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Free elective module information
The elective period comprises 12 weeks of the trainee intern year during which students have a free choice of activity - medical, paramedical or medico-social. The entire elective may be taken in one field of study or may be divided into two consecutive six-week electives in one quarter. Shorter electives are not encouraged. Your elective period is 12 weeks – not 9, 10 or 11. We allow a few days for travel. You may wish to do it all in one place, or break it e.g. 2 x 6 weeks, or 4 + 8 weeks, or 3 x 4 weeks.
The free elective module is intended to encourage experience outside the Otago province, whether within New Zealand or overseas. The choice of elective requires prospective approval (see later). Flexibility within the course is possible e.g. if students choose a 12 week medicine or surgery elective they may then be able to undertake an alternative attachment for the 6 week medicine or surgery ward attachment. This choice must be established at the beginning of the year and must have the approval of the convenor of the module, and the relevant Head of Department. If you wish to discuss this further please make an appointment to see Professor Rob Walker.
The selection of an elective is the responsibility of the individual student, but advice and information can be obtained from many staff members and from the present Trainee Interns. The Medical Library has on file (under year) previous Trainee Intern elective reports and also information regarding some overseas electives and these may be helpful in choosing an elective. You can also search for elective reports via the Electives Database –
The Electives Database website is merely a search engine and once you have found what you are looking for, you will physically need to go to the Medical Library and look up the respective elective report.
You should discuss elective plans with your proposed supervisor, and also with Professor Rob Walker, who will give final approval. In all cases, a letter of acceptance from the Supervisor along with information as to the nature of the proposed elective, together with your elective protocol form must be submitted for written approval to Professor Rob Walker (see Appendix A, or download it from Blackboard). Arrangements should be completed as early as possible and AT LEAST THREE MONTHS BEFORE YOUR ELECTIVE QUARTER BEGINS. Please ensure Professor Walker’s Secretary has a copy of your elective protocol, and an address where you may be contacted.
The elective period is a prescribed part of the medical course and evidence of a satisfactory performance is an essential requirement before the Board of Examiners approves graduation. Your elective assessment has two principal components.
At the conclusion of your elective you are required to submit a report outlining your elective experience (See Jan Kettink for reporting requirements). The report should be typewritten, in electronic format and should include any projects undertaken or especially interesting clinical or other aspects of the attachment. Your comments and the value of your particular elective and any recommendations to those undertaking electives in the future are welcomed. You are advised to write this report during the last two weeks of your elective attachment. Excuses for lateness WILL NOT BE ACCEPTED and your report must be in the hands of Jan, together with all your supervisor's assessments, by the following dates.
In the case of those students taking electives in the final quarter you should ensure that Professor Walker receives your report one week before completion of your elective, i.e. by Friday 11 November 2011 at the latest. Your qualification depends on the submission of a satisfactory elective report. This report must reflect your three month elective experiences. A three to five page brief synopsis is not acceptable. If you wish to view your supervisor's assessment form please contact Jan.
Your supervisor will be requested to report on your elective. When you arrange your elective you should make it plain that this is a prescribed part of your University course and as such there must be a nominated supervisor who will be agreeable to provide a brief written report on you. Before the end of your elective you must give your assessment form (Appendix C) to your supervisor (in person) who should either post/fax it to Jan, or return it to you so that it can be handed in with your elective report.
In the event of either an unsatisfactory elective report or supervisor's assessment the student will be required to present for an elective assessment viva with the electives sub-committee which will consider whether he/she has completed the prescription for the course. This will include students in the fourth quarter who may be required to return to Dunedin specifically for this purpose.
A wide variety of excellent clinical experience is available for those willing to work hard and accept responsibility for patient care. Most smaller hospitals in both the North and South Islands have had students over recent years. Your approach should initially be to the Medical Superintendent of your chosen hospital giving some indication of your interests, e.g. medicine, surgery, paediatrics, etc. When you accept an elective at one of these hospitals you should note that it will not be satisfactory for you to be rostered on a number of different specialties for very short periods. The contact people for the main centres are:
You may very reasonably be asked to undertake some service work during your time at peripheral hospitals, but your experience is unlikely to be enhanced by standing in as Acting House Surgeon for a week or 10 days duration on four or five runs while the local House Surgeon takes his holidays. As a general rule, runs of less than six weeks duration will not be acceptable.
If you are considering undertaking your elective in Dunedin or Southland, please refer your enquiry directly to the Trainee Intern Course Coordinator who holds the master timetable and therefore able to advise if any of the disciplines listed below could potentially be available. All Dunedin or Southland based electives MUST be arranged through the Office of the Trainee Intern Course Co-ordinator in Student Affairs, NOT with the Department or Consultant concerned.
