A Guide to Studying Abroad
Fourth Year Timeline
A GUIDE TO STUDYING ABROAD
Experience cultures and explore medical practice outside the U.S.
Learn about diseases that are more prevalent abroad.
Learn language and cross cultural skills that you can bring back to a U.S. practice.
Enhance appreciation of primary care and public health.
Learn about ways in which you could be involved in international medicine.
Expand your own frame of reference on the role of a physician.
It has been estimated that 10% of jobs for future U.S. physicians will be abroad as U.S. health corporations go global.
2. IS IT A GOOD IDEA FOR ME?
Please contact Mick Godkin, Ph. D., Director of International Education, to discuss your ideas. He can be reached in Room A3-225 of the Benedict Building or contacted at x6-3917. He will have you complete a placement self-assessment form which will help you focus on your ideas and begin a process of discussion to help clarify your goals, and discuss any requirements.
3. WHAT KIND OF OPPORTUNITIES EXIST?
Clinical electives (fourth year students).
Public health and international development.
4. WHEN DO I GO AND FOR HOW LONG?
Preclinical students usually go abroad the summer after their first year.
Clinical students usually go abroad for part of their fourth year.
Some students extend medical school to five years to allow more flexibility.
Things to consider:
A. Policy on credits for international study:
Preclinical students: Currently, no credits are given to preclinical students studying abroad after their first year.
Clinical Students: During the third and fourth years combined, you must complete 56 weeks of required clerkships within the UMass system. Another 24 weeks of electives are required, but are very flexible. You can do up to two months of Type B (direct patient care) electives and two months of Type C or D (limited patient care) electives internationally. To receive credit you must get approval from Dr. Godkin or the appropriate UMass Department Chair. Approval of the elective is based on personal knowledge of the site by UMass faculty or a written commitment from the particpating international preceptor outlining the patient population, student's role and level of supervision.
B. Important fourth year dates (*requires your presence in the U.S.)
- One month between August and November: Apply for residency*
- Last week of October: Review Dean's Letter*
- November and December: Schedule interviews for residency*
- One month between November and January: Interview for residency*
- Mid March: Match Day
- Two days before Match Day: Scramble (for those who do not match)*
- June: Graduation. August or March: USMLE Step II (register three months before the test)*
- December or April: ACLS (available at other times, call Cont. Ed. at 856-6105)(ACLS certification is valid for 2 years)*
WHAT IF I WANT TO GO ABROAD FOR LONGER THAN FOUR MONTHS?
Students who have been abroad for longer periods have usually needed to delay graduation for one year. If you do this, you switch to an Extended Student Program, either with or without Leave of Absence.
Extended Student Program without Leave of Absence: You must apply to be put on this status. Your application will be reviewed on a case-by-case basis. You must meet with Dr. Rogoff and submit a proposal to the Pre-clinical or Clinical Science Academic Evaluation Board. The proposal should include: where you want to go, how long you plan to stay there, what you plan to do, who will supervise you, and why you think the experience will be beneficial to your education. Your plans should include significant educational experiences. UMass does not limit the number of rotations that you can do before graduation. The benefits of this program are that you are still considered a student and do not have to start paying back student loans, but are still eligible for financial aid. In addition, once you pay tuition for eight full semesters, additional semesters are tuition free, although charges still exist for program fees and health insurance (about $950). You are covered by UMass malpractice insurance and are eligible to purchase UMass health insurance (about $1000 annually) and disability insurance ($85 annually). The learning contract payback time is not extended by being in this program.
Extended Student Program with Leave of Absence: If you choose this program, you must submit a written request for approval by the appropriate Academic Evaluation Board. You are not considered a student for the time that you are away, and therefore do not have to make plans for educational experiences during your leave. You pay no tuition or fees, receive no financial aid, and get no credit. If you need insurance, you can purchase it at the same price as other students plus the $200/semester student health fee. If you plan to do clinical work, you must arrange for your own malpractice insurance.
