Going Abroad

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How Pre-Health Students Can Make the Most Of Their International Experience

So, you have decided to go abroad? Congratulations! A global learning experience offers incredible opportunities for personal and professional growth, and memories that will last a lifetime. In this article, we provide advice specifically geared toward pre-health students that will help you to make the most of your experience.

Are international experiences feasible for Pre-Health students?

As a pre-health student, you are one of the busiest people on campus. You take a full load of courses, including tough science classes, study for entrance exams and participate in an array of extracurricular activities. It can be hard to imagine how you might fit an international experience into your schedule, but with some reflection on your goals and advance planning, it is possible.

 

TYPES OF INTERNATIONAL EXPERIENCES

First, recognize that there are many types of international experiences available to college students. Your university likely offers semester-long as well as shorter summer or winter intersession programs for course credit. If not, it may be possible to enroll in international programs offered by other universities for credit that will transfer to your home institution. A great benefit of participating in a university-sponsored study abroad program is that you can have confidence that faculty and administrators have vetted the program and found it to be academically appropriate, ethically sound and safe.

Alternatively, there are a variety of third-party study abroad providers that offer overseas programs to undergraduates. The experiences offered by these groups vary widely; some focus on academics while others emphasize service-leaning or even recreation. Some providers may have academic agreements with your university, while others have no formal affiliation. Often, providers that officially collaborate with your university must provide reasonable assurance that they have planned for your health and safety and offer an appropriate learning environment. However, providers that offer study abroad experiences outside of the structure of your university may operate with very little oversight. In these cases, you are solely responsible for determining if the provider can deliver the experience they promised in a safe and ethical manner. 

Finally, many students find opportunities to participate in international service or mission trips with family, healthcare practitioners in their community or even religious organizations. These experiences can be meaningful, but they usually are not professionally evaluated.

 

Considerations for clinical & service opportunities while abroad

If you are like most pre-health students, you cannot wait for the day when you have the opportunity to care for your own patients. In addition, an important component of any application to professional school is participation in health-related activities. As a result, international programs that promise opportunities to gain hands on, clinical experience may seem like perfect opportunities for pre-health students. However, be warned, participating in healthrelated activities while abroad can be fraught and any international experience with a clinical component must be approached with a great deal of caution.

To put it bluntly, providing healthcare without proper training and licensing is illegal and unethical. A simple way to determine whether an experience is legal or ethical is to ask yourself “would I be able to do this in the U.S.?” If the answer is no, then you should never do it while abroad. For the typical undergraduate student, extracting teeth, closing an incision with sutures, assisting in a birth and dispensing medications are all out of bounds. If, as an untrained student, you participate in these types of activities, you place patients at risk, make yourself liable for prosecution at home or abroad and violate basic ethical principles of clinical practice, which could lead admission committees to question with you are fit for a career in healthcare.

Therefore, you should do your homework and avoid programs that are likely to put you in an unethical situation. Even if you are not directly practicing healthcare you must avoid situations that could lead members of the local community to assume you are a professional. For example, some programs allow undergraduates to wear white coats, which could lead patients to assume that these students are licensed practitioners. Generally, international experiences that include participation in existing health education campaigns or service activities that indirectly result in positive health outcomes (e.g. developing strategies to inform families about the benefits of breast milk) are appropriate for undergraduate students while those that involve direct participation in healthcare are not. We have provided some resources at the end of this article with more information about ethical issues associated with participating in health-related activities while abroad. 

Aligning your study abroad experience with AAMC’s Core Competencies

You may be wondering: “if undergraduate students should avoid situations where they may be asked to practice healthcare, then what is the value of an international experience for a pre-health student?” Although participation in health-related experiences is an important part of your development as an applicant, it is just one part. For many students, it may not even be the most important part. For example, the American Association of Medical Colleges has developed 15 core competencies, or desirable traits, for entering medical students (and we would argue that these competencies are relevant to students interested in any area of healthcare, not just medicine). We note that “clinical skills” appears nowhere on the list of core competencies and we are confident that most admissions committees would agree that an accredited professional school is the only appropriate place to learn these skills. 

So, what are the traits found on the list of core competencies? They include inter- and intrapersonal competencies such as social skills, cultural competence, ethical responsibility to self and others and resilience and adaptability. A study abroad program or other international experience provides an excellent opportunity for you to grow in these areas and others.

Here are a few examples:

SOCIAL SKILLS

Successfully navigating your international experience will require strong social skills. For example, while abroad, students often realize that the fast-paced nature of life in the U.S. and direct communication style used by Americans is not typical throughout much of the world. Spending time internationally can help you learn to pay attention to social and behavioral cues of others and make appropriate adjustments to your own behavior. As a healthcare provider, learning to recognize your patients’ subtle, nonverbal cues that they are afraid, they do not understand your instructions, or that they do not have the capacity to comply with your directives, is critical to providing appropriate care.

CULTURAL COMPETENCE

Unique socio-cultural factors in countries around the world lead to patterns of behavior that are different from those common in the U.S. Obvious examples (that are also of practical importance to any world traveler) are norms related to everyday activities like dress or tipping for good service. An international experience provides you with an opportunity to demonstrate that you are mature enough to research cultural norms 30 APPLY in the places you will visit, learn to recognize these differences while you are abroad and make respectful adjustments to your expectations and conduct. As a healthcare provider, the majority of your patients will be different from you (i.e. different age, race, gender, physical ability, socioeconomic status, etc.). Learning to respect cultural norms or practices that are different from your own now will make you a more effective provider in the future.

