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Electing something different

The line-up of experienced and well-travelled consultants for the Oxford Electives Conference in November promised a thought-provoking day, but the challenges and advice I was given went far beyond the expected. The establishment and perceived orthodoxy of the doctors invited lured me into a false expectation that I’d receive sensible advice on how an elective could develop my career, or provide research opportunities. Instead, I was told to forget those concerns and begin dreaming! One speaker told us that medicine is a “strong mistress” who can quickly bind us into straight-jackets; we should avoid worrying about the future, money, or safety while we still can. He told us to take our electives as an opportunity to push adventure to the limit: plan well, prepare properly, and, most importantly, dream big.

Of course, throughout the day was a smattering of the usual and very appropriate advice about going somewhere new, doing something we might never do again, exploring a new culture, and experiencing medicine in an unfamiliar system with different resource challenges. But the real gems we gained were the unexpected and bold statements of people who had lived their medical careers on the edge. They had practised their preaching of not letting worries of the future limit their horizons. Two separate consultants shared stories of how their seniors had told them it was irresponsible, even career suicide, to dream of working abroad. But their tales of adventure decorated exciting and successful careers including the challenges of setting up a new hospital and a global training program in emergency life-support. Needless to say, both of them are now extremely highly regarded and established in their respective specialties, and excited to see us take risks in our careers too.

We are extremely privileged to have the incredible opportunity to organise an elective, something which is unique to our vocation… So use it to do something interesting and exciting, don’t join the homogenous crowd: you could work on a boat, go out with flying doctors, work with a rural community, visit a continent you’ve never been to before, go down to the Antarctic, or up into the mountains.  

The practical advice

Although dreaming was a strong message of the conference, it was grounded with the insight that to realise a dream requires good planning and wise preparation. As with all the best things in life, you have to work and sometimes fight to make opportunities; no-one is going to serve us them on a platter.

Among the best shared were:  

  1. We must be prepared to trail through online reports and reviews and be unafraid to email relentlessly.  
  2. We should ask anyone and everyone for advice as we well know the medical world is full of people wanting to give you their opinions! Listen to and weigh them carefully; be inspired but also ensure that others’ fears of the unknown don’t put you off.  
  3. Beware you don’t get entwined in financial stress. For example, find out whether any bursaries are available and check your insurance well so you can have all the crazy adventures with peace of mind.

How to get the most out of it

One consultant shared her passion for learning words in the language of those she speaks to, both in her diverse patient population in the UK, and during her travels abroad. Nelson Mandela once said “If you talk to a man in a language he understands, that goes to his head. If you talk to him in his language, that goes to his heart”. Even if you make some effort to overcome a language barrier, such as learning some basic phrases in a local language, it will go a long way.  

Also, remember we are but humble medical students on a pilgrimage of knowledge and adventure. The advice given was not to be a ‘colonial waster’. We are going to learn and listen and serve; it is dangerous to assume the privilege of high-level education provides us with anything superior to the years of practical experience and sheer determination of those serving needy communities in low-resourced settings.  

I particularly enjoyed being implored not to work the whole time! There is probably some truth in Oxford students being overly-conscientious sometimes, and we’ll be working solidly for the rest of our careers. As well as medical experiences, we must take the opportunities to get involved with the local community, see the beauty of the local area, and learn about living with different challenges and fewer luxuries.

An elective may only be the beginning

For the majority of medical students, their elective is a one-off insight into an unfamiliar world of medicine with challenges and inspiration they may never see again. As we go through each specialty, we will find doctors reminisce through the decades to the unique and shaping experiences of their own electives, and they encourage us to get out there and do the same. But some of us may feel tugged to lands abroad for much longer than 10 weeks, and for those inclined, the road less trodden is there to be sought. The speakers on the conference all had different stories: some had travelled in an FY3 career gap year, or taken unpaid leave and career breaks (NHS employees are apparently entitled to unpaid sabbaticals after 5 years of service); others had worked abroad as part of their infectious diseases research, or sought an international community here in the UK through an interest in medical conditions predominantly affecting those born outside the UK. One speaker told us to join organisations which encourage a global interest, and plan our careers carefully to allow ‘fitting in’ time abroad. He went on to explain you must also marry the right person, if you choose to marry at all! Definitely the first time I’d had marriage advice in a lecture, but it makes sense – if you do dream of working abroad, particularly in developing nations, there will potentially be family sacrifices worth anticipating.

So after talks and workshops, lots of tea, biscuits and excited chatter, the conference had certainly given me food for thought. Dreams have begun sparking for the adventures ahead…


Helen Please is a third year graduate-entry medical student at Harris Manchester College  

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