Loans may have to be repaid:
- Stafford Loans have a 6 month grace period. Once you enter repayment status, you cannot get a deferment or another grace period, even when you come back to school. Also, unsubsidized Stafford Loans will accrue interest during your leave, while subsidized Stafford Loans will not accrue interest during grace period, but will after the grace periods ends.
- SLS, PEP, Share, and TERI loans enter repayment one month after you exit student status. Once you enter repayment status, you can no longer defer, even when you come back to school.
- MAL loans are like TERI loans, except the grace period is 6 months and you may negotiate for a decrease in the payments.
6. HOW DO I FIND AN APPROVED SITE?
We have for the most part done this for you. Specific opportunities are listed in the back of this handbook. Contact Dr. Godkin if you plan to study abroad; he has more complete information on everything listed in this guide. He can let you know if anything is preventing approval of a site.
Also, for more details about sites through NGOs, browse through our database at http://library.umassmed.edu/ihoc.
Defining your program:
It is helpful to clearly define your learning objectives. Even if you are doing a clinical elective your learning should focus on cultural issues and the socio-political/public health context of individual care. Students on clinical electives for credit are required to identify a small project and produce a brief written report upon returning. The project should be based on whatever interest or question initially led you to seek the international experience. It may involve a case study that has interesting cultural and clinical aspects or an examination of issues affecting a larger population, e.g. maternal and child health.
Confirming your site:
A letter of agreement and understanding from your primary supervisor abroad is required for any program for credit and recommended for all experiences. The letter should validate the suitability of the site (e.g. types of clinical involvement, adequacy of supervision, commitment to evaluate student) as well as practical issues (e.g. dates, plans to meet student housing, means of contacting student, availability of health care, safety considerations, and contingency plans for emergency evacuation).
Lynn Eckhert, M.D., in the Department of Family Medicine and Community Health, conducts an informal series each year. This will help you prepare for the issues you may encounter.
Passport and Visa:
Locate the nearest consulate or embassy of the country in which you plan to do your elective, as well as any that you might visit on the trip. You should be able to find the country embassy or consulate by calling directory information (1+area code+555-1212). Some area codes are: Boston (617), New York (212) and Washington (202). Determine whether you need only a passport or if both a passport and a visa are needed and have them send you their visa application if necessary. Begin obtaining your passport or visa at least three months prior to your leaving date (a passport may take much longer than a visa and it must be obtained before the visa). It may be a good idea to carry extra passport-size photos with you in case you decide to visit another country in the area and need another visa.
Note: A passport is obtained from our government while a visa is permission from a foreign country to visit or work in their country.
Health and Immunizations:
A) Sources of information:
1) "Advice for Travelers," The Medical Letter, v.38, no.969, March 1, 1996 is a good general guide. Dr. Godkin has copies of this in his office.
2) The Centers for Disease Control Web site is http://www.cdc.gov/travel/travel.html. To get a complete set of information:
a) First, Check the "Blue sheet" to see if your travels will take you to areas with reported cholera or yellow fever.
b) Next, check the "Yellow Book" under "Vaccination Information" for "Vaccination Certification Requirements".
i) Under "Vaccination Certificate Requirements for Direct Travel from the U.S. to Other Countries" you should check to see what kind of documentation might be required.
ii) Under "Yellow Fever Vaccinations Required and Information of Malaria Risk and Prophylaxis by Country" you should check under each host country to determine your needs for yellow fever vaccination and malaria prophylaxis.
c) Next, scroll down to "Geographic Health Recommendations" and read information on all the areas youíll be entering. This includes excellent information on Malaria, Dengue Fever, Japanese Encephalitis, Yellow Fever, Ebola, Typhoid Fever, Cholera, Hepatitis A and B, HIV, Parasites, Meningococcal Disease, and Rabies. You can print these out to take with you to the physician and on your travels.
d) Specific information on vaccines is also available on the CDC website, including geographic incidence of the disease, efficacies of types of vaccines, dosing, and contraindications.
