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Hi, everyone. Thank you so much for joining us. Um, we'll just get started in a few moments. If, till then anyone who hasn't already would mind just, um, filling in this quick questionnaire that's on the screen and also in the chart, um, it just helps us learn a bit more about why everyone wants to do elective where everyone's main questions are at the moment about elective. So we can hopefully, um, help the most and give the best information. It shouldn't take more than a couple of minutes. If anyone hasn't done it already, we'd be really grateful. Also, if anyone's watching the recorded version later, if you don't mind, um, doing it as well, we'd be really grateful as well. Thank you. We'll just get started in a couple of minutes. Thank you so much for coming to everyone who's just joined. Um, we'll just get started in a few minutes if, till then anyone who hasn't been able to yet would mind doing the pre questionnaire for us. So the QR code on the screen and also a link in the chart, it shouldn't take more than a couple of minutes and we'd be really grateful just to get some more information about what people want out of their electives and how we can best help. Thank you. Hi, everyone. Thank you so much to everyone who's just joined again as well. Um, we'll just get started in a couple of minutes. Um, if in the meantime, anyone who hasn't been able to yet would mind doing the prequestionnaire for us. There's a QR code on the screen and also a link in the chart. It shouldn't take more than a couple of minutes. Um, um, the slides will be sent out and they'll be recording. So if anyone wants to watch this back link, send it to anyone who wasn't able to come. If you go back to the link where you joined, there will later be something called catch up content and then you can see the whole um event again at any time. You wish we'll just get started in a minute. Ok. We'll get started. So thank you everyone again for coming today. Um to student me London and Saint George's Me societies, how to plan and make the most. If you elective. If you haven't already, please do scan the QR code on the screen or click on the link in the chart to help us um, learn a bit more about what everyone wants after elective and how we can help the best. Um, a little bit of information about who student me a London is. So we're a community interest company. And we aim to coordinate the redistribution of excess medical supplies to individuals, communities or places in need by organizing projects that link prospective donating organizations with receiving organizations. We're hoping to help you guys with your electives do this as well. So if anyone is going to a hospital or region that's in need of medical supplies, you can definitely reach out to us and we can help you take some supplies there to donate and really make a difference to the place that you're um volunteering and doing your elective in our vision is for everyone around the world to have a fair and equitable access to healthcare and healthcare resources and also to future health care professionals to have awareness, motivation and ability to have a positive impact on global health and sustainability. And we want to do this by making a network of donating and receiving organizations and also have volunteers to help distribute the medical equipment to regions most in need a little bit about some of the things we've done. So we do this redistribution of medical resources. We educate students in London and nationally and internationally about global health and sustainability issues. We do research in the field of global health and sustainability. We facilitate the equitable access of medical resources in health care and in the UK and abroad, we host talks and speakers in the field of global health and sustainability. And we also have our annual global health hackathon. So if anyone would like to get more involved with us, please do check out our website, sign up to our newsletter or follow us on social media. Also. If anyone hasn't been able to already, please do help us out by scanning the QR code that's in the corner of the screen or using the link in the chat to just give us a bit more information about what you want out. If you're elective, shouldn't take more than a couple of minutes. So today, we've got the amazing opportunity to hear from current doctors and medical students who've completed their electives abroad. And they'll be telling us about why they did their elective abroad, how they went about planning it, including how they chose where to go, any difficulties they had and any support, they received some insight into their elective itself, how long it was for what they did, what they learned, highlights and challenges, what they wish they had known and lots of tips for us and we have lots of chances to ask questions at the end. So we've been really lucky to have three amazing speakers today who've given up their time from what's really busy schedules and we're really grateful. So we've got Doctor Na Patel, he's an Fy one at Royal Stoke Hospital and now had done her elective in Zambia. Um, we've got um, Doctor Briony Bowman who's in Fy one working in Salisbury and Briony did her elective in Nepal and we've got Anisha who's a final year med student at University of Birmingham and she did her elective in Bangkok. So neither if it is. Ok, I'll just share your slides and can get started. Is that all right? That's ok. Thank you. Ok. Hi, guys. So, like Shazia said, I'm now, I'm one of the um f one doctors at Stoke. I graduated from Kiel this year. So, and did my elective earlier this year. So it's really fresh. Um And hopefully I can speak about more about my elective. So I did my elective in Zambia if we go on to the next slide, if you don't mind. Um So at Kiel, we do our electives um at the end of the fifth year. So I did my electives in Zambia and I did it at one of the main hospitals in Zambia, which was um in the capital Lusaka um at one of the university teaching hospitals. So I was there for two months. I had one month in um A&E um adults and I did one month in A&E and ward in pediatrics. So why did I pick Zambia? Um I think Zambia was amongst the other one. quite a few where I wanted to go, I always wanted to go somewhere in Africa somewhere where health care is very different from the UK where when you hear about stories, it's a very much developing or a third world country. I always wanted to go somewhere where they push your boundaries in reality and it really did. Um, Zambia was a bit easier for me because I have family there. So it was between South Africa, Zambia and it was just easier to go Zambia because I had family there and I had people I could stay with, which made it easier for me. Um, but in reality, even if you, if I didn't have that, um, I think at the end of the day, I'm really glad I went to Zambia. Um So even though I was at a