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Yes! Pre-Departure Training is essential, here's why...

Pre-Departure Training (education) is the content and structured contemplation that happens before you start the experiential learning component of an international elective.  It may take several forms, from an organized pre-elective training day to completion of online pre-elective training modules. This preparation should be guided by experts who understand both your training and the local situation where your elective takes place.  There are aspects of pre-departure training that are the same regardless of where you go for your elective (such as learning about what culture is), and then there are aspects that are very specific to a particular geographic area (such as a specific culture’s approach to topics such as death and dying).

                                                 

Cultural humility: Resist the temptation to think one’s own culture and way of doing things is superior to another.  When done well this results in respecting another culture.                                                                                                                                    

Cross Cultural Effectiveness: Successful navigation of situations and relationships that are informed by different cultures and approaches.                                                          

Ethics: Advice on maintaining ethical standards (principles outlined in World Medical Association (WMA) International Code of Ethics) and approaches to ethical decision making e.g. working within the limits of your expertise and education level.     

Scope of Practice: Ensuring that the activities you engage in during your international elective are appropriate.  Being able to respectfully decline providing clinical care for which one is neither trained nor legally permitted to undertake (as per the Forum on Education Abroad  and WEIGHT guidelines)                                                 

Spirit and Purpose of the International Elective: Students should be primarily learners and you should not engage in clinical activities that you are not trained to do or that disrespect local licensure and medical professionalism norms.  As learners, students must have appropriate supervision and redundancies in clinical activities (so more senior doctors are reviewing the decisions and actions of students) so work is double-checked for accuracy and appropriateness.                                                               

Preparatory Global Health Education: Facilitated learning about the host health care system to ensure awareness of the following areas in contrast with home:

  • Characteristics of the hospital, clinic, public health effort or organization where you will be undertaking your elective (e.g. teaching hospital where there will be local medical students present, outpatient clinic, community-based NGO, etc)

  • Local epidemiology and burden of disease

  • The health system (including the role of certified health professionals and community or traditional medicine practitioners)

  • Available health care and services (if it is a low resource setting, the differences in practice e.g. resources, equipment, essential medication list etc.)

  • Political context                                                                                                                           

  • Language competencies in the local language as well as language awareness (what languages are spoken) as well as health and general literacy; what are local customs for interpreters; what do you do with patients who can't read/write? how does it affect obtaining consent for procedures, for example?                                                                        

One example of pre-departure training (although not destination specific) is The Practitioners Guide to Global Health.

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