How do I pick the program that is best for me?

You may be asking yourself, with so many programs offering similar things, which program should I choose? Several factors can help you decide which program to select. The most important factor to consider is personal safety. Research the political situation of the country you are interested. Check out www.travel.state.gov for a listing of countries that are on the State's Department Warning List. Also, use the checklist below to help assess the safety of the programs you are interested in.

Housing is another important factor to consider. Some programs have host families or dorms that house participants, while others offer no accommodation.

Cost is always relevant. You may want to ask the program what is included in any fees. For example, do they provide transportation within the country, or does the student have financial responsibility for all transportation? Do the programs organize excursions, and how much extra might they cost? On occasion, they may even provide cellular phones.

Finally, assess your objectives. Is language acquisition or strengthening a primary objective? Do you want to go as an observer or do you want hands-on activity? Ask the program specific questions to make sure that your objectives will be met. You should also be aware of what types of environments you enjoy working in. Are you an independent person who wants to work in environments where there is less structure? Or do you enjoy working with a group in a very structured program? Also examine your program's approach to service. Is it compatible with your value system? Consider whether the program is religiously based, grassroots based, or paternalistic.

Do certain programs have more difficulties being recognized for credit by the student's home institution? If so, what can be done?

For various reasons, some schools are less accepting of clinical rotations overseas than others. You can have the program you are interested in send your school detailed information about the elective. This will give your school and the other school a chance to reach a resolution to your benefit. You also have the option of creating a project worth credit at your school, working with a faculty member.

Language: do I need to speak the local language?

Although several hospitals will not require you to speak the local language, various difficulties can arise that may frustrate you, so a good attitude will go a long way toward a positive experience. That said, practicing medicine in the United States means that at some point, you will probably have to use a translator. It is more difficult than it would seem, so a comfort level with translators is an asset you might develop. Choosing to work in a country where you do speak the native language will allow you to benefit from the overall experience without the additional stress of not being able to communicate with the native people.

However, one of the single most important skills you can take away from time in another culture is a functional level of another language. It allows you to connect with patients on their turf if you - literally - speak their language. They will feel more comfortable with you, and the intimacy so fundamental to the therapeutic alliance of the patient-physician relationship is a natural extension of their gratitude for your effort. If you choose to learn one of the languages clearly useful in the area where you will live and practice, you will then have direct access to many of the underserved populations whose health care is otherwise compromised by language barriers. Though studying language coursework within a country where it's not the local language is useful, it is much more efficient (and exciting and fun, if a little scary) to take the plunge into immersion language training before you enter the clinical setting. If you can possibly take an extra month to do intensive language immersion before you get into the clinics abroad, or work with a program that offers both, you'll take away a skill you can use for the rest of your life. Clinical experience is important, and the perspective you gain from learning about other systems and circumstances will enrich your ability to care for patients, but language skills are priceless.

Questions to ask About Housing

  1. Do you have dormitories for international students?
  2. What are the differences between the dorms specified for international students verses those for regular students?
  3. Are homestays available?
  4. Are meals included in my housing options?
  5. Is their electricity? Running water? Cooking facilities? Hot water?
  6. How far are the dorms from the hospital/clinic?
  7. If I have to walk to the hospital, will I feel safe walking?
  8. If I cannot walk to the hospital, is there readily available, cost effective, and reliable transportation?
  9. Will I feel safe using the public transportation system?

Concerning Safety

  1. How are foreigners viewed in this country?
  2. Have they been any recent kidnappings?
  3. What is the current political situation in this country?
  4. How much contact will I have with the outside world (internet)?
  5. Will I be able to lock up valuables when I am absent?
  6. What is this country's perception of women?

Assessing Program Content

  1. Is the program highly structured, or will I be organizing my own schedule?
  2. What are my clinical responsibilities?
  3. What will be my duties as a student?
  4. Will I be with other students from the United States?
  5. Can I speak with someone in the department I am most interested?
  6. What types of outside programming is offered? Classes? Excursions? Service projects?
  7. Is there an orientation? Cultural awareness training?
  8. How much community input is taken into account?
  9. What are the relationships of the people who work in the program with those in the community? Are they integrated?
  10. What access will I have to textbooks?

Packing

  1. What items do I need to bring with me (mosquito net, etc.)
  2. What medical supplies and personal items should I bring?
  3. What will the weather be like?
  4. What is the dress code, both for working in the program and in the community? How can I dress to be culturally sensitive?

If you manage to get all or most of these questions answered in a way that pleases you, you've probably found a program that's a good match for you. Good luck, and let us know if you have any questions, insights, ideas or stories you'd like to share!

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