Pennsylvania has also been getting more involved in global health initiatives, having launched a global health residency track in 2008.
For medical students, rotating overseas can be costly, as the sponsoring institution frequently cannot offer support. The good news is that there are some funding opportunities available for medical students. Penn keeps a website of resources at other institutions that are typically open to all medical students interested in rotating in Europe, Africa, Latin America, or elsewhere.
If circumstances don't work out while you're a medical student, you can still work overseas later in your career, and there are programs, such as The Lancet Fellowship, that will help support a global health experience financially.
Medical school can be a tough experience. Knowing the resources available to students, particularly in overseas clinical opportunities, can really enhance not only your medical school experience, but also your applications to residencies and jobs down the line.
Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How to Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.