Surinder Dosanjh
Foundation Year 2 Doctor, Broomfield Hospital
There was a great deal of upset in my year group when it came to electives. I was not in the year group where the idea of going abroad was completely out the question. Instead, for us it was a touch and go situation, dependent on country policies and the ever-fluctuating situation of the COVID pandemic. Many of those who did plan to go abroad had to cancel their electives and opt for a local department, few managed to fulfil placements abroad at the time. In a time of great uncertainty, I opted to arrange an elective with my local department through my university. Here I explain how staying local benefitted me.
Cheaper:
There are many bursaries and bursary prizes available specifically for those embarking on an elective abroad. These are well worth looking into. However, in most instances these bursaries do not completely cover all the costs involved. You may find it cheaper to perform an elective in one of the hospitals attached to your universities, which can often be free. It is important to plan well ahead and investigate if fees are attached to your planned placement. Many international universities do charge to have elective students, and this is worth keeping in mind.
Easier to organise:
Staying within one of the university affiliated hospitals made organising the elective a great deal easier. The process was streamlined. A few emails, a short form filled, and it was arranged. Occupational health clearance was also easier as I was already a student who had completed rotations within the hospital. This took a great deal of weight off my shoulders. I was secure in knowing I had my elective arranged early. This meant that I could keep my full focus on the upcoming examinations. At the same time many of my peers were trying to organise their electives abroad, sending emails back and forth and many were not sure if they would be able to travel abroad at the time of placement (due to the ever-evolving situation of the pandemic).
Quicker to hit the ground running:
Following my rotation in Ophthalmology in medical school my eyes had opened to the possibility of pursuing it as a career. I quickly came to understand the competitive nature of applying to Ophthalmology with stern competition left, right and centre. A competition ratio of near 10:1 is no joke (1). I was determined to simultaneously gain more information and experience in the specialty whilst also working meaningfully towards the portfolio. I chose to do my elective in the same department in which I had been a medical student and made my ambitions known prior to starting the elective. This meant that I was able to begin work on potential projects from day one. Some of which I managed to see through later to publication and presentation. Additionally, because I was already used to the hospital and healthcare system, I could spend more of my focus and effort on Ophthalmology and engaging whilst on elective. From developing new knowledge, to scrubbing up in during theatre or developing skills in the use of slit lamp. Had I gone abroad to a completely new department in a new country I can’t guarantee I would have been able to get stuck in quite as quickly. I can imagine I would have spent at least a week settling in with accommodation, a new route to travel, and completely new environment to experience. Many who go on elective spend their time exploring and experiencing a new culture, whilst not on placement. I would have been the same and would have struggled to have been as objective on working towards application and engrossing myself in the specialty. This would have by no means have been a negative. I believe we should take the opportunity to experience new cultures and go abroad when we can. Do note that many who go on electives abroad and write up case studies and become involved in research that they would otherwise not have had the chance to be involved in. At the same time many manage to make international connections in Ophthalmology which they would not otherwise have made.
Easier to keep up:
Since the department in which I did my elective was not far from where I am based it made it a fair bit easier to keep up with the department and with ongoing projects. This may not have been the case if had done an elective in a tropical country. This meant that I could go back and complete work on outstanding projects which I did not manage to complete during the elective.
A note on research projects:
It can at times feel like a rat race and in instances that might be the case. If one projects falls through it does not mean that all of them will. It could be worth trying to suss out people who have a genuine interest in research and trying to work with them. Be sure to make your ambitions known from the outset. If you want to aim for publication, then make sure you make this clear about this in the beginning. It would not be ideal aiming for a publication from a project which had no chance in the first place. Most people will be honest and tell you what the chances are. Do be aware most projects will not be worthy of publication, but they may have value in presentation, which could also gain points on the ST1 application portfolio. Points are also available for quality improvement projects/audits which do not need to be published to score some points (2).
Try to avoid getting disheartened if things do not fall in place straight away. I have been involved in numerous projects which either fell through or did not take off. In fact, the number of unsuccessful projects I have been involved in outnumber the number of successful ones by about 4-fold. There may be an element of chance involved in being lucky enough to work on something with potential. Only by putting yourself forward and trying will you have a chance of working on something that could be successful.
Pros and Cons on doing an elective locally/in the country.
Pros
- Likely cheaper
- Might be easier to drop into the department early and show your motivation towards Ophthalmology and working on projects.
- Easier to keep up with the department and complete work you may have started.
- Easier to focus on Ophthalmology, rather than getting distracted or spending time to adapt to a new environment.
Cons
- Missed opportunity to visit a new country, experience a new way of working.
- Missed opportunity to apply for travel bursaries/awards.
A Final Note:
I am incredibly grateful to the department for taking me on as an elective student and helping me to achieve my aims of for the elective. In a time of uncertainty about placements I opted for certainty by staying in the country. Where many may see it as a missed opportunity to go abroad I did not. I saw it as a chance to focus. I began the elective with the mindset of engrossing myself in Ophthalmology and working towards developing my skills, knowledge, and portfolio. I was able to carry this mindset through the placement without getting distracted as I imagine I might have become had I gone abroad.
If you have the chance to go abroad on elective, then do consider it. Many of my peers who did manage to go abroad thoroughly enjoyed it. To those considering doing one within the country there may be extra benefits beyond saving some money.
References
- 1. National Health Service England. Workforce, training, and education: Medical Hub Competition Ratios for 2023. [online]. 2023 [Accessed 24 January 2024] Available from: https://medical.hee.nhs.uk/medical-training-recruitment/medical-specialty-training/competition-ratios/2023-competition-ratios
- Health Education England. Severn Postgraduate Medical Education Ophthalmology: Evidence Folder [online]. 2024 [Accessed 24 January 2024] Available from: https://www.severndeanery.nhs.uk/recruitment/vacancies/show/oph-st1-24/evidence-folder-lib