The Erasmus scheme was established in 1987 to promote the exchange of students between European countries and many medical students take part. Lewis Gray gives an overview of the programme and describes his experiences as a preclinical student in Switzerland

The European Community Action Scheme for the Mobility of University Students (Erasmus) is the cumbersome title of an excellent programme, named after Erasmus of Rotterdam (1466-1536), a Dutch humanist, and theologian, who travelled and studied throughout Europe.¹ The scheme provides organisation and funding to enable university students of any discipline to complete a period of study abroad, attending a university in any one of 30 member European countries.

Who can apply?

In general, students who study subjects other than foreign languages use the scheme to add a touch of interest and diversity to their course. An increasing number of medical schools are offering Erasmus exchange programmes to their students.

Erasmus schemes with universities in different countries are usually arranged in advance by participating universities and they provide students with a short list of countries from which to choose. The home university then makes flexible arrangements so that important modules and exams are still completed.

What level of language is necessary?

This will depend on your university. Students typically visit European countries with some experience of the appropriate language.

Is Erasmus different from an elective?

Erasmus exchange in medicine is quite different from the elective period. Although electives usually concentrate on practising clinical medicine in a specialised field or an unusual setting, Erasmus is specifically for people going to Europe and is linked directly to a university. The period abroad can also last for a year or a couple of months depending on the university.

In which year is Erasmus done?

This again depends on your university. Some medical schools offer the scheme to students in preclinical years, bur Erasmus is also an option for others later into medical student life.

How much does it cost?

Again this depends on the home university and the cost of living in the exchange country. Grants are available to study abroad and each participant university has an office that deals with this. The whole European programme for education (Socrates) of which Erasmus is a part has a budget for 2000-6 of around €950m (£650m; $1100m).²

My experience

Studying in a foreign country as a junior student rather than a senior one was an opportunity not to be missed. Without the emphasis on clinical knowledge and with increased time outside of study, I had much opportunity for learning, travelling, meeting other international students, and learning the language. During my third year at the University of Leicester Medical School, I took this opportunity and decided that Switzerland was the ideal location for me to continue my studies for three months. An integral part of this decision was the availability of skiing and chocolate, my limited ability in the French language, and a brief visit as a child.

I landed in Geneva airport early on a rainy day and I arrived on time in Lausanne--a steep, hilly city on the northern banks of Lake Geneva in the French speaking canton of Vaud.

The accommodation provided was a student hall block, reserved specifically for foreign students, facing the main university teaching hospital of Lausanne--the Central Hôpital Universitaire Vaudois--where the main medical teaching in the third to sixth years takes place. Although the accommodation was reasonably priced, the cost of everyday living was higher than in the United Kingdom. Tuition fees were expensive but fortunately were paid for by Lausanne University and a careful choice of budget flights kept the costs down. As exchange students, we also received a grant of about £650 courtesy of the Swiss government and the university which just about covered spending.

Introductions to all the academic staff were done via a lecture from the Erasmus coordinator to medical students from all over Europe studying in Lausanne. I was then asked to submit an individual timetable of subjects chosen from an immense list which covered all the subjects studied by Lausanne medical students in the third, fourth, and sixth years. I chose to study some subjects which were mainly lecture based, to help improve my French, along with subjects which had practical classes and others which were based on hospital wards. Several subjects were new to me, but I chose a few old favourites to see how the teaching differed in Switzerland.

Initially, I struggled with the language in university even though much of the medical teaching involved English texts and slides, and the clinical library had plenty of English books. But French lessons provided by the university at the hospital twice a week helped me to improve my language skills. By the end of the trip, I felt fairly confident in understanding medical French--and ordering drinks.

Language was not a barrier with the other exchange students as they were in the same boat as us. When my French lapsed into English, many of them could understand the resultant Franglais and the Swiss students in my learning group were accommodating and helped me with my French whenever I needed it.

It was always fascinating to see whether the stereotypes matched up to the reality. Switzerland is a country in which things really do work--even rural bus stops have electronic signs displaying information about the next buses. And a reduction for students in train travel and admissions to most museums and exhibits meant that I was able to visit many other parts of the country. Naturally, I made the most of the skiing opportunities, which were cheap for students.

Overall, studying medicine in a foreign country was a fantastic experience and one I would recommend to any student, regardless of language skills. Since the scheme began in 1987, over 700 000 students have benefited from the Erasmus experience,³ and as a medical student you could become one of the next.