Students who feel able, both physically and financially, to spend their elective periods overseas are encouraged to do so. Some electives are arranged through the Health Department or other agencies, but others may be available by personal negotiation with the overseas location of your choice. Advice can be given to any students wishing to travel overseas but uncertain of contact addresses. Please note that students are NOT to undertake unsupervised surgical procedures and if in doubt should contact Professor Rob Walker IMMEDIATELY.
First quarter has a 2 week vacation period in the middle however, you can take this at any time during your elective quarter. The choice is yours. There is also a 2 week vacation between third and fourth quarter and if your elective is in either of these quarters you can take this vacation time when you like also.
The Electives Network in partnership with Medical Assurance Society
The Electives Network Ltd. (TEN) is a non profit company founded by Dr Gordon Hamilton in 2001 whilst a pre-clinical medical student at Oxford University. The primary goal of TEN was to provide medical students with a comprehensive planning tool, one which would provide up to date information as well as a forum for dynamic student interaction.
We have expanded the TEN databases to its current size of 5,000+ hospitals in over 120 countries worldwide. We deliver this content via a professionally designed and maintained Content Management System CMS which together with a continuous stream of student feedback reports results in a self updating website interface.
Since our establishment in the UK and Ireland, and our launch in Australia in 2005, followed by New Zealand recently, we have been aided by major sponsors, the Medical Defence Union (UK and Eire), MDA National (Australia) and Medical Assurance (NZ) to intensely target the medical student population in these countries. For example, in the UK, between 20-30% of the student elective market will access the TEN site each week, with a similar percentage using the Australian site. We are also extremely encouraged by the positive response to us by the New Zealand medical elective students so soon after the launch and we also continue to have a massive number of medical students requesting access from countries where we are yet to provide our services.
With the launches of the mirror TEN site in Australia and New Zealand and plans to shortly expand into parts of Western Europe, we are achieving our long-term strategic goal of being 'the leading electives planning resource for medical students around the world'.
If you need help with planning your elective you can access TEN through the Medical Assurance Society website. Simply go to www.medicals.co.nz , click on ‘ Electives Login’, then enter your Membership number and password. If you don’t have a password or are not a Member, please call on 0800 800 MAS (627) and they will set one up for you.
However if you have returned from your elective your feedback really does benefit those students who want to follow in your footsteps so we ask that you go to the electives feedback section and complete the form which should take no more than 5 minutes to fill in all the fields.
Whether your elective is ahead or behind you we send you all our very best wishes for many exciting times in the future.
You will really want to go somewhere e.g. Nepal, India, UK, the Australian Outback, the Pacific Islands, work with an Aid Agency, Greymouth and the West Coast. You could be keen for a particular specialty in a large teaching hospital (ie Paediatrics at a Children’s hospital); or you may be interested in research and want to do a nonclinical elective. Remember also, people have had some exciting and interesting electives in New Zealand.
Once you have decided where you want to go and what you want to do, you contact the Hospital or Service. If you are unsure, please discuss with Professor Rob Walker, or some of the hospital staff. Some of the larger Hospitals/Universities have application forms on their web sites. You would generally write to the Convenor of Electives if it is a large hospital, or the person in charge of a Service. When you write asking for an elective, tell them the exact dates you are wanting a placement and if appropriate, a choice of one or two specialties. Tell them that this is a formal part of your final year and must be supervised and reported upon. You might like to send a brief CV with your initial letter.
Enquire about tuition / administration fees / any other special requirements –eg immunisation, specific insurance cover as well as medical indemnity. Also enquire about accommodation – ask if hospital accommodation is available, recommendation/suggestions of other places where elective students stay and approximate cost. Staying in hospital or recommended accommodation is a good way of meeting other medical students.
Some places will send you back a formal application form to complete, and some also require a letter stating you are a bona fide student of the school. Student Affairs Office can provide you with this letter of recommendation.
Canada (and some other places) require you to have a medical examination, chest x-ray, hepatitis screening, etc. You must contact the Canadian Embassy in Sydney for details about this and allow plenty of time for the processing of this.
Be prepared to write to several places to get what you want. Some places (one being the Pacific Islands) are not quick to reply and you may need to phone them after a few weeks to check that they have received your correspondence and ask if it is OK for you to go there. Ask for confirmation in writing, make and keep copies of all correspondence (especially emails) with your host hospital – this is most important to attach to your Elective Protocol for signing off by Professor Walker, and you may also need to produce it for visa or immigration purposes, or on arrival at the hospital.
Going overseas on a medical elective is an exciting opportunity and there is good evidence of educational benefit(1,2). However, travelling outside the relatively supervised environment of the medical school to a situation where you may be expected to perform clinical tasks unaided carries some vulnerability to occupational risks. The local clinical setting in developing countries may be in an area with high HIV prevalence, the worksite may for a variety of reasons have poor infection control practices, and students may be exposed to HIV and other blood borne viruses(3). In addition, tropical travel is associated with possible exposure to tropical infections and other environmental risks.