3) The Center for Disease Control's annual handbook, Health Information for International Travel, has an updated list of the immunizations needed for every country. We have it in our office, or you can find it in the "Government Document" section of the Library, call number HE 20.7315.
4) The CDC has a Traveler's Information hotline at: (404) 332-4559 (24 hour access with touch-tone phone).
5) You can call the Massachusetts Department of Public Health at: 799-8555.
B) Obtaining vaccinations/prescriptions:
1) If you will need the Yellow Fever vaccine, you must be seen in a government-approved travel clinic. Locally, this includes the UMass Travel Clinic, the Fallon Travel Clinic, the Worcester Department of Public Health, and the clinic at Logan Airport.
2) For all but the Yellow Fever vaccine, your primary care physician can take care of you. You may want to contact the CDC to find out what you will need beforehand and bring this information with you to the appointment (http://www.cdc.gov/travel/travel.html). If you have the UMMC student insurance, the Student Health physicians are used to accessing the appropriate immunizations. In addition, you will only have to pay charges for medicines you purchase through the pharmacy. An alternative resource is the UMMC Travel Clinic (x61720) which is more expensive than student health.
3) In general, make the appointment at least 2-3 months prior to leaving, as many immunizations are given in a series over a period of weeks or months. Be sure to update your immunization records during the visit. At the same time as getting your shots you should discuss any health concerns, including allergies, and ask about prophylactic medications. It is generally a good idea to bring Immodium and ciprofloxacin.
It is important to confirm that you are adequately covered for health insurance, including coverage in the event of emergency evacuation or repatriation of remains.
Dr. Godkin has a catalogue of programs available to learn Spanish and other languages for the summer between first and second years. Also, Spanish classes are being offered at UMMS. In addition, many of the high schools in Worcester offer night courses. Most clinical electives in non-English speaking countries require fluency in the countryís national language.
The cheapest flights from Boston probably can be found with the ticket brokers out of New York City. Although this is true, they are less dependable and you need to be flexible with your departure date, which is not always possible if you are expected at a site on a particular date.
Begin inquiring about flight arrangements at least three months in advance.
Some recommended agencies include:
1. The Student Travel Network (informative, flexible, excellent rates):
273 Newbury Street
Boston, MA 02116
Hours: M-F 9:30-5:30
2. Council Travel Service (Experts in Student Budget Travel):
729 Boylston Street, Boston, Phone: 1-617-266-1926
84 Mass Avenue, Cambridge, Phone: 1-617-225-2555
1384 Mass Avenue, Cambridge, Phone: 1-617-497-1497
3. World Trade Travel (excellent for Latin America) is located in NYC but will arrange flights from Boston and can be reached at 1-800-732-7386.
4. Alan Travel (excellent for flights to India) is located in Newton and can be reached at (617) 254-8045.
5. Travel Center (used for a good rate to Vietnam) is in NYC and can be reached at (212) 766-2288.
6. Premier Travel (used for flights to Africa) can be reached at 1-800-545-1910 or at http://premiertours.com.
7. Travel Bargain is in Milford, Connecticut and can be reached at 1-800-937-3273.
In addition, the New York Times and Boston Globe Sunday editions list cheap flights, although often this requires that your travel plans be flexible. American Express often offers student discounts and travel coupons to students who have AE cards.
In general, remember to bring your passport, visas, immunization records, and authorization to perform medical work (student ID or letter from the host hospital). For certain places you may need items like an electrical converter, a tape recorder, a flashlight with extra batteries, a portable typewriter, mosquito repellant, mosquito netting, an extra pair of glasses/contacts, your prescription, sunblock, toilet paper, paper towels, an umbrella, and a sheet. An extra supply of necessary medications (including birth control pills) in original containers is essential. In addition, The Lancet states that in developing countries an emergency health pack containing needles and a drip set is an essential part of equipment to prevent HIV. If you will be doing clinical work, bring your own gloves, scrubs, gowns, safety glasses, and medical equipment.
