Pre-planning is vital if you want to work abroad as a medic in a humanitarian role. You can just pick up sticks and go but it is far better to plan 18 months to two years in advance and know what you want to do and what you want to achieve – whether that is helping with education, to gain clinical skills which will count towards your training, or simply gaining experience in a different environment.
If you are currently in a training programme, you will need to get permission from your training programme director and head of school (depending on timing.)
It may help if you can find a time to go when there are natural breaks in your training programme. For example after Foundation training or before applying for registrar training posts but think about what experience you have and what you can offer at the different stages of your career. Some shorter trips can be squeezed in during annual leave and there are fellowships available that can be counted for training (OOPT) or an ‘out of programme experience’ (OOPE).
Your trip may also need to be funded. Some charities and NGOs will pay a small in-country wage and travel expenses, but many small organisations need you to financially support yourself. Now is the time to search the internet to try and find grants and resources available to medics who are planning to work abroad as volunteers. This may also depend on your speciality. For example, the Association of Anaesthetists of Great Britain and Ireland do offer bursaries to anaesthetists who are volunteering for humanitarian work. The Royal Society of Medicine also has a bursary scheme.
Lots of medics who want to work abroad work hard to get money by running marathons and doing charity fundraising. When you get to your destination, ensure that you have a credit card that will be accepted in remote areas of Africa, Asia or wherever you end up. Buy the best insurance you can afford and read the small print – you want it to cover you if you decide to shoot those Grade 5 rapids on your weekend off! Again, some charities and NGOs will cover this for you, but check. Ask your medical insurer about your cover as a medical professional too. A quick call to the Medical Defence Union will pay dividends in the long term. For longer trips also think about GMC revalidation and your NHS pension and how your trip may affect this. Lots of organisations are very specific about what they need, but if not, be proactive and find out what you will need to deliver and what you will need to bring with you. Go on preparatory courses and speak to those who have been out to where you are going, they will give you top tips you won’t find anywhere else!
Your own health will be important throughout the trip so visit a travel clinic and get the correct jabs for the country where you intend to travel. And take precautions when you arrive. For example, wearing insect repellent and sunscreen in hot climates and avoiding swimming in standing water where water-borne parasites are known to breed. Some immunisations require a course of injections and so important to check out what you may need early. Also check out the availability of Post Exposure Prophylaxis if involved with clinical work, as it might be necessary to take some with you.
Expect a bit of culture shock when you arrive – life can be very different from what we’re used to in the UK – but it will also be an amazing experience you will never forget. I took a bottle of Tabasco because it made the food taste nicer and reminded me of home. Take things to help you relax and unwind. Friends suggest downloading podcasts or a dozen Desert Island Discs onto your iPad. And then there will be reverse culture shock when you come back. You may find you need to talk to people about what you have seen and done so keep your support network around you. Plan a break with family and friends rather than going straight back to work and you can adjust slowly. Enjoy and make the most of your experiences!
Dr Green is co-organiser of the RSM ‘opportunities in expedition and humanitarian medicine’ conference, find out more here.