Working in global health: A planning and implementation framework for international electives.

PURPOSE: Propose a framework for planning and undertaking an international elective.

METHODS: On returning from conducting maternal health and well-being research in several remote communities in India, two undergraduate medical students have reflected on and documented their experiences with the view to assisting other students (and their supervisors) considering undertaking an international elective.

RESULTS: A framework for undertaking clinical or research electives in remote or rural communities is presented. The framework comprises three distinct phases: Pre-departure planning and briefing, in-country experiences and returning from the elective and considers a range of factors to ensure that, as a minimum, visiting students "do no harm" and are themselves not harmed.

CONCLUSIONS: Students' home institutions have a duty of care for preparing them for their international electives by providing pre-departure training, support during the elective and comprehensive de-briefing on their return. These electives should be evaluated (including by host communities) to ensure that exchanges are socially accountable, with no harm to the often-vulnerable communities in which students gain considerable experience. Also important is that future students build on the positive experiences of their predecessors to ensure sustainability of any interventions in host communities.