Credit cards, ATM cards, and travelers' checks can be lifesavers while traveling. If you arrange ahead of time with American Express, you can request additional travelers¹ checks from any international American Express office. ATM cards in some locations will give you the best exchange rate. You may want to bring a money pouch (one that can be worn inside your clothing) to keep your valuables hidden from pickpocketers. Some people wear a money pouch inside their clothing (with their true valuables) and a fanny pack outside their clothing with smaller change. This way, if they are robbed, the thief will steal the fanny pack but not think to look for a separate money pouch.
9. HOW DO I PAY?
(See funding section for complete listing of funding organizations and additional details)
See Section II, Formal Programs through the Office of International Education, as well as the section on Funding.
Some students have been able to expand their loan package with sufficient notice of foreign travel, although the practice does not seem to be encouraged by the Financial Aid Office. Any award would also be contingent on the type of loan.
Established External Sources:
These are listed in the section on Funding.
Religious organizations, Sister City Organizations, Ethnic Organizations, Pharmaceutical and other corporations, as well as local and regional chapters of professional organizations (e.g. medical societies, Lions Clubs, Rotaries, Jaycees).
10. WHAT DO I DO WHEN I ARRIVE IN THE FOREIGN COUNTRY?
Register with the U.S. Embassy in the country so that they know where you are staying and how you can be reached in case of emergency. Also ask them about prophylactic medications and hospitals in case you become ill, and any other recent health issues or risks (e.g. water quality, foods, and areas of potential political unrest). Take it easy when you arrive in order to recover from any jet lag, dehydration, altitude changes, or stress. Many health problems can be avoided if you model yourself on the way the locals act. Do not drink unpurified water or eat the ice. Also, avoid fresh vegetables that may have been inadequately washed or may have been washed in unpurified water.
11. WHAT DO I DO WHEN I RETURN TO UMMS?
Take pictures and keep a journal while you are gone and think about giving a presentation to students. Help other students by leaving a record of your experience on file with Mick Godkin, Ph. D., Family Medicine and Community Health, A3-225. He has a form for you to complete so your experience can be useful to other students. Students on clinical electives for credit are required to submit a brief summary of their project (see above) to Dr. Godkin.
Time Line for Fourth Year Elective
(Check off and date activity once completed)
TWO YEARS BEFORE DEPARTURE
__ Consider the following:
__ When in medical school is best?
__ Note important dates in your calendar (see p.8)
__ Identify an advisor
__ Assess your motives for choosing an elective
__ Assess your learning style
__ Identify possible sites/request information
__ Estimate program costs
__ Identify a possible funding source
__ Assess language requirements
__ Should you study a foreign language?
AT LEAST ONE YEAR BEFORE DEPARTURE
__ Select a site
__ Begin research on the country's culture/customs
__ Determine your role/advisor's role in contacting the site
__ Select elective dates
__ Get department approval for your plan
__ Arrange to get academic credit
__ Determine total cost of your program
__ Start raising money
__ Attend orientation and preparation seminars
SIX MONTHS BEFORE DEPARTURE
__ Confirm department approval
__ Explore specific details of the elective
__ Is there a letter of agreement from the site?
__ Identify an on-site advisor
__ Who will evaluate you and how?
__ Where will you live?
__ How can you be reached?
__ Inquire about airline schedules/costs
__ Reassess your funding/budget
THREE MONTHS BEFORE DEPARTURE
__ Apply for a passport
__ Apply for a VISA if necessary
__ Schedule immunizations
__ Arrange for insurance (health and medical evacuation)
ONE MONTH BEFORE DEPARTURE
__ Recontact on-site host or supervisor
__ Send travel schedule to on-site supervisor
__ Make on-site housing arrangements if possible
__ Begin packing clothing, supplies, medication
__ Complete travel documents (passport, VISA, tickets)
ONE WEEK BEFORE DEPARTURE
__ Reconfirm flights
__ Obtain travelers checks
__ Anticipate a let down/reverse culture shock
__ Prepare your report
__ Submit evaluation requirements
__ Thank your on-site host
__ Share your experience