university teaching hospital, which is one of the biggest hospitals Zambia has to offer. I still was able to see a variety of things which I'll talk about a bit later. But in reality of how I contacted the hospitals, um I honestly just picked up area I wanted to go to. So when I was searching, you can search online different or big hospitals and you can find their websites online or you can use elective network website, which I found really helpful, which has preexistent contacts people have used on their website and you can search the hospitals or the areas you want to go to and contact them. Unfortunately, when you're, when you're contacting people abroad, majority of the times you're emailing them or maybe whatsapp because, and usually phone, you can try ringing them, but usually it's email and unfortunately, it does take a lot of time. So I'd say email as many hospitals as you can um, and have patients and if they've not responded back to you within a few weeks or a month, email them back, trying to see if they've got back to you. They do take a while to get in contact and there's many hospitals which II emailed but wasn't able to get in contact with. And fortunately enough u th um, emailed me back and when they email you back, they'll ask for some documentations which you can fill out or ask the med school if there's something you can't. So if you're have struggling finding email addresses online through the website of the hospitals, try the Elective Networks website, um which is really good or the MDU also have a guide on elective planning documents. They have a documentation that you can find on their website, which is really helpful, which tells you step to step guide on what you should be looking at and doing prior to your elective. Uh Just a few tips I thought right now um that you might want to think about alongside where you want to go. You might want to think about what type of area I want to be. So not only do you need to think about? Oh, where do I want to go? And what do I want to experience? You need to think about when I go there. Am I going to be able to communicate with the people So in Zambia, I was lucky enough, majority of the people speak English, however many other countries, their first language may not be English. So have your priorities of what do you want to get out of it? I really wanted to experience a different environment but also be able to do a lot and be able to see and do a lot. And for, for me to do that, I thought communication of the same language would be key. So even though I had communication difficulties at times when patients came from rural areas of Zambia, majority of the people spoke English. So I was able to take histories and speak to the patients and majority of the times, a lot of the doctors already speak English in many other countries as well, but I really wanted to speak to the patients. So language may be something you want to think about if we go on to the next slide, please. So um like I spoke before, I carried out my elective um at the largest hospital in Lusaka, um which is the capital of Zambia. Not only is it the largest um hospital, it's, it's also a tertiary center. So majority of the facilities that the hospital has is probably the only facilities that Lusaka has or Zambia has. So if it's not available at this hospital, it's most likely not available anywhere else. And a lot of the hospital is also public um or government run hospital So that means that it's funded by the government. So it's a public hospital. However many things in Zambia is still private, so you still have to pay for healthcare. But there is an element of public or free healthcare. And the important thing for me was that despite it being the largest hospital and I still was able to see what I wanted to see. So Zambia is known for, not known for, but it's most common to have, have diseases which you wouldn't see in the UK. For example, a lot of the patients when I went there were Hepatitis HIV positive, I saw a lot of cholera. So a lot of malaria and infectious diseases alongside that, you also see a lot of crime. So a lot of gun and knife crime. So as I was based in A&E you're dealing with these patients. Unfortunately, in Zambia, they don't have a lot of out of hospital um care or um paramedics or anything like that. So pretty much the people that are coming through your door or how they were um when they had the road traffic accident. So open fractures, a lot of trauma and orthopedics, a lot of things that you wouldn't see in the UK because they've already been seen elsewhere. You got to see that I got to see. So I'm, I always um wanted to see how trauma was in a different country. II wasn't the biggest fan of infectious disease, but um as a student. But when I went there, you when you're put in it, you see the importance you get to see, I got to see a lot of um, how do I say? Um I got to see a lot of things that are common in the UK that are so scarce elsewhere. So example, um should we say take gloves um in the hospital when you go, you know, your size, either a small, medium or large or sometimes you can even get extra small when I went to Zambia. One of the things that I found really strange, they have no size gloves, it's a large or nothing. Um and at times that can be really dangerous or for your own safety. But also that's what they have unfortunately, because it was a government facility, it is what you are provided. But at the same time when you face those barriers, you also get to see and do a lot. I was in recess, but their recess is pretty much like itu with patients on no adrenaline and inotropic support, but also intubation and you get to experience a lot or it depends on how much you want to do. So I got to um, eventually you get your intubating patients, you're part of the cardiac arrest team or you are the only one with the other doctor, part of the cardiac arrest team doing CPR on patients. And it's a good experience in a different country because they actually actively need you. It's not, it's how much you want to get involved. And I really wanted to get involved and I was able to get involved a lot. Um, but it's a really good experience. It's really opened my eyes to health care abroad. Um, and it makes you appreciate what the NHS is like here. Um Some of the difficulties I thought you may find, um, or what I found was the communication with the hospital. So it's the initial communication. When you're dealing with the hospitals, it can take a while for them to respond back to you. Like I said before, language barriers between patients or fellow colleagues, I was lucky enough that they all spoke English and I was able to communicate well and some people might find it difficult in terms of funding. However, if you are looking for funding for the elective and you're doing a certain type of elective, you might want to look at the Royal Colleges. I know the Royal College of Anesthetics and other