When it comes to elective planning, students like to know they are getting the best deal. But how do you get the balance between cost and quality right? How much should you expect to pay to ensure that you get what you want, and when should the warning lights be flashing to alert you to a bad placement and wasted funds?
Earlier this year we ran an alumni survey, which included a section on the most important factors when booking your elective. In this article we’ve tackled those key criteria to help you understand more about what you should be looking for in a quality elective, and to give you more information about where your money goes when you book with a healthcare provider. At the end you should have a good idea of whether your planned elective is good value for money!
Students want a programme base that offers good placement opportunities as well as a variety of travel and social opportunities.
What’s it worth? Choosing a destination with set criteria is hard to price up. How much time do you have to research, and how flexible are you?
Booking with Work the World: We have 9 bases: Takoradi, Ghana; Arusha, Tanzania; Dar es Salaam, Tanzania; Pokhara, Nepal; Kathmandu, Nepal; Iloilo, Philippines; Dumaguete, Philippines; Arequipa, Peru; Kandy, Sri Lanka; and Anuradhapura, Sri Lanka. Each has been chosen because of the variety of placement options available, as well as the suitability of the area. For example we know students want to travel at weekends, so we take into account good travel links and can recommend local travel agents for the most popular weekend trips. We also know that access to internet cafes is important, as well as bars, restaurants and places to relax during afternoons and evenings.
A simple booking process with easy to access information
Lots of students commented that a lot of confusion and hard work stemmed from visa applications and university requests.
What’s it worth? So much of this is related to your time. If you don’t mind doing the research and keeping on top of your paperwork then this isn’t going to be a key factor for you.
Booking with Work the World: Shortly after signing up for your placement you will gain access to your own personal "MyTrip" webpage, which will help you prepare for the trip. This includes a comprehensive information pack and a timeline of preparation points to keep you on track. We also make sure any supporting material required by your university, or for visa applications, is instantly available for you to download.
Preparing for culture shock!
...and for all my questions and concerns (of which I had many) there was always a friendly voice on the other end of the phone to put me at ease.
Although nothing can entirely prepare you for life in another country, in particular what you will see on placement, lots of returning students made the point that having some idea of what to expect is invaluable.
What’s it worth? Again, the more time you spend preparing, the better equipped you will be! The cost is just your time and any books you buy.
Booking with Work the World: Our Operations Managers place a real focus on pre-departure preparation and speak to you at length about what to expect, what to take with you, how to navigate customs, who you need to speak to about what etc. Along with the documents available on MyTrip, they make sure you have all the information you need, and also that everything you want from your placement is communicated to the staff in country.
A guaranteed placement in your chosen department
I’d originally looked into organising my own elective, but after contacting a few different hospitals I found the planning increasingly complex, especially with my finals looming! Many friends were also having similar trouble, and I saw a few hit complete dead-ends, even as the time for our departure drew near.
Hospitals and clinics are very busy, understaffed and in most cases not aware of what an elective is. It can take a huge amount of time and administrative red tape to negotiate and agree what you want. Even when you feel like you have it in the bag, many students still find themselves subjected to those “sudden changes” that are typical of developing countries: different departments, change of start date, lack of supervisor…you know what me mean! With limited time to take placements, our alumni said that a guarantee that they could arrive and get started in the right department straight away was one of the most important things to get right.
What’s it worth? Ensuring you have a placement is the driving factor behind your whole trip, so it’s worth putting in the hours. Again, the cost is your time and any of that pesky “red tape” paperwork that the hospital may ask you for.
Booking with Work the World: Your Operations Manager will spend time discussing exactly what your requirements and objectives are for the hospital placement. We then liaise with our permanent in-country team to facilitate and confirm your placement. We have strong relationships with all the clinics, hospitals and partner institutions we use and our team will meet with the relevant departments to discuss each individual student, ensuring you are matched to the most suitable position and that everything is ready for your arrival.
Fully supervised elective, structured according to your level of skill
The BMA and other regulatory bodies are very clear about their recommendations for overseas electives – you have an ethical and moral duty to provide the best level of care to patients. This is reflected in your indemnity cover, which stipulates that you must have a supervisor and you can only work to your skill level. This is all good and well, but as we’ve already mentioned – many hospitals do not understand the ins and outs of electives. A quick internet search will highlight how often the rules are ignored – sometimes to terrifying consequence.
What’s it worth? In terms of cost, everyone has to pay a placement fee to the hospital. Depending on where you are going, there is a registration fee plus a weekly charge that can sometimes reduce after you have been there for 6 weeks or so. If you work in two or more hospitals, keep in mind the registration fee for both hospitals will apply. This fee does not guarantee your placement will be structured or supervised.
Booking with Work the World: Contracts are in place guaranteeing students safety and supervision, and also to ensure we are not a drain on much needed medical staff. All placement fees are included in the cost of our placements. We also make donations to different departments and supervisors throughout the year.
A good supervisor and opportunities for learning, education sharing and patient interaction
A supervisor can make or break an elective. You can feel included and useful, or completely alienated and in the way. Our students wanted to make sure their supervisors were of a high standard!
What’s it worth? This one is difficult to put a price on because in most cases you are not going to know what your supervisor is like until you arrive and start working with them. You can put the hours in (again!) and try and research recommendations.
Booking with Work the World: Work the World choose their placement supervisors because they provide excellent teaching. In return students are encouraged to share skills and make it an educational experience for everyone involved. We also make sure that supervisors have no more than 4 students with them at any one time (our busiest placements), and that this number is balanced with in-country students. Don't think you can just sit back and get invited to do things though - you still need to build relationships and prove yourself in the hospital. We'll get you there and support you, but then it's over to you.
