Bhanu Krishnan and Toby Briant-Evans fill you in on what you need to know to do an elective full of the proverbial French charm

Risking the classic cliché of your average, unimaginative travel book, France really is a country of astonishing diversity. From the romance and art in Paris to the mountain activities in the Alps and Pyrenees, and to the warmer climes of the Mediterranean coast, France is a great country in which to spend time working and brushing up on your French while either steeping yourself in culture or enjoying adrenaline ridden sports. Those who fancy spending their afternoons topping up their tan after a morning on the wards are well served by the sunny beaches of the south.

There is also, of course, the opportunity to further the progression of the cirrhotic liver begun in medical school at home, by visiting the vineyards and tasting those famous wines. France's proximity to the United Kingdom means that money otherwise spent on long haul flights by those travelling further afield on their elective can be saved and spent instead on exploring France thoroughly.

France's current prime minister, Jacques Chirac, was elected in May 1995. He makes all the major policy decisions, and his attempts to reduce welfare payments, among other issues, have resulted in widespread strikes in recent years.

Good healthcare provision

The standard of healthcare provision, as you might expect, is very high. Being at the forefront of research in many fields, the population is well cared for: 2.8 general practitioners, 0.02 public hospitals, and 0.05 private hospitals per 1000 people. Health care is funded by a complex cost sharing system between state funding and individual private healthcare insurance. Anyone falling ill in France has the choice of visiting their local general practitioner or "service des urgences," as in the United Kingdom, but may also self refer themselves directly to a specialist. France, being part of the EU, has a reciprocal health agreement with the United Kingdom, so if you require medical treatment, bring along your E111 form and you should be entitled to a refund of 70% of the cost of treatment, although it is advisable to have your own private insurance policy.

Medical training

Medical training is similar to that back home, with courses of around six years. However, there is a two year "premedical" course that the majority of applicants are accepted on, and only the top performers are selected to continue their medical training. There are various opportunities for medical students to arrange exchange attachments between medical schools.

Health and safety

France is generally a safe country. The main risk to any young traveller is probably road accidents, but this is no different from the United Kingdom.

Apparently Lyme disease is prevalent in forested areas, so take some insect repellent. Rabies is a well publicised, but rare, risk. You may be able to persuade your general practitioner to give you the human diploid cell rabies vaccine available but as medical students are hardly a high risk group, you will have to pay. If bitten seek medical help immediately.

There are no special vaccination requirements necessary before entering France, neither are any particularly recommended. An estimated 90 000 people were reported infected with HIV in 1995, according to figures from the World Health Organisation, so take the usual precautions. Avoid dehydration and sunstroke in hot weather. The tap water and food are usually completely safe.

Other useful information

To spend an elective working in France, no visa or work permits are necessary. The other great bonus is that the Medical Defence Union and Medical Protection Society covering us for indemnity in this country can extend their services to Europe for the cost of a phone call. Being so close to home is definitely an advantage; getting there is really cheap, even if you fly. If you have any intention of seeing something of the country it is really worth taking a car--the ferry is cheap and the quality of the French autoroutes is excellent. Cash cards with a Cirrus symbol work, as do mobile phones, but remember to lift the international bar before you leave home.

One word of warning: in order to get the most out of the working part of your elective it is necessary to be reasonably fluent in French. If your grasp of the language extends about as far as ordering a couple of beers then you are unlikely to be able to overcome the language barrier when communicating with patients, which would be limiting and frustrating. Admittedly a lot of the population speak good English, but you are far more likely to experience that "Gallic charm" if you can be seen to be making an effort with the language.

Key facts

• Capital - Paris
• Language - French
• Currency - Franc (10FF: = £1 at the time of going to press)
• Population - 57 660 000