Boost or burden? Issues posed by short placements in resource-poor settings

摘要

An estimated 40% of medical students seek out experiences working in resource-poor settings during their training and significant numbers also contribute after graduation.1 It is argued that this benefits their hosts and, some believe, the UK too.2,3 In this issue Elnawawy et al report on the complex issues identified through qualitative study of one such voluntary primary care scheme in Nepal.4 Despite a small number of respondents from a single non-governmental organisation in one country, these interviews highlight a number of important issues that chime strongly with our experiences, including the risk of significant unanticipated negative impacts. We argue that elective students, doctors seeking out-of-programme experiences, and experienced GPs should be encouraged to deeply consider what they are hoping to achieve, and how they can ensure their contributions are positive, both for themselves and their hosts. ‘Donor’ organisations facilitating placements (including medical schools and deaneries) should also plan, prepare volunteers, and carefully consider contextual issues as part of their responsibility.