A scoping review of the ethical impacts of international medical electives on local students and patient care

被引:3
作者
Chmura, Magdalena [1 ,2 ]
Nagraj, Shobhana [1 ,2 ,3 ]
机构
[1] Univ Oxford, Med Sci Div, Oxford, England
[2] Univ Oxford, Oxford Univ Global Surg Grp, Oxford, England
[3] Univ Oxford, Ctr Global Hlth Res, Nuffield Dept Med, Hlth Syst Collaborat, Oxford, England
关键词
Ethics; Electives; Medical students; LMICs; CLINICAL ELECTIVES; HEALTH ELECTIVES; PARTNERSHIP; CHALLENGES;
D O I
10.1186/s12910-023-00998-7
中图分类号
B82 [伦理学(道德学)];
学科分类号
摘要
BackgroundInternational electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common, ethical considerations of such practices emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs.MethodsWe systematically searched PubMed, Global Health and Embase databases using the search terms "(ethics) AND (medical electives)". Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results.ResultsA total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. More publications were written from the medical student perspective (n = 14), than by the host-institution (n = 5), with nearly half written from third-party perspectives (n = 18). Negative impacts on local host students and impact upon patient care were identified as additional ethical considerations.ConclusionsOur review demonstrated that while there is a degree of awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students' access to medical education and patient care, continued work is needed to ensure equitable partnerships. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses and post-elective debriefs to increase medical students' awareness of the impact of their presence on host communities.
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页数:8
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