A well travelled doctor, Mark Wilson has some useful advice

As a doctor or medical student medicine can be your passport to the world. We can turn up virtually anywhere around the globe and be welcomed and then suddenly involved in the most important part of people's lives, their health. There is probably no other profession that offers such a unique way of experiencing the true culture of another country.

There are three basic rules in planning electives and working abroad. Firstly, start thinking early. Most flying doctor posts in Australia get booked out over three years in advance, and many specialist hospitals have their places filled over a year in advance. That said, if you have left it to the last minute there are still plenty of great places to try. Secondly, do what you want. This is one huge opportunity to do what- ever you wish - make the most of it. If you want to work for the National Aeronautics and Space Administration (NASA), write. You'll never know unless you try. Finally, have a holiday - you'll need one before finals.

Checklist

Here's a checklist of things to consider.

Developing or developed world?

Both have advantages and disadvantages. In most African and many Asian hospitals you'll be "working" rather than "observing." This is an excellent way to learn and gain new skills. On the other hand, you may find that some of the poorer hospitals are limited in the treatment they can give. Seeing procedures done in hi-tech facilities in the United States may be more relevant to your work in Britain. Remember, you can combine both into an elective.

Non-hospital work

There are huge opportunities outside of hospitals. Ski patrols, diving research institutions, mountain rescue, NASA, and many non-governmental organisations that arrange community work can all be considered. Can you combine a hobby with your elective - for example, join a motor racing medical team if that's your thing?

Safety

Think about occupational health issues. In some parts of Africa the HIV prevalence is 50%. Do not be blasé about this. You may well have to do exposure prone procedures while there. Also avoid wars. Check with the Foreign Office at www.fco.gov.uk/ travel for advice.

Language

You won't get very far if you don't speak the language (except in areas where a translator is provided), but http://world. altavista.com/ can help you write and translate letters.

Finding out about places

The student BMJ has regular articles that are a great starting point. Go to the library and look through past issues or alternatively go to the studentBMJ website. Seniors' elective reports are another source. Perhaps your consultants know someone? There are many links on www.medicstravel.com, which also lists hospitals, non-governmental organisations, and recruitment agencies.

Getting funding

Try everyone. Write to local companies, Rotary type organisations, your old school (if a posh one, offer to do an assembly). Sublet your room, computer, bike, etc, while you're away. There are loads of prizes and grants for the taking. A full list is in the back of The Medic's Guide to Work and Electives Around the World, but other books to use include: The Directory of Grant Making Trusts (Charities Aid Foundation), The Grant Register (MacMillan Press), Sponsorship for Students (CRAC/Hobsons).

Immunisations, malaria prophylaxis, etc

Start thinking three months before you go about this. Check out www.masta.org/ immunisations for the latest information.

Indemnity insurance

This is not usually a problem, but get in touch with the Medical Defence Union or the Medical Protection Society for advice if you're going to the United States, Canada, or Israel.

Things to take

There are the obvious things - stethoscope, Etc - and the not so obvious. Here are some of the latter. For the hospital - especially in the developing world - take spare copies of the British National Formulary, old text-books, drugs, supplies if requested. Contact ECHO: cs@echohealth.org.uk and recent Sunday newspapers for any ex-pats who might be working in your chosen country. For yourself, take the specialities Oxford handbooks, a BNF, goggles (and gloves especially if you have allergies), padlock and chain (to hold your bag on buses), and an old passport (hand it over in hotels rather than the one you need to get out of the country).

Final tip

Scan in your passport, visa, etc, and send it to yourself as an email. Then if the real thing gets pinched at least you can print off some identification.

Taking time out once you have qualified is becoming increasingly popular especially now that some jobs in Australia and New Zealand can be used towards the MRCP and MRCS examinations. There are a host of things to consider, from getting registered in the country to continuing pension contributions. Do not be put off, start thinking about it now-here's so much more out there than just the NHS.

Medicine really is your passport to the world. Have fun. If you find a good place please do add it to the list on www.medic- stravel.com so others can also visit.