Department of Internal Medicine II, Centre for Complementary Medicine, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Emergency Medicine, Cantonal Hospital of Neuchâtel, Neuchâtel, Switzerland.
Hum Resour Health. 2022 Jan 17;20(1):9. doi: 10.1186/s12960-022-00707-2.
International medical electives are one the highlights of medical training. Literature about international electives is scarce, and understanding what made a student choose one destination over another is unclear. Many medical students based in Europe travel to Africa each year for their elective, however, students' expectations and motivations are yet largely unexplored.
To gain insights into the factors driving students to travel to Africa, we analyzed two large international elective databases based in Germany. We reviewed elective testimonies and extrapolated geographical data as well as the choice of discipline for electives completed in Africa. Based on pre-defined categories, we also investigated students' motivations and expectations.
We identified approximately 300 elective reports from medical students from German-speaking countries who chose to travel to Africa for their elective. Students commonly reported destinations in Southern and East Africa, with the Republic of South Africa and Tanzania being the most frequently selected destinations. Surgical disciplines were the most commonly reported choice. Diverse motivations were identified, including the desire to improve knowledge and clinical examination skills. A large proportion of students reported a link between destination choice and the potential to partake in surgical procedures not feasible at home; whether these surgeries were not or no longer practiced at home, or whether students could not partake due to level of training, was not ascertainable from the data. A trend-analysis revealed a growing interest in travelling to Africa for electives within the last 15 years. We observed a sharp decline in reports in 2020, a phenomenon most likely related to SARS-CoV-2-related travel restrictions.
This study suggests that medical electives in Africa are commonly reported by medical students from German-speaking countries, with diverse motivations for the choice of destination. A non-neglectable proportion of students identified the possibility to engage in surgical procedures as one of the main reasons for choosing Africa. This poses a series of ethical dilemmas, and well-structured pre-departure trainings may be a solution to this. The recent dip in overseas electives should be seen as a unique opportunity for medical schools and universities to restructure their international elective programs.
国际医学实习是医学培训的一个亮点。关于国际实习的文献很少，也不清楚是什么让学生选择一个目的地而不是另一个目的地。许多欧洲的医学生每年都会去非洲进行实习，但学生的期望和动机在很大程度上仍未得到探索。
为了深入了解促使学生前往非洲的因素，我们分析了两个基于德国的大型国际实习数据库。我们审查了实习报告，并推断出完成在非洲的实习的地理位置和学科选择等地理数据。基于预先定义的类别，我们还调查了学生的动机和期望。
我们从选择去非洲实习的德语国家的医学生中识别出大约 300 份实习报告。学生通常报告的目的地在南部和东部非洲，其中南非和坦桑尼亚是最常选择的目的地。外科是最常报告的选择。确定了多种动机，包括提高知识和临床检查技能的愿望。很大一部分学生报告说，他们选择实习目的地的原因与进行家里无法进行的手术的可能性有关；无法在国内进行手术的原因是手术在家里不进行或不再进行，还是因为学生的培训水平而无法进行，从数据中无法确定。趋势分析显示，过去 15 年来，学生对去非洲实习的兴趣不断增加。我们观察到 2020 年报告数量急剧下降，这种现象很可能与 SARS-CoV-2 相关的旅行限制有关。
本研究表明，德语国家的医学生普遍报告在非洲进行实习，选择目的地的动机多种多样。相当一部分学生认为有可能进行外科手术是选择非洲的主要原因之一。这带来了一系列伦理困境，而结构化的出国前培训可能是解决这一问题的方法。最近海外实习的减少应该被视为医学院和大学重新构建其国际实习项目的独特机会。
