Evaluating and Ameliorating the Impact of International Medical Electives: A Canadian Perspective

International medical electives (IMEs) have demonstrated positive impacts on students' education and career development, but there are growing concern about the potentially negative impact of students from higher income countries in healthcare settings in low-income countries.

Within Canada, particularly at Western University, students have led development of standardized predeparture training and its evaluation. With the aid of partners from Canada and outside we have conducted a literature review and led a scan of electives offered through 14 Canadian medical schools to document all aspects of these electives and to assess the student and host experience.

Preliminary results indicate much variation in the nature and scope of the placements, the pre-departure training offered, and the extent of program evaluation at the schools. We need to assess both pre-departure preparation and global health courses for effectiveness, and develop standardized procedures to prepare students for international placements. Rigorous evaluation of positive and negative impacts on host communities and medical facilities is also required. We are now developing an evaluation framework and designing a prospective study of the impact of GH education and to better understand the immediate and longer-term impact of IMEs on both students and hosts.

This presentation will also comment on evolving Canadian priorities in global health and medical education, in light of 1. the CANMEDS Competency-based framework for medical education highlighting the Advocacy role of physicians, and 2. the new Social Accountability Agenda of medical schools stressing ethics.