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Overseas midwifery placements - planning your elective

Overseas midwifery placements - planning your elective

Overseas midwifery electives

As awareness of global health increases, many midwifery students are keen to take their university electives in a developing country. Working in this contrasting environment can build your knowledge and skills base while challenging your perceptions of midwifery – a great way for you to develop both personally and professionally. However, it is important to plan your elective well to make sure that both you and the country you are visiting benefit from your placement.

The RCM has worked with Dr Gaynor Maclean, author of ‘Electives and International Midwifery Consultancy: A Resource for Students, Midwives and Other Healthcare Professionals’ (click here to read a free chapter of the book) to develop an i-learn module to guide you through the process of planning and preparing for your overseas midwifery elective. The module includes:

  • Activities to clarify your motivations for undertaking an overseas elective
  • Preparation for the cultural, emotional, and professional challenges you may face
  • Opportunities to reflect on your personal development before and after your elective
  • Advice on planning and resourcing your elective
  • Links to our i-folio platform so you can create a body of evidence of your development through your elective.

Find the module by searching ‘elective’ on i-learn or click here

Rob Giddings, Operations Manager at Work the World, explains how students can benefit from taking their electives in a developing country and how to plan it.

As awareness of global health increases, many midwifery students are keen to take their university electives in a developing country. Working in this contrasting environment can build on your knowledge and skills base while challenging your perceptions of midwifery – a great way for you to develop both personally and professionally. However, arranged badly, it can be a very different story, placing both you and the women at risk. 
Busy hospitals with limited resources can result in students often finding themselves involved very quickly and needing to rely on the basics of their midwifery training to diagnose and treat. If supervisors do not adequately understand a student’s level of skill or experience, procedures are at odds with UK teaching or cultural differences affect treatment, then numerous clinical or ethical dilemmas can arise. 
What should you be looking for in an elective?
Dundee University identified four key learning domains for electives: clinical knowledge and skills, attitudes, global perspectives and personal and professional development. They also noted two broader issues: institutional benefits and moral/ethical considerations. In every case they felt opportunities were missed due to a lack of structure and planning. The conclusion was that electives do not benefit from ad-hoc arrangements. (Dowell and Merrylees, 2009).
Whether you decide to book an elective through an established company or independently, the best advice is to start planning it as early as you can. Do the research to find out what opportunities are available, and then be very clear when you get in touch with the hospital or company about your experience and goals. As a student you will also need to make sure the overseas staff understand what an elective is. Many will not appreciate your level of training, which could lead to enormous confusion about the level of supervision you need. 
Although this sounds like it could be achieved simply by sending a few emails, many misunderstandings result from hospitals or staff that don’t place the same level of importance on your elective as you do. Many students arrive to find themselves placed in a different department, or even turned away from the hospital because there is no one to supervise them.
There is also the concern of unscrupulous hospitals that have placed the revenue from student fees above both patient care and student experience: ‘I was in competition with every other student to see and do the interesting things that were difficult to experience at home… I usually found myself about three or four rows back in the ward rounds, and sometimes I could not even fit in the room.’ (Blake, 2011).
To make sure you get what you are expecting, try to find out as much as you can about how your placement will work in advance. One of the most important factors is your supervision, something that could make the difference between an amazing learning experience and two weeks of feeling alienated and removed from the team. Try and establish who you will be working with, whether your role will involve patient interaction and how many other medical students will be working with you. If you are booking independently, put the hours into research, follow up communications and try and get everything in writing, signed where relevant. 
At this point you should also start thinking about your safety and support while working overseas. Any travel brings with it an element of risk, so you must make sure you have suitable travel insurance and indemnity protection, as well as a plan of what to do if things go wrong. It is also wise to research and book recommended accommodation and arrange visas, insurance and inoculations (if relevant).
As part of your research you should also give serious consideration to the bilateral benefit of your elective. Until now we have focused entirely on how you will get what you want, but what about the host community? Any project you join should be sustainable and the fees you pay the hospital should support this. It may be your dream to travel to Africa and make a difference, but you must think about what happens when you have gone. You are there to assist and learn within an existing department and you should treat it the same way as you would a placement at home.
Taking the hassle out of elective planning
If, like many midwifery students, you are reading this and thinking you do not have the time to invest in all this planning, there are other options. Companies like Work the World specialise in healthcare placements including midwifery. Alasdair Thompson, Elective consultant at Work the World, said: ‘We have memorandums of understanding (MOUs) in place with each of the hospitals we work with, giving us the flexibility to tailor placements around each student’s interests and needs. These agreements also guarantee supervision levels and limit numbers of international students.’
You also receive comprehensive pre-departure preparation that will ensure you are totally prepared for your trip and 24/7 support when on your placement. Fees are used for training and support of local hospital and ground staff as well as the management of sustainable projects. There are also the added benefits of accommodation and meals in private Work the World houses that you share with like-minded students from around the world. 
Of course, the issue with booking an elective via a specialist company is that for some students the increased cost is prohibitive. Before you discount your dream of working in an under-resourced environment though, there are ways in which you can raise money for a placement. We’ve talked about the benefits to your career, but these also apply to the industry. Many companies are prepared to invest in your future by sponsoring you and there are lots of different awards and bursaries that you can apply for. You can also think about fundraising – volunteering in a busy hospital and using your midwifery skills to support an under-resourced team is a definitely a worthy cause.
Contact Work the World on 01273 974634 or email info@worktheworld.co.uk
Dowell J, Merrylees N. (2009) Electives: isn't it time for a change? See: http://www.ncbi.nlm.nih.gov/pubmed/19161481 (accessed 29 March 2012).
Blake M. (2011) Medical Electives in Developing Countries: Making a Real Difference? See: http://eview.anu.edu.au/medical_journal/vol3_12/pdf/ch19.pdf (accessed 29 March 2012).