Royal Colleges. Um You can, they sometimes fund electives or partial funding of the electives. If you submit documentation, if you're gonna go do the elective elsewhere. So you might want to look into that or organizations that might be willing to fund or partial of the elective and the best parts like I've mentioned, you, you're experiencing a new healthcare system and it's really eye opening and I'd say it's the best thing I did and I'm so glad I went to Zambia. Um, and I think anywhere abroad is really good. It really is so different from the NHS. You get to see a lot of medicine and disease that is not so prominent in the UK and in other countries, it's got to a stage where it's no longer example, a first stage. Um, here patients might present with malaria but it's picked up very quickly, they might present with cancer which is picked up very quickly. However, abroad, cancer is not picked up because their primary system is not as developed, especially in Zambia. So you're getting late stage cancers, malaria, you're getting a lot of neurocytic cos because parasitic um parasites like sanitation is not really not key but it's not available there. So you're getting a lot of parasitic and seizure patients. Um It's very hands on and you can get a lot out of it if you put yourself in those situations and it also gives you the opportunity to travel. Um and do other stuff. You don't have to be based at the hospital 24 7. Even on your elective, you can get to do a lot of traveling and seeing rural medicine as well. Um I don't have anything else if anyone had questions or I think we're doing questions at the end. Yeah, I think it would be best to do questions at the end. But um thank you. So much now. It was really informative. Thank you. Thanks. Um Initial, would I be ok to share your slides and for you to give you a talk? Yeah, that'd be great. Thank you. So, whenever you're ready, thank you so much. So, um hi, guys, my name is Anushka. Um I'm finally a medi medic from the University of Birmingham. Um Thank you so much. Um Naha, your presentation was actually really interesting. Um uh My elective is um kind of the other side of um the scope of places that you can go to. I ended up going to Bangkok in Thailand, which is very much so um a big city in an upper middle income country. So I'm excited to kind of talk you through what I did there. Um If you don't mind clicking the next slide, please. So, um my reason for wanting to do an elective abroad and specifically in Bangkok is because I did my indication in global health. So, um I've already had a bit of exposure to um the more intricate parts of um tropical medicine and maybe learning about other healthcare systems. And I did my project there in India where I got to see kind of a lower middle income setting. And I was also able to do a bit more of a vigorous research project um where in addition to visiting clinical areas, I had to carry out a massive qualitative interview based project um for our university, we had to actually either write up a report or create a research project whilst we were away on elective. And because I'd already done my global Health, I kind of thought I might um choose a bit more of a relaxed option. And I decided to do a reflective essay um about my time in Bangkok, Thailand. And I also wanted to use it as an opportunity to travel with my peers. Um The clinical experience was the other reason. So I specifically chose to do my work in an obstetric environment. Um because I've done quite a bit of research in obs and gynae and pregnancy, especially in relation to infectious diseases. So I wanted to see if I can have a bit more of a hands on experience, especially because I'm still in med school. So we do our elective at the end of fourth year and we don't get to do OBS and Gynae until fifth year. So I thought this would be the perfect opportunity to kind of get a bit ahead of the curriculum in that way. Um As I mentioned, I wanted to travel with my friends and we ended up going in a big group of eight people to Thailand together, sorry, my heat was going off. Um And we all decided to go to the same hospital and we all did very different specialties, but we all got very different experiences from it. Um Actually, we went to a couple of different hospitals. Um But um in regards to med aid and the fact that one of your aims is about sustainability, I thought I'd also mention um that electors are really what you make of it because I know a person that wanted to carry out a global health slash elective project in Mongolia and their entire project was centered around um air pollution in Mongolia and measuring the air pollution levels there as well as having some clinical exposure. So the way that they traveled to Mongolia was um they wanted to have the most um eco friendly way possible. And um they took their entire trip from the UK to Mongolia via train. So that, that in itself was an interesting opportunity and it stood for a lot and they were able to fight about a lot. Um The other thing that I found very helpful about doing my elective abroad was I was able to extend my research network and my research contacts. So I was able to take um my basis in um sort of pregnancy and infectious diseases, specifically COVID-19 and able to make contact with a cohort of people and another hospital in Bangkok. And um I think the contact is there. We haven't quite yet started the next phase of research, but there is opportunity for that. Um And finally, I feel like um as most people would say, I think electives are one of the most life changing experiences. I feel like you learn a lot about yourself, both as a person and as a clinician. So I think it was just a huge opportunity for personal growth. Um Next slide, please. Thank you so much. So, this is very similar to what um was said in the previous talk. I think planning is it's as wishy washy as, as it can be because um it's just about chance and kind of sticking at it. So the way that we did it because um we went as a big friendship group, we kind of split up the work between us and we each Googled a bunch of different hospitals in the region of um Bangkok. Um And I think going to a big city like Bangkok was quite a, a good choice because they are very used to students coming in for elective. So they already have programs set up and they have channels, but it did take a lot of initial back and forth with the emailing and exactly as um N heads had said, if you don't get a reply within a couple of weeks, I would highly recommend you keep following up because that's the only way you're gonna get a response. Um Once you get the ball rolling though, however, and you have someone that's consistently in contact with you, it becomes significantly easier and you can just get the whole process started and you can find a supervisor there. Um The other things I'd like to mention. So in addition to the bursaries given out by the BM and the Royal