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Educational Objectives for International Medical Electives: A Literature Review

Cherniak, William A. MD; Drain, Paul K. MD, MPH; Brewer, Timothy F. MD, MPH

doi: 10.1097/ACM.0b013e3182a6a7ce

Purpose Although most medical schools and residency programs offer international medical electives (IMEs), little guidance on the educational objectives for these rotations exists; thus, the authors reviewed the literature to compile and categorize a comprehensive set of educational objectives for IMEs.

Method In February and July 2012, the authors searched SciVerse Scopus online, which includes the Embase and MEDLINE databases, using specified terms. From the articles that met their inclusion criteria, they extracted the educational objectives of IMEs and sorted them into preelective, intraelective, and postelective objectives.

Results The authors identified and reviewed 255 articles, 11 (4%) of which described 22 educational objectives. Among those 22 objectives, 5 (23%), 15 (68%), and 2 (9%) were, respectively, preelective, intraelective, and postelective objectives. Among preelective objectives, only cultural awareness appeared in more than 2 articles (3/11; 27%). Among intraelective objectives, the most commonly defined were enhancing clinical skills and understanding different health care systems (9/11; 82%). Learning to manage diseases rarely seen at home and increasing cultural awareness appeared in nearly half (5/11; 45%) of all articles. Among postelective objectