International medical electives during and after the COVID-19 pandemic - current state and future scenarios: a narrative review

Abstract

Background International medical electives are an important and popular component of the academic curriculum in many medical schools and universities worldwide. The purpose of abroad electives is to provide medical students with an opportunity to gain a better understanding of education and healthcare in an international context. The COVID-19 pandemic, however, has substantially changed the international elective landscape. Travel restrictions, closures of international elective programs and the expansion of virtual methods for education caused a widespread disruption to abroad electives. A comprehensive analysis with regard to other consequences for abroad electives, however, has not been done before. Thus, we sought to a) summarize the current transformation of the international medical elective and b) to address potential challenges for post-pandemic international medical electives. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on international electives during the last two years of the COVID-19 pandemic. Results Students worldwide had electives postponed or canceled. Apart from evident immediate pandemic-related consequences (such as the substantial decline in global electives and impaired elective research opportunities for educators), there are other several problems that have received little attention during the last two years. These include challenges in the elective application process, poorly-understood consequences for host institutions, and growing global (ethical) disparities that are likely to increase once elective programs will gradually re-open. There is ample evidence that the post-pandemic elective landscape will be characterized by increasing elective fees, and a more competitive seat-to-applicant ratio. Ethical problems for international electives arising from an unequal global vaccine distribution will pose an additional challenge to students and elective coordinators alike. Conclusion The COVID-19 pandemic transformed the international medical elective landscape in an unprecedented way, and future generations of medical students will face a series of additional challenges when applying for global medical electives.

Clinical electives in China: trends, experiences, barriers

“…Although largely from pre-pandemic times, our data may allow for important first insights in motivations for (and barriers to) electives in China. Data from the last 2 years would be most desirable, but is largely unavailable due to COVID-19 related travel restrictions and closure of international elective programs [ 13 , 20 ].…”

“…International medical electives (IMEs) are pertinent to global health education and allow students to immerse in foreign healthcare system for a short period [ 13 ]. IMEs have been associated with various educational benefits, potentially increasing students’ medical, cultural and linguistic competences [ 14 ].…”

Long-term trends in international medical electives fees: a database mining study

“…Globalization has given medical students the opportunity to pursue electives abroad, which may enhance the long-term socialization of medical professionals and foster cross-cultural exchange in a globalized world [ 5 – 9 ]. Electives also allow students for a global view on health problems of current times in a world where “the separation between domestic and international health problems is no longer useful” (Dr. Brundtland, Director General of the World Health Organization 1998–2003) [ 10 ].…”

A study on perception of medical students regarding implementation of elective module in India

“…Many recent studies have discussed the role of elective courses in undergraduate education (Lumb & Murdoch-Eaton, 2014;Kusurkar & Croiset, 2014;Suzuki & Nishigori 2018;Daccache et al, 2020, Willott et al, 2019, Cherniak et al, 2013. Many studies have reported the benefits of electives like increased knowledge and skills, enhanced critical thinking and problem-solving skills, Improved communication and teamwork skills, increased self-confidence and motivation, a more well-rounded education, opportunity for exploratory learning, lateral thinking, immersive learning, and development of spirit of enquiry (Khilnani & Thaddanee, 2022;Ramalho et al 2020, Al-Taher 2022Stys et al, 2013, Stone at al., 2022Bath et al, 2020, Storz, 2022. Also, electives affect the future choices of students regarding their clinical practice (Alkhaneen et al, 2018;Zuckerman et al, 2016;Dada et al, 2022;Rudasill et al, 2022;Alghamdi et al, 2022;Anand & Sankaran, 2019).…”