Colleges, um what our university recommended to us was using um private bursaries. So we found, um if you are doing, you're elective in a particular area or if you're doing your elective project or if you have to do a project rather, um they, you might find some private medical Bursary. So I know one of the people I went an elective with, she did hers on a hematology ward in um Bangkok hospital. And she was able to get a hematology Bursary. It wasn't able to cover all the expenses, but it did manage to cover. Um I think, I think she got close to half, half a grand, which was a considerable amount of money. Um And for that, she had to submit her protocol and what she intended to learn from it. And I think she might have submitted her um end project as well. Um In addition to that, um obviously, this is dependent on your own situation but um NHS ba three NHS England, um they were able to cover um travel as well as um accommodation for the elective period. So I'm actually from Wales. So I got NHS Wales, which doesn't cover the elective travel, but all my friends were able to cover their travel and accommodation um using the money provided from them and then they were able to claim it back after the elective period was over if I remember correctly, I think they got given a maximum of 50 lbs per night for accommodation expenses, which translated to a lot of money and we would stay in quite a nice place. Um As far as choosing an elective goes, um our university actually provided us with a list of previous places that people had previously gone to. And we also were able to make contact with the global health integration course and see if they had any contacts in anywhere in the world. And they kind of gave us initial emails. And similarly to the previous presentation, the medical Elective network was really, really useful. Um I think um we found a lot of random emails um that we were able to use to make contact with hospitals and that really did help. The other thing was um this wasn't particularly useful in this case, but when I did my Global Health project, um I was able to use like contacts like friends of friends or anyone that a professor knew to kind of help create that initial contact, which is um a bit biased. But I think if you can put your friends in contact with anyone that is really helpful. Um And finally, our university rec recommended that we took out a travel insurance with them, but that did not cover very many things. But um what we were always told to do by all the years was use the Wesleyan Elective Insurance. So they're a private company that have, um, insurances specifically for medical students on medical elective. And one of the most important things that they do cover is if you, um, touch where this doesn't happen, but if you do fail your exams whilst you're away on elective and you have to come back for your research, they will cover the cost of or at least attempt to cover the cost of your flights coming back. And I think um we all took out the Wesley Elective Insurance and it also covered um any sort of health expenses that you might have out there. Um And I think at the time we did it, which was um earlier this year, it was 98 lbs for the baseline cover. Um So that's a very important thing. I think I recommend everyone would look into. Um Next one, please. Um So my actual elective project was um like I said, we, we were all tasked with doing either a research project or um coming back with some sort of written essay. So mine was a reflective piece um about morale in obstetric and gynecological um environments in a Bangkok hospital. Um The hospital I chose to work with is in um the central Bangkok is called the Veera Hospital. Um It's quite a large hospital and I think it has an equal amount of public and private funded care. So, uh I was lucky enough to see a variety of cases through this um I think some of my other friends worked in um slightly bigger hospitals that were available throughout Bangkok. But um in Thailand specifically, I think you are able to see such a range. Um I also had a couple of other classmates that were working in northern Thailand. Um and they were working in a health clinic. Um and this health clinic um specifically served refugees that were traveling out of Myanmar. And um that was a whole other clinical environment where they had a lot more of a hands on role and were able to see um more of an acute environment as well, so very different um experiences all within the same country. Um Next slide, please. So um just a little bit more about what I actually ended up doing on my elective. So, because mine was an observational reflective essay, um I didn't actually have much prep planning to do other than my initial protocol of what I was trying to get out of it from the research side of things, but um having had experience in doing projects abroad. Um And if that is something that you would like to do or if your university recommends that you do, um there's a couple of hurdles that you need to go through. So um I think one of the things I would always recommend is making contact with whoever you're about to work there and um liaise with them enough that you can give them the role of being your supervisor on location. And um we'd always recommend that you have a supervisor um at your, at your own university, which I think would be provided anyways. So, liaison between your two supervisors is critical. Um Also depending on the nature of the project that you want to do um creating a protocol having that approved in both locations and then also getting ethics approval in advance if that's done or if that's able to be done, that would be probably the best thing if you could do that beforehand. Um It'll save a lot of staff, but um the process of getting ethics approval anywhere is always gonna be a little bit more. Um It's, it's always a tedious process, but if you can get that started as soon as possible, I think that's one of the things that you could try to do. Um And then with things like ethics approval is just um thinking about the logistics of carrying out any sort of research, whether you need to create consent forms, who you would need to ask on the ground, whether you need to speak to staff beforehand, um Whether you would need to have a translator in place um to sort of explain consent forms, those are sort of things that um you'd have to take into consideration. Um But like I said, because mine was more observational, I kind of decided to park all of that with my indication and I just wanted to do, um, a bit more of a relaxed, um, elective. So, what I actually had was I had a lot more experience um, on the labor wards, I got to see how, um, patients interacted differently with healthcare staff. I got to see how, um, in Thailand where at the time when I went. So earlier this summer, it's just been about one year since there was a recent change in abortion laws where they could ex um they had just