Please make an appointment at Student Health Services to discuss your travel, at least 8 weeks before you intend leaving.
In a questionnaire study on Tasmanian students returning from medical electives, 64% had experienced some form of health problem while overseas(4), while a few developed serious infections (including leptospirosis and paratyphoid) and several students reported assault or sexual harassment. Similarly, a group of medical students on elective from Glasgow, Scotland(5) reported a 45% rate of ill-health while overseas, of which 77% was gastrointestinal. With regard to the risk of blood borne viral disease, a study reported in BMJ by a medical student and two virologists in 1999(6) using a questionnaire in students after an elective overseas, suggests that accidental percutaneous or mucosal exposure to potentially infected body fluids had occurred sometime during their training in 44% of a group of UK medical students, but the majority (75%) had not reported this. Of the 220 students, four had been exposed to possible blood borne viral disease during their electives and three of these students were in areas of high endemicity for HIV. This risk is not just in medical students: a group of Dutch doctors working in Africa have reported that 61% had percutaneous exposure during an average 21 months stay, and there was an estimated occupational HIV infection risk of 0.11% per annum(7). Due to relative inexperience, students may be more clinically vulnerable(8).
A number of medical schools internationally have considered that there is a duty of care to advise medical students going on clinical electives overseas even though ultimately the degree of personal risk is something that a student has to weigh up for themselves(9). Some destinations may be considered too high risk (a current example would be Zimbabwe because of political unrest) while some may be very low risk and require minimal pre-travel health preparation, such as most Australian electives. However, for electives in tropical countries or HIV-endemic areas or if there are considered to be other significant environmental risks, adequate pre-travel preventive health care and advice is recommended. Although risk is part of life some risks can be reduced by awareness and appropriate preventive measures including but not restricted to vaccinations and malarial chemoprophylaxis. In addition some risks, such as possible HIV or rabies exposure, need to be managed by secondary prevention using post-exposure prophylaxis (PEP).
Suggested guidelines for management of health-related risks for overseas clinical electives:
You will need a longer than average consultation to discuss the travel issues in the table below. Your first appointment will be with a nurse and this will cost $50 which covers Doctors visits also. This will be to discuss your itinerary, the date you leave Dunedin and New Zealand and which countries you will be visiting. We will discuss previous travel and childhood vaccinations. If there are any vaccines we think you may need and you are unsure if you have had these, we can organise blood tests.
We will then book you into an appointment with a Travel Specialist Doctor. Vaccine costs are additional.
The Travel Clinic appointments are primarily Tuesday mornings but we will do our best to accommodate you as we can.
If you are taking a first quarter elective, you must ensure that you do not book your travel to commence until AFTER the unofficial results of the fifth year examinations have been advised to you, usually by email from the Student Affairs Office, approximately ten days after the fifth year final examinations. If by chance you fail these examinations, you will NOT be allowed to undertake your elective, as you will not be a sixth year medical student. Therefore, booking travel to commence before this date, is at your own risk. We strongly advise against paying for travel before the unofficial results come out. The official results will follow from the University at a later date. If you fail, you will be required to meet with the Associate Dean and discuss the special examinations and/or any remedial work/Terms requirements. The specials examinations are usually held around the end of January each year. If you pass these, you will be permitted to commence the sixth year course at the start of the second quarter (i.e. around the end of February), and you will then complete your degree twelve months later, subject to a successful pass in all of the attachments/modules.
If taking a fourth quarter elective, officially you are required to be back in Dunedin for the last week. However, if you have made contact with all the module conveners, prior to leaving Dunedin to check that you have met all the requirements for the award of Terms in all disciplines, and are not required for a pass/fail/distinction viva in the last week of the quarter, then this is not necessary. However, you must ensure that your elective report and supervisor’s assessment has been returned to Professor Rob Walker, ONE WEEK BEFORE the end of the quarter. Your graduation is dependent upon this.
You cannot leave for an elective attachment, until your elective protocol has been seen and signed off by Professor Walker, at least three months before the elective is due to be undertaken.
The last week of the sixth year course is when the pass/fail /distinction vivas are held across the three schools, and there is also a prize-giving and complimentary (free) graduation and farewell dinner held on the Thursday night (17 November 2011). This function is to award the local School prizes and is a social function hosted by the Dean and staff of the Dunedin School of Medicine, and the Southern District Health Board, to congratulate and farewell our new graduates. This is your last chance to get together with your colleagues and consultants before you depart into the big wide world of employment so please put this date into your social calendar now.
It is strongly recommended that travel insurance is purchased. This insurance typically provides cover for:
In addition, some policies provide Personal Liability cover, which meets costs resulting from accidental injury to third parties and damage to their property.