ETHICAL RESPONSIBILITIES TO SELF & OTHERS

Although we have tried to make the case that pre-health students can learn a great deal from any study abroad experience, you may still choose an international experience with a healthcare component, which could put your ethical decision making to the test. Because healthcare providers carry out actions that can have a significant effect on their patient’s health and livelihood, they have a responsibility to behave in ways that do not cause unjustified harm or suffering. An international experience can provide you with an opportunity to reflect on your limitations, and learn to say "no" when asked to participate in an activity beyond your level of training.

RESILIENCE & ADAPTABILITY

There is no experience like international travel to test your resilience and ability to adapt. Multi-leg flights, public transportation, lost luggage and communication in an unfamiliar language are all part of a typical international experience. Some students find the challenges associated with breaking out of their routine to be exhilarating while others struggle to keep their composure. No matter what category you fall into, proving to yourself that you can successfully travel abroad, integrate into a new culture, make friends and learn something along the way is an intensely satisfying experience that can help you feel more confident when you experience the unexpected as a student or practitioner. 

THE BOTTOM LINE

A global learning experience offers you a wealth of opportunities to prove to admissions committees that you possess the pre-professional competencies that they are seeking in students. The experience may even help you identify those areas where you could benefit from additional growth. 

Planning your experience

FIRST IDENTIFY YOUR GOALS

When you are deciding whether to go abroad, ask yourself the following questions: Why do I want to go abroad? What do I expect to get out of this experience? What skills do I bring? What are my limitations? Answering these questions is the first step toward identifying the best experience for you.

TIMING AND COST

Once you have decided that an international experience is for you, you should meet with your advisor, preferably early in your college career to discuss the ideal time to go abroad. Depending on your major and career goals, you may learn that one semester is better than another to be away from campus or that going abroad is more achievable if you take courses in a different sequence than your peers. Whatever the case, the sooner you start the conversation with your advisor the easier it will be to fit an international experience into your academic plan. 

If you are planning an international experience that will provide course credit, be sure to talk to your advisor about how this could affect your application to professional school. Professional schools have policies about what types of study abroad or international credits they will accept, and you should understand this prior to going overseas.

Meet with representatives from your study abroad office to learn which opportunities are available to you. In addition, your study abroad office can provide information about scholarships and may have insight into which programs have historically worked well for pre-health students or students with similar majors. Some students find it difficult to fit in a study abroad experience without taking a “gap” year between graduation and matriculation to professional school. The thought of a gap year is off-putting to some students, but do not dismiss the idea too quickly. For most students, delaying their application to professional school by a year (or more) to study abroad could certainly be justified by all that can be learned from a quality international experience. 

Practical advice for getting the most out of your study abroad experience

PRE-TRIP RESEARCH

Taking the time to prepare before your trip is the first step towards a successful experience. Even if travel is being arranged for you, you should understand the basic logistics of your trip. Where are you going? Where is the airport in relation to your final destination? What is the currency and exchange rate in the country you will be visiting? Are credit cards widely accepted and, if so, which ones? Is tipping expected? Do not be passive when it comes to logistics. By taking an active role in planning the “details” of your trip, you will have a richer, and safer experience. 

Without a doubt, you should inform yourself about the history and politics of the country you are visiting. How long has the country existed in its current form? What are the major ethnic groups? What is the form of government? Since you are interested in healthcare, understanding a little bit about major public health issues and the health care system should also be of interest to you. Developing a basic understanding of these issues prior to departure will make the trip much more meaningful by providing you with important context.

WHILE ABROAD 

Plan to be fully engaged in your experience and take advantage of every opportunity to learn. Talk to your study abroad instructors, your host family and even your Uber drivers about what you observe around you and ask them to help you understand your experiences. 

Keep a journal; list your observations and questions along with anything that surprises you, causes joy, wonder, stress or anxiety. Your journal entries will not only help you make sense of your experiences, but they may prove invaluable when writing application essays or preparing for professional school interviews.

During your free time, take a walk or ride public transportation and observe the daily life of those around you. If you are in an international city, spend time away from areas that cater to tourists. Although sightseeing at major “tourist destinations” is sometimes an important part of a travel experience, these areas will not necessarily give you a sense of the daily life of the people whose country you are visiting (remember those core competencies).

At a minimum, learn to say hello and thank you in the language of the people you are visiting. This is a great way to demonstrate respect and endear yourself to your hosts.

BACK HOME

Share your experience with others but focus on what you learned, how you were challenged and the personal growth that took place, not simply where you visited and what you did. When you return to the U.S., seek out faculty members or mentors with international experience who may be able to help you debrief. Doing so will help you process and frame your experience. Do not be surprised if at first you cannot find the words to describe your trip fully. It often takes time and reflection to process the meaning of your experiences.

WHAT IF IT IS NOT FEASIBLE TO STUDY ABROAD? 

Despite all the benefits associated with studying abroad, doing so may be too expensive, incompatible with your personal life or interrupt your academic trajectory. If you find yourself unable to study abroad, you can find many of the benefits associated with an international experience in the U.S. Look for opportunities in your local community to broaden your horizons and develop the core competencies desired by professional schools. Engaging with communities different from your own (e.g. refugees, people experiencing homelessness, etc) in your own backyard can be just as challenging and rewarding as doing so while abroad.

Final Thought

At the end of the day, taking the time to meet someone who is different from you, either locally or abroad, will enhance your life, help you grow and prepare you for future interactions in your career. Safe travels!

 

 

Inside Health Education

• Topics: Perspectives,  Extra Credit,  Pre-Health Development
• Authors:
• Date:  February 1, 2019