extended the amount of time um before a pregnant person can have an abortion. I don't know if I worded that correctly, but um previously, you can only have an abortion if it was under 12 weeks and now it's 8 to 20. So that had a massive um impact on the types of patients that we're seeing similarly. Um I think um Thailand particularly has uh quite a significant rate of HPV, um infections and cancers due to HPV. And I think there are a couple of different strains specific to the region. So I was able to see a lot more of that. Um So because of the nature of me just being an observer, I didn't really need to stay in one place. I could hop between the obstetric environments and go also onto the gynecology clinics as well. And I also got to go to surgery for C sections. Um The other thing that was really, really good about Bangkok was, um, it's such a big elective hotspot. I met quite a few other students from all over the world. Um And surprisingly, I also met a bunch of people from the University of Birmingham that we didn't know we were going to go there. So it was just a lot of medical students and we went during May, which I think is quite a big period for um students. So it was quite interesting. We also met a few people from, I think Japan and Germany who are also doing um medical actives at the same time in our hospitals, which was a really good experience next Weds. So, um this was just one of the things I wanted to quickly touch on because um I think as everyone that's planning an elective, I think these are just things that we were told to be aware of and being from a global health background. I think it's always something to be wary of is um wherever we end up going. Um I think it's quite easy to fall into the mindset that we're traveling from Britain and we've got the NHS and we're very um co comfortable with how our health system works. I think it's very important to just go in with an open mind. And um it's important for us as students not to impose notions of trying to be a bit of a savior or volunteer or volunteerism by that. I mean, be careful with like taking photos of patients and our usual um sort of rules of asking for consent and working within your competence, do apply elsewhere. Um I think it's also really important that um when you go in with an open mind, you can learn a lot from different places, whether it is from more of a low income country or uh also another high income country. I think whenever you're in a different culture environment, you can always pick up on new things that you can take home for your own clinical practice. Um And finally, I think um one of the things that we always talked about whilst we were planning our elective and it was a big concept that we were um kind of made to think about during uni was um is the idea of an um elective still ethical. The idea of us going to a different country in order to learn, we not even learn from them. I think the initial notion was to gain experience. But I think if we flip it more to what can we learn from this other population, what can we bring back to our own practice and what can we take back to them? And kind of sharing of information, I think is more so the goal of electives. And um so the ah era um next slide, please. Um So if you just click through these, I think these are just a couple of photos. But um honestly, um my activity was honestly very, very fun. We did do a lot of, um, time in the hospitals. We got to go and watch a lot of very interesting surgeries that I don't think we would have had the opportunity to or at least the time to because when you're a working med student in the UK, um, I think your mind's always half thinking I should be doing some pass med right now, but we had the chance to kind of stand around and watch a surgery and really spend time with patients from the moment they come into the door to the moment that they leave after giving birth. It was, um, really good to have that time set aside to spend on the ward. Um, and also in all honesty, we just used it to, we use a lot of the time to explore, um, Thailand Bangkok and also travel through the rest of Southeast Asia. We got to meet a lot more medical students and we also got really close together as a friendship group. And that's not, um, to say that you shouldn't travel on your own because we also met a lot of people that had traveled on their own and we'd met a lot of medical students that had come as just one or two people. And I think we've made quite a good like group of friends for life. So I would really highly recommend, um, just exploring wherever you do end up going. Um Next slide, please. Um Yeah, so I think those are just my ending points. I think your elective is kind of what you take away from it. Um Whatever you do end up doing, just make sure that you set aside some time to either go explore um the area because I think when you enter the world of work, it's always going to be a bit difficult to have that time. Um Just be open to whichever new environment you're in. And I'd highly recommend you utilize the Bries because it saved us a lot of money um in the moment. Yeah. Thank you so much. Thank you so much, Nishika. That was so, so useful. Thank you. Um Bri if you wanna unmute and then um if you're OK for me to share your slides, would that be all right? Yeah, that, yeah, that's great. Wonderful, great. Thank you. Sorry, everyone. My camera doesn't work on this laptop. So I'm gonna have to keep my um and my camera off. Um I'm Briony. I'm currently in F one in Salisbury. Um The same as Nahid. I did med school at Kiel. So I just did my elective at the end of fifth year for eight weeks and I went to Nepal and I did a split between an elective and the Himalayas going up to every space camp and um in Kathmandu, which is the capital city. Uh So the next slide, please. Um So why I chose my elective abroad. The main reason was just to get abroad to experience medicine properly. Um And I wanted to experience some expedition medicine, which is why I did part of my elective going up to every space camp. Um It's not obviously a part of medicine that you ever really get to experience much in med school unless you're lucky enough to kind of get involved in air ambulance kind of stuff. Um So I really wanted to um experience something completely different. I'd never seen before. I'd done some previous clinical experience in Zimbabwe, but that was prior to med school. So that was very much observational. Um I was kind of doing a lot more helping out with the nurses and the healthcare assistants in Zimbabwe, whereas I wanted now to do it as a more of a medic um and see the kind of difference that it was and especially in a different setting. Um So, um I also wanted a chance for a bit of a holiday before starting F one. which I think quite a lot of people wanted to go when they were picking a kind of an abroad elective as well. All right, that's the next slide, please. Um So kind