'I've always wanted to work abroad but…' is a phrase I often hear from junior doctors who have moved from the carefree days of student electives into the harsh realities of postgraduate training and the Modernising Medical Careers system. Many have the impression that time out to work in developing countries is not an option while in training, and may jeopardise their career. However, several government reports have recognised the benefits of international experience, (1) (2) not just for the individual doctor and those with whom they work abroad, but also for the NHS which is enriched by the skills they bring back.
The reports recommend that health professionals should be allowed to interrupt their training to work abroad, and that educators and employers should make it possible for them to do so. The BMA's new handbook, Broadening your horizons (3), is a useful guide to the different ways of taking time out of training or employment. One such option is the OOPE - Out Of Programme Experience. Here's what two CMF members have done.
Orthopaedic OOPE in Malawi
Verona Beckles, orthopaedic SpR, is currently at the Beit Trust Cure International Hospital in Malawi. She writes:
You can go! Yes, You! If you had spoken to me five years ago, there was no way I could see myself living in Africa for over a year. I planned to be a serious surgeon, you know. Then I met some amazingly inspiring surgeons who work in Malawi, serving patients and training doctors. Although there are committed local health care professionals here, they are few in number - coming to support and encourage them has taught me so much about what is important in life. Yes, it took a bit of planning and there were administrative obstacles to overcome but I tell you what - there is absolutely nothing like being in the place where God wants you and then looking back at the ways in which he's equipped you and blessed you.
It is possible to come at any stage of training. I have met some who have come as medical students, others who have come after foundation years (and flown back to get two offers of training programmes), and many registrars and consultants from all around the world. The opportunities are endless as there is a lack of skilled personnel at all levels in this part of the world. I've had brilliant trainers in the UK but the truth is that here in Malawi I have had training which is second to none - a delicate balance of empowerment and supervision. I have opportunities to teach on courses, to do research, and to operate on far more cases than in the UK. I've also learnt how to play tennis! I have never been so healthy financially, physically and spiritually in my working life.
Yes, I miss Japanese food and Häagen-Dazs, and grannies with fractured necks of femur, and power tools - hand drilling is completely overrated! And, obviously I miss my family and friends back in the UK but God's provision of a wider adopted family and friends here continues to be so astounding that I'm staying an extra three months!
Ophthalmic OOPE in Sudan
Matt Hawker, ophthalmology SpR in Norwich, spent two months in Sudan with his young family as part of his hospital's link programme with Gezira Hospital. Some of the time was counted as study leave, the rest as OOPE. He had done a one week visit in 2007, when a three year plan to set up a glaucoma service was initiated. He returned this year to help implement this plan, building on the relationships he had already made:
It was an amazing opportunity to use the knowledge and skills I have gained through my training here. There was masses to do - I saw hundreds of people in clinic and operated on patients aged four months to 70 years. I gave tutorials twice a week - people were so keen to learn. As a family we experienced what life is like for the majority of the world. It was good, it was hard, there were a few tears, but overall it was great fun.
Hospital links are a great way for health professionals here to contribute to services in developing countries. Lasting relationships develop as repeated visits are made in both directions and there are opportunities for training and service in different fields. Why not consider forming a link at your hospital? The Tropical Health Education Trust (THET) will advise (4).
Vicky Lavy is CMF Head of International Ministries.