Medical Electives in Sub-Saharan Africa: A 15-Year Student/NGO-Driven Initiative

Quaglio, Gianluca; Maziku, Donald; Bortolozzo, Marta; Parise, Nicoletta; Benedetto, Chiara; Lupato, Alice; Cavagna, Chiara; Tsegaye, Ademe; Putoto, Giovanni

doi:10.1007/s10900-021-01045-5

Cited by 7 publications

(7 citation statements)

References 47 publications

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“…For the purpose of this analysis, rather than being grouped by the type of journal article, the papers were grouped by the "perspective" on which they were based. The rst group was publications based on interviews and re ections of students returning from electives (14 papers) [8, [17][18][19][20]22,24,26,27,29,[31][32][33][34]. The second group consisted of publications written by members of host institutions in LMICs, or based on interviews with them (5 papers) [2,25,28,35,36].…”

Section: Literature Selection Resultsmentioning

confidence: 99%

“…Overview of the selected studies Travel destinations were mostly based in Sub-Saharan Africa (including Malawi [17,18], Zimbabwe [17], Zambia [18], Uganda [2,19,20] Tanzania [18,20], Botswana [21,22], Ghana [23,24], Benin [25], Kenya [17,26] and South Africa [19,26,27]), but also included other LMICs such as Solomon Islands [8,28,29] and India [2,17,22,26]. Students described in the studies mostly came from the USA (including Michigan [24] and Pennsylvania [21]), the UK (including London [17], Oxford [30], and Birmingham [31]), and Canada [2,22,26,32].…”

Section: Literature Selection Resultsmentioning

confidence: 99%

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A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

Chmura

Nagraj

2023

Preprint

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Background: International electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common following the global pandemic in 2020, ethical considerations of such practices re-emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs. Methods: We systematically searched PubMed, Global Health and Embase databases using the search terms “(ethics) AND (medical electives)”. Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results. Results: A total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. Most publications were written from the medical student perspective (n=14), rather than by the host-institution (n=5), with several written from third-party perspectives (n=18). Negative impacts on local host students and impact upon patient care, were identified as additional ethical considerations. Conclusions: Our review demonstrated that there is limited awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students’ access to medical education, and patient care. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses, and post-elective debriefs to increase medical students’ awareness of the impact of their presence on host communities.

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Section: Literature Selection Resultsmentioning

confidence: 99%

Section: Literature Selection Resultsmentioning

confidence: 99%

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

Chmura

Nagraj

2023

Preprint

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“…3,4 A scoping review by Dobiesz et al identified 56 studies involving 17 wars and 17 countries, and found that the most common barriers were insecurity, displacement, lack of resources, and psychological distress. 4 Additionally, the impact of war or conflict on medical education has been studied in various countries and regions, such as Iraq, 5 Libya, 6 Yemen, 7 sub-Saharan Africa, 8 and the Middle East. 9 These studies have revealed the diversity and complexity of the effects of war or conflict on medical education, as well as the resilience and innovation of medical educators and students in adapting to the changing and challenging circumstances.…”

Section: Introductionmentioning

confidence: 99%

Medical education in Syria at a time of crisis: Analysis of the results of the knowledge‐based National Medical Examination

Soqia,

Ataya,

Saadoun

et al. 2024

Medical Education

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ObjectiveThis study explored how the Syrian crisis, training conditions, and relocation influenced the National Medical Examination (NME) scores of final‐year medical students.MethodsResults of the NME were used to denote the performance of final‐year medical students between 2014 and 2021. The NME is a mandatory standardised test that measures the knowledge and competence of students in various clinical subjects. We categorised the data into two periods: period‐I (2014–2018) and period‐II (2019–2021). Period‐I represents students who trained under hostile circumstances, which refer to the devastating effects of a decade‐long Syrian crisis. Period‐II represents post‐hostilities phase, which is marked by a deepening economic crisis.ResultsCollected data included test scores for a total of 18 312 final‐year medical students from nine medical schools (from six public and three private universities). NME scores improved significantly in period‐II compared with period‐I tests (p < 0.0001). Campus location or relocation during the crisis affected the results significantly, with higher scores from students of medical schools located in lower‐risk regions compared with those from medical schools located in high‐risk regions (p < 0.0001), both during and in the post‐hostilities phases. Also, students of medical schools re‐located to lesser‐risk regions scored significantly less than those of medical schools located in high‐risk regions (p < 0.0001), but their scores remained inferior to that of students of medical schools that were originally located in lower‐risk regions (p < 0.0001).ConclusionAcademic performance of final year medical students can be adversely affected by crises and conflicts, with a clear tendency to recovery upon crises resolution. The study underscores the importance of maintaining and safeguarding the infrastructure of educational institutions, especially during times of crisis. Governments and educational authorities should prioritise resource allocation to ensure that medical schools have access to essential services, learning resources, and teaching personnel.

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“…International medical electives are a popular component of the curriculum of many medical schools and enjoy huge popularity among medical students [ 1 , 2 ]. Abroad electives are nowadays a common part of the student’s final year experience and considered a necessity to provide global health training, and to facilitate international clinical experiences [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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

Beckschulte,

Lederer,

Storz

2024

BMC Med Educ

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Background Abroad medical electives are recognized as high-impact practice and considered a necessity to provide global health training. As of recently, the COVID-19 pandemic and its related travel restrictions prohibited most international elective activities. Another important barrier to abroad electives that received comparably little attention is elective and application fees, which – combined – may be as high as $5000 per month, and may prevent students with limited financial resources from applying for an international elective. Elective fees have never been systematically analyzed and trends in teaching and application fees have rarely been subject to dedicated scientific investigations. Methods Using data from two large elective reports databases, the authors addressed this gap in the literature. The authors analyzed trends in abroad elective fees within the last 15 years in some of the most popular Anglo-American elective destinations among students from Germany, including the United States of America, Australia, New Zealand, the Republic of South Africa, Ireland and the United Kingdom. Results The authors identified n = 726 overseas elective reports that were uploaded between 2006 and 2020, of which n = 438 testimonies met the inclusion criteria. The United Kingdom and Australia were the most popular elective destinations (n = 123 and n = 113, respectively), followed by the Republic of South Africa (n = 104) and the United States of America (n = 44). Elective fees differed substantially—depending on the elective destinations and time point. Median elective fees were highest in the United States of America (€ 1875 for a 4-week elective between 2018–2020), followed by the Republic of South Africa (€ 400) and Australia (€ 378). The data also suggests an increasing trend for elective fees, particularly in the United States. Conclusions Rising fees warrant consideration and a discussion about the feasibility of reciprocity and the bidirectional flow of students in bidirectional exchange programs.

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Medical Electives in Sub-Saharan Africa: A 15-Year Student/NGO-Driven Initiative

Cited by 7 publications

References 47 publications

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

A Scoping Review of the Ethical Impacts of International Medical Electives on Local Students and Patient Care

Medical education in Syria at a time of crisis: Analysis of the results of the knowledge‐based National Medical Examination

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

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