of the planning for this similar to what um the other two doctors have said, utilizing a lot of emails is the best way to go. I sent quite a lot of emails to quite a lot of hospitals um around all different places. So I utilized Google quite a lot, found um hospitals in places that I wanted to go to um emailed them and um was just hopefully getting answers. Sometimes they didn't, um sometimes they did and at that point, it was kind of then quite easy to then plan once you've got the emails, uh email replies, but there was quite a lot of emails involved. Um I also spoke to quite a lot of doctors in the hospital. I was based out in Stoke, um and in Shrewsbury and um kind of asked them, do you have any contacts abroad? Um And through that, I actually got contact in India, the Seychelles and Nepal, um which is how I got onto the elective at Everest Space Camp through one of the consultants in Stoke Hospital. Um who then gave me the email address of um someone based in Nepal and that's how I got into the ever space camp section of my um elective once that's kind of confirmed. Um It was quite easily sorted after that. Once you've got a, a supervisor, things kind of flowed a lot easier after that. Um Our med school also got us to kind of have a little bit of backup elective. Um So again, I just kind of went to speak to some of the consultants that I knew in the hospital. Um and just said, explained what um what I was planning for my elective and, um, could I potentially come to with them for eight weeks if anything got canceled or anything happened? Um, and mostly, um, I just managed to get one on the oncology department in Stoke as a backup. They were quite chilled about it. Really? They didn't mind too much. Um, but I know that previously elective has been canceled abroad for people from our med school. Um, so that's why they encouraged us to do that. Uh Next slide, please. Um So my actual elective in abroad uh abroad was split like I said, between um Himalayas and Everest base camp and Kathmandu. Um So the Everest base camp part of my trip was mainly observational. It involved quite a lot of trekking. Um Some days we were walking kind of 67 hours, some days, maybe one or two and then we'd have rest days visiting hospitals and clinics. Um And then actually at Everest base camp we um stopped uh there's a hospital there. Um It's kind of one of the tents up at every space camp um run by the Himalaya Rescue Association as well as um the doctors that we were actually based with. Um pretty much every team up at every space camp has a doctor. So we spent time with different doctors kind of seeing what they do day to day, but it was all completely observational. Um And then the second part of my elective was based in Kathmandu. So I was in a hospital based in Central Kathmandu, which was a lot more hands-on. Um, but it was again, very different to the normal kind of medicine used to. Um, because of the time of the year I was there, there was a lot of stuff coming down from the mountains. Um, so, um, people who have been unwell when they have been tracking and they get flown back into Kathmandu, um, or lots of traffic accidents, there's a high rate traffic accidents um in the pool. Um and then also lots of similar to how I had said the infectious diseases are very different. Um So lots of different type of infectious diseases that I've never really seen before. Um I did also try and spend a lot of my time visiting around. I took like long weekends, so went down to the jungle, um went around to other cities around really tried to make the most of my time that I had out there um to just get the most of my experience. Uh next slide please. This is just a few of the pictures. Um So this is one of the hospitals that's on the way up to every space camp that you spent. Um some time at. Um you can see it's quite small, that was the main entrance, there was just one ward er and then an outpatient section where there are two doctors who work in this hospital who are on call. 24 hours. That's where they're based. And then this is the kind of environment that you're in. Um up at this point, it's um obviously very mountainous. Um Not much around. Uh next slide, please. And then this is ever space camp. Um So they're not the best pictures. Um um just because II had altitude sickness at this time and I didn't take great photos. Um But both of those have got every space camp in and you can kind of see on the little photo uh the the the tents and the kind of size that they are. So everything up there is 10, it's um quite high. You're at like 5000 300 m. So a lot of what's going on is altitude sickness. It's obviously quite cold, there's a glacier all around, um it's very rocky, so medicine there is, it's quite different. Um The main aim is to treat and then get out. Um And that's just by helicopter back down to um kind of Kathmandu really uh next line, please. And then this is the middle photo is a another hospital. Um I spent some time at this is Himalayan Rescue Association Hospital. It's run by volunteers every year. Um who who go out for three months of the year and they treat um tourists and they treat the locals um predominantly for um injuries or illnesses that are related to altitude um or trekking and that and that kind of stuff. And then on the left is the only airport that's actually um any way in and out unless you walk for a good couple of days. Um So if you're not a good flyer, I wouldn't really recommend a next slide, please. And then this is the hospital that I visited in Kathmandu. Um It's called Corina Hospital, which is actually a private hospital, but it did take um um uh patients who weren't private and they would get some kind of government subs um subsidiary for it. Um on the bottom, it is a um surgical theater. Um and they did quite a lot of surgeries here, predominantly saw some kind of c sections. The man who owned the hospital was actually a neurosurgeon. So this hospital would get um neurosurgery patients from around Kathmandu. And um the final picture on the right is actually a children's hospital. Um This is a tertiary orthopedic hospital that um I visited um which it takes patients from all over India and Nepal and does um quite considerable amount of surgeries which is really interesting to see because their orthopedic surgeries are extremely different to the to the kind of stuff that we've been seeing in the UK. Um And there's quite a lot going on, lots of kids there, good couple of 100 kids all in small cramped spaces and the only imaging they have actually is x-ray. So there's no MRI S no CT S, everything's X ray and then straight to theater uh next slide please. And then this is just me visiting. Um I'm actually at the back of that photo so you can't really see uh when I went to the jungle. So I definitely recommend getting out and about and wherever you visit. Uh it like this. Um So on the positives of kind of how I thought of my elective