A sustainable placement programme
The focus for electives is almost always on the benefits to the student, but what about the host community? What happens when you leave?
What's it worth? Making sure your placement is beneficial to the community will be up to you - if you want to put money / time into projects on the ground, you need to factor in the cost of this.
Booking with Work the World: Our unilateral exchange programme uses the fees paid by students to reward individual mentors, wards and departments at the hospital, as well as to train local staff to manage sustainable projects. Because we have the numbers, we are able to employ local staff to run our Work the World houses, buying in local produce for meals and supporting the local community. We also encourage students to get involved with local orphanages and community projects.
Opportunity to broaden your healthcare elective with different placement
I think working in the health post really brought on our clinical abilities – having a limited set of tools our skills in clinical examination and deduction were really tested and they improved greatly. I think our medical careers will have really benefitted from having had this experience on our electives.
You will know from the various rotations that you have already completed, just how different one placement can be from another. This is no different to hospitals overseas, and splitting placements between hospitals and / or clinics is invaluable to help you understand the greater picture of global health. Working in a developing country offers even more scope for placement options as urban and rural communities have wildly different options, and some countries put more faith in alternative healing methods than Western medicine. Working within a small community is a unique cultural experience that will give you amazing insight into the delivery of primary healthcare in developing countries.
What's it worth? Organising placements in different hospitals / clinics will cost you the separate admin fees discussed, as well as the time to communicate with two centres. When it comes to a rural community, this is where going alone could put you at a disadvantage. It is enormously difficult to arrange a placement and home stay within a community yourself and so you will have to find someone to do it for you in-country. There is no guarantees that your skill-set will be communicated, you will get to go when you want or the placement will conform to your expectations...
Booking with Work the World: As well as offering plenty of placement opportunities in each destination, we have created Village Healthcare Experiences in Ghana, Tanzania, Nepal and the Philippines as well as an Ayurvedic Healthcare Experience in Sri Lanka. Mornings will be spent working in a local health clinic treating anything from children with malaria to tribal hunting injuries, as well as administering vaccinations and delivering babies. At the Ayurvedic hospital you will focus more on the creation and application of traditional cures. During the afternoon you will be joined by your personal guide to explore the local area and find out noire about your community; cooking traditional dishes, visiting local healers, farming and joining in at colourful ceremonies. It is a unique experience that you cannot arrange yourself.
Travelling abroad does bring risks, and working in a developing country hospital increases those potential problems. What happens if something goes wrong? Will you be all alone out there?
What's it worth? Can you put a price on your own safety?
Booking with Work the World: We provide safe, secure accommodation, collect you at the airport when you arrive and also give you a local orientation so that you know how to get money, where to buy food, any areas to avoid etc. We will also take you to the hospital to introduce you to your key supervisors, showing you how to navigate local transport. Our staff are on hand 24/7 and are happy to give you advice whenever you need it.
Safe, secure accommodation
Although home stays sound as if they would be the best way to completely immerse yourself into society and learn more of the language and culture, after spending a day working in a busy hospital environment, returning students all told us that living with peers was far preferable. It also gave their parents peace of mind!
What's it worth? Well it depends on where you go. Mid-range hostels in the right locations will cost you as much as £30 - £35 per night in Dar es Salaam, hotels would be more. In Sri Lanka there is a split between local prices and tourist and a month long stay could be as much as £600. Meals on top of this can come in at around £25 per day if you are eating in decent eateries, and if you want to immerse yourself in the language then you will need to consider the cost of lessons. Again, the cost of this depends on where you go, but a weekly 1 hour private small group lesson in Ghana could be up to £25.
Booking with Work the World: One of the big additional benefits of our placements is the Work the World houses. They provide safe, secure and social housing for all of our students. We often get feedback to say they are one of the highlights - the fact that after a day on placement there was a comfortable home to relax in, amazing staff and delicious meals, as well as friends to discuss the day with and plan trips to the bar or weekend travels, made their trip. We also provide free language lessons at the house and have staff on hand if things go wrong, whether that is during your placement or whilst living in their country. As a comparison, the Dar es Salaam programme is £50 per day inclusive of everything and the Sri Lanka programme is £40.
My trip to Tanzania with Work the World was great value for money and, I felt, gave me the right balance of structure and independence to explore what and how I wanted. Perhaps, if you’re fiercely independent and just want to be able to go where the wind takes you, this might not be the elective for you, there are some rules, but for me, having just finished finals, it was stress free perfection.
If you have the time to put into planning an elective and the flexibility to amend your plans as you go, booking independently will save you money. You must be aware though that the responsibility lies entirely with you. If you arrive to find that your accommodation is shoddy, or the hospital have not entirely understood what you want, you will have to sort it out. If something goes wrong then you will just have to deal with it, and if it's not quite the experience you were hoping for then you will have to accept it. For some people, this is fine and all part of the adventure. It's not for everyone though, so have a think about what is important to you and what your expectations are.
With Work the World you are paying more for the simple reason that someone is doing all the work on your behalf. You do not need to worry about what you will find when you get there (it will be one of our staff in Work the World tee-shirt if you must know!) and how your placement is going to be organised (exactly as discussed with your Operations Manager). You don't need to concern yourself as to how you will cope with the food - we cater for all tastes - and whether your hotel will be ok. There is no need to panic about being a lone traveller as you will be living with a group of new friends who all want to make the most of the travel experiences available, and lastly, if something goes wrong then don't worry - we will be on the case quick as a flash!