The University's insurance broker, Marsh, has arranged a comprehensive policy (the "Studentsafe-Offshore Policy" insured by Vero), which provides this cover at a competitive price. If you wish to find out more about this policy, please see below for contact details. Other insurance companies offer similar packages, but it is important that you make sure that any insurance you purchase covers the areas listed above.
Professional Indemnity insurance provides cover for claims by third parties for breach of professional duty by reason of negligence, error or omission. The University's professional Indemnity policy covers students as long as they are under the direct supervision or control of the University, however as there is no such direct supervision or control while a student is overseas, this cover is effectively limited to New Zealand. For this reason, the University requires that all trainee interns join the Medical Protection Society (MPS), which provides worldwide indemnity to its members.
Students intending to travel on overseas elective should be aware:
Definition of public liability is the common usage for describing certain events that are insured where a person is involved. Because it deals with damage to the public and property not your own.
The OFFSHORE policy uses Personal LIABILITY to describe the same risk you will note the subsets 1 2 3 which define the elements of the cover.
The heading could use "Public" or "Personal", according to our technical person.
The University will not approve electives in war zones, areas of high terrorist activity, or areas with health issues (eg SARS).
It is your responsibility to check what your host hospital/country needs by way of personal insurance/public liability cover as well as the above. Some places in Australia are now asking for proof of insurance for personal injury and public liability (if you have injury to yourself or an accident in regards to property and assets). The University of Otago strongly advises you to get in touch with the following person for travel and health insurance when on elective as they have designed a policy specifically for this purpose. The policy is called the Student-Safe-University Pack and details and application forms are available from the following person:
If you are really keen to go to some of the third world countries you need to check on the HIV situation and find out if the hospital has procedures in place for accessing appropriate antiretroviral therapy etc. These things must be sorted out BEFORE you commit to an elective attachment. Please remember that Professor Walker has the final signing off of any elective arrangements. The SARS outbreak affected elective plans, and when things like this happen, the University (on advice from WHO) has the final say if you can go to these areas or not, also check the Ministry of Foreign Affairs website for information on travel advice: http://www.mfat.govt.nz/travel/index.html Please check with Professor Walker about visiting these places.
Medical Protection Society (MPS)
MPS provides indemnity cover for medical students during their final year, and this cover extends to electives. You must contact them and provide them with information about your elective e.g. where you are going and the dates. They may also require specific information in case of any changes in cover due to SARS, terrorism etc.
It is a prerequisite for all Trainee Interns to have Medical Indemnity cover. The University currently recommends joining the Medical Protection Society (phone: 0800 22 55 677. There is no subscription for this cover until the House Surgeon year. This protection covers indemnity insurance while you are on your elective and protection is worldwide including Canada and the USA. If medical protection is not taken out, this would be a breach of agreement with the District Health Board and hence Trainee Interns could be personally liable if they were involved in any litigation proceedings.
When Trainee Interns are heading off on elective, MPS are happy to provide a certificate; however there are certain steps you need to take before this can happen and they are as follows:
You MUST contact MPS on 0800 225 5677 or email firstname.lastname@example.org
If students are heading over to Australia there is a different procedure and that is why it is important that MPS are contacted first. Once MPS has your elective information they will then send the appropriate documentation to you.
Overseas professional indemnity confirmation for Australia
Following changes in Australian medical legislation in July 2003, MPS administrative arrangements for electives in Australia are slightly different to those elsewhere in the world. In brief, this new legislation stipulates that every health care practitioner in Australia, including students, must be covered by an insurance policy. As MPS is not an insurance company they have made arrangements with Medical Indemnity Protection Society (MIPS) based in Victoria to cover your elective whilst in Australia. The MIPS Student Members Master Policy is underwritten by the Australian insurance company, Health Practitioners Australia Pty Ltd. (HPIA), which is wholly owned by MIPS.
You will remain a member of MPS and there will be no additional subscription to pay
Remember to include your MPS membership number
Private international and government sponsored students
MAAP - Medical Aid Abroad Programme
Guidelines for pandemics, infectious disease exposure, political unrest or any "threat" to personal safety
Upon your return to Dunedin please contact the Trainee Intern Course Coordinator to discuss alternative arrangements for your elective. Please note that you will not be penalised for not meeting “terms” in the event of unexpected situations that are a risk to your safety.
An informal 20-minute interview for information sharing with members of the Trainee Intern Committee will be arranged within six weeks of the end of your elective quarter. The Dean of the Dunedin School of Medicine convenes this meeting and any Trainee Intern unable to attend on the day selected should contact Jan for an alternative date with a subsequent group. The review session will not normally be part of any assessment procedure.
The following forms must be completed:
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