generally. Um it was exposure to things I've never really seen before. Um Again, like, like it's been said in the other two talks, um It's completely different to the NHS. You're seeing things you've never really seen before, especially for me with um expedition medicine, I've never seen anything like that, never had any exposure to altitude medicine before. And I was really lucky because it's a usually very restricted environment. Um ever space camp you can't usually stay at. Um you need permits to stay at. Um So I was really lucky in terms of that. I also got a really good chance to visit around. Um I used all my spare time to go out visit and see the country. The only negative really is the cost. Um I think that has been mentioned, there are bursaries that you can use. Um But it is quite expensive. Um And secondly, the observational aspect of expedition medicine, I wasn't allowed to get hands on. Um My insurance didn't cover me to do any hands on medicine at um altitude. So everything was purely observational um next slide, please. Um So just a few tips, a lot of things that I would say tips have already been mentioned. Um But I would definitely say spend as much time abroad as you can. Um And if you're worried about kind of costs or being away for too long or I know some people get exam results while they're uh away on elective, which we had, you could consider a split elective between the UK and abroad. Um And that helps with kind of um issues with both of that. I definitely utilize contacts in your current hospital. That is how I got onto the Selective by just going around and talking to the consultants. Some of them I didn't really didn't know very well and they were more than happy to give um information. Um and I've written NHS Bursary on here. I know there's lots of other bursaries to help out, but the NHS Bursary does have the um travel a part of it and uh if you're still paying for accommodation and you can get an accommodation Bursary when you go on your elective. I think a lot of people at our med school didn't realize that and it is just an extra tiny bit of um money that you can get. Um So that's all happy to take any questions at all. Um Thank you very much, Bernie. That was really, really helpful. Um If it's ok, we'll just have a few questions and um if, if any of you want to um answer, um that would be great. Um I think one of the main questions is how much they cost, so how much it cost for you guys, how much, you know, it tends to cost for other people and depending on where um I think for me, the main cost was my flight tickets. So my flight tickets took a lot of my cost and for me it was different because I was living with family, but still I had other costs. I saved a minimum two grand. Um I'd put aside for my elective. I know it's different for others. It's just because even though NHS Bursary does help and give you your money back eventually, you still have to pay first and then you'll get reimbursed later. So a lot of my money went towards my flights which cost me um, 800 lbs return or 900 lbs return. So they were a lot of mine, but I took at least out 2000 lbs and then some of that was reimbursed through NHS for accommodation and vaccinations and insurance. I don't know how it was for the rest of them. Um, so similar to na my flight's probably about 700 lbs. Um, the section of my elective going at every space camp was quite expensive. Um, and um, I was really lucky the, the team that I went with were happy for me to pay later. So, um, I started to pay some of that after. Um, I got a job. Um, but that can be difficult. Um, I think overall, II think mine was probably about three grand overall, just purely based on that. Um, uh, for space camp section. If I'd have just stayed in, uh, the capital city probably would have been maybe 1.5 grand ish. It pretty cheap place to be. Um, yeah, I don't think I have anything different to say. It was very similar. We had to fork out most of the money beforehand. Um, and like I said, I had NHS Wales so I didn't actually get the travel. Um, sorry, the accommodation come back. But what, what I was very grateful but what my friends did was because there was seven of them that all had England bursaries, we pulled together that money and then did shared accommodation and then they paid on my behalf and then they got reimbursed that way. But, um, it was a lot of money that we have to pay upfront. Um, and also the other things, um, is that, um, in Thailand and places that know that you get a lot of medical students, um, they have an elective fee, I think it was about 100 100 and 20 lbs. But um, most hospitals know that they have a, a scope to make money. So if it is kind of a very touristy place, I think please expect that there might be a small fee like that. If I just mentioned, like said, hospitals don't have a fee, I'm sorry, hospitals do have a fee dependent on hospitals. It changes, but also where you want to do au elective. If you're going to a country like South Africa or more developing countries, how much you're paying to stay there is much cheaper than you go into a more modernized westernized like America, which would be much more expensive to stay. And um example, food and things like that would be much more expensive and to go around would be more expensive than if you were to go somewhere like Africa or India or something like that. Yeah, just to touch on that, I think I, even though we spent so much beforehand, when we got to Thailand, we really were able to save a lot of money, food was very affordable and because we shared accommodation together, it was really, really good and we know a lot of people that also did hostels and um similarly more affordable options. So those are things to definitely look into. Thanks so much guys, that's so helpful. Um Another question we have is how in advance would you suggest planning your elective? I'd say as soon as you know, where you want to go, I do that it can take months for hospitals to get back to you. Um So I started at least six months prior and especially with our university. They had like, um they wanted us to send them forms much earlier on. So we were going through, but we did ours at the end of our fifth year and by December we, I'd already been in contact with the hospital, so I'd say as soon as you can um start contacting hospitals. Um I think my timeline was very similar um because ours was end of fourth year. Um We had a internal med school deadline where we had to submit exactly where we were going and who we were working with in the other country by December. Um So that also meant that because we had to do something academic, we also had to have the majority of that sorted. So I think it was like um 40th before I started in July. So it was July till December was the majority of our planning. So about six months and then after that, we didn't do much after. Yeah, I again, I just agree. Um I obviously went to med school