Every year, around 15,000 medical students pack their bags and prepare for an unforgettable experience abroad thanks to IFMSA exchanges. For at least one month, they are fully immersed in a new cultural environment and learn how to practice medicine or medical research in a new context. They develop friendships and experiences, and they have more than the daily recommended amount of fun. However, how prepared are they for such an enriching yet challenging experience?
Imagine you are a student doing your first clerkship in a country where the socio-cultural context is very different from your own and doctors have different expectations of the medical student.
How would you behave in front of a patient with an undiagnosed mental illness if there is a stigma against mental illness in the country? And how would you behave if your tutor required you to perform procedures beyond your competencies?
There is no easy answer to any of these questions, so it is with this perspective that IFMSA has developed a Pre-Departure Training (PDT) in collaboration with the UNESCO Chair in Bioethics.
Research shows that in the current globalized world, health issues are becoming increasingly transnational (Battat et al., 2010). In light of this, it is extremely important for medical students to be up to the challenges of modern medicine, which necessitates adaptation to the needs of a new, multicultural society. Literature also shows that Pre-Departure Trainings have a positive impact on outgoing students by giving them the skills to face ethical and cultural issues they may encounter in their host community (Anderson et al. 2012, Centre for Intercultural Learning, Canadian Foreign Service Institute 2005) .
The IFMSA UNESCO Pre-Departure Training has been pioneered with the goal of increasing exchange students’ ability to face ethical and cultural challenges in their host countries with greater confidence and to protect the patients they will encounter. This also translates to a generation of future physicians better skilled at treating patients from cultures different from their own.
Battat et al., Global health competencies and approaches in medical education: a literature review. BMC Medical Education, 2010, 10:94.
Anderson et al., Are We There Yet? Preparing Canadian Medical Students for Global Health Electives. Academic Medicine, Volume 87 – Issue 2 – p 206–209, 2012.
The training features sections on basic medical ethics, culture shock and cultural competence, exceeding level of skills, and basic research ethics. It is a combination of theory and case studies (12 case studies and 2 examples) that participants discuss in small groups.
The training has been tested in its preliminary version in 2017. To quantify the impact of this training, the students filled out pre and post test assessments. Through the improvement of their self-rated competencies, we were able to conclude that the students felt they had learned in the domains of basic medical ethics, cultural competency, understanding their level of skill, and basic research ethics. More importantly, we found that the training benefitted students in the same way regardless of their level of training and regardless of whether or not they had had an ethics course before.
In this toolkit, you can find the final version of the Pre-Departure Training, as well as the complete transcript of the training (the PDT manual), the evaluation form, and a short manual on how to deliver the training.
If you are going to facilitate this training, we recommend you to start your preparation by reading the “How to deliver the training” manual.