in. So I had very similar timelines. Um We had a deadline and we had to provide everything. There were a few people who um missed the deadline for various kind of um incidents or things got canceled, who did manage to get elects abroad, but they were quite stressed. So they were trying to organize kind of January February before um elective in May. And they were really quite stressed about it. So as soon as you can really thank you so much guys. Um Another question is, are there any prior applications required for the NHS Bursary or is it a selective thing? Um I know I've mentioned the NHS Bursary. I honestly can't remember how to apply. I'm really sorry. Um I would recommend going on the NHS Bursary website. Um There is some information on there and it's quite, I think I remember it to be quite detailed about how to apply. And he, um, he was eligible for specific um, Bursary at, at specific points. I think if I remember correctly, I think for travel expenses. So both placement in your fifth year of med school and placement for elective, those travel expenses are not means tested. It's just other aspects of them and it's just basically three, that's means tested. But, um, I don't think it's there for Wales and it is if you are a UK resident. Ok. So I did NHS Bursary. So if, if you're in fifth year, you can apply for NHS Bursary. And if you apply for NHS Bursary and receive NHS Bursary, you can then apply for the travel um expenses which cover also elective. So I was able to get back. So I had a lot of um, vaccinations that I did prior to going to Zambia, um which I was be able to get reimbursed by NHS, but also my medical insurance and I took a, I took um HIV, prep malaria tablets, prophylaxis. So I had a lot of medical expenses towards elective which NHS Bursary were able to cover. So if you're able, if you get the NHS Bursary, then you can apply with a form for the travel and also example, travel that you do during, as a student, you can apply in that as well through them. So it also covers not only elective but other um, travel as well during your placement, but it's all on their website like Briony said, thanks so much. I think we've only got um maybe a couple of more questions. Um So another question is um any advice on applying to multiple hospital placements abroad? I would say with that you just need to be as organized as possible. Um And make sure once you get kind of a supervisor settled in one hospital that you explain to them that you are going to multiple um multiple hospital placements, um They know what your plans are. Um especially if you're going into multiple countries. Um because I did that the both hospitals that both placement parts they did. Um They all knew what I was doing and especially because I was coming down for a space camp, they knew that I might be late for the first section and they, they weren't worried. So just give them all as much information as possible. Um And hopefully it should be, it should be ok. II if they're happy with it just something for me to add on to that. When I was in contact with Zambia, they give me the go ahead of, I could do my elective there. But after that, their responses were quite not enough to say. So it was only until when I went there was I able to tell them where I wanted to be and that's how they work. But, um, II knew where I wanted to go and I'd been in contact with them, but they hadn't officially told me that I could go to A&E and, um, be in A&E for two months. But they give me the go ahead and the documentation that they were happy for me to come for those two months. So sometimes it's, sometimes you just got to go there. Um, but it's very different in different situations. I didn't really have a supervisor name, um, until then because they hadn't really authorized where I was going to go. But that's how they worked because only when I went there, did they make me do the rest of the paperwork? So, um, I wasn't able to be as thorough as Briony was able to be with her supervisors cos that's just not, they expect international students but they very much work in person. So that's how it worked for me. Sometimes you just, I just had to turn up and be like this is where I wanna be and is she got anything to add or should we go to the final question? Um We've got a couple of more specific questions that it might be maybe best. Um If you guys have a chance to maybe have a look at the chart. But I think because our last um kind of main question, um it would be what I think both of you, all of you mentioned some other bursaries and if in specific, which ones are there any other means to get financial support as well as the NHS? Um So our, it's really not any specific particular type of advice. We did a lot of Googling. Um I think someone in the year above had just sent a couple of links to where they went. Um But in addition to royal colleges look for societies. Um so like national societies, I think that there was one uh like British Indian Medical student societies, it was very competitive. I don't think we got it. But um I know a couple of people applied for that. There was one that was the Hematology Society that I know a couple of people got. Um So it was just a lot of Googling. There wasn't really a hard or fasting, but it might be worth asking your med school or any academics in your med school because they're usually quite well versed with trying to get bursaries the same for me. It's honestly just Googling the best Googling and seeing what happens because I know a lot of the, um, if you're applying to some of the bursaries, I know a lot of the Royal colleges have deadlines and if I know some of them end very early, so as soon as you can start searching because the deadlines are soon, the deadlines end quite quickly. So after this, if you know you're doing the elective and you want funding and bursaries look as soon as possible, don't leave it last minute. Yeah, I mean, I don't have much to add. I'm a actually a post grad um meds, I was post grad med student and there are a couple of different um uh bursaries available if you're post grad. Um There are some bursaries that are unavailable if you're a post grad. So if you're a post grad, you will have to make sure that you kind of read the information quite well to check about that. Um Just to make sure that you are eligible. Great. Thank you so much guys. Um If anyone else has any um major questions, you know, were most um kindly happy with me to put their email addresses in the chart so I can do that. And if anyone has any specific questions, then more than welcome to get in touch with them. But other than that, thank you guys so much for joining. If you'd like a certificate, please do fill in our feedback form. Um and that would be emailed to you. But other than that, thank you guys so much for coming and yeah, we're really grateful for everyone's time. Thank you. I'll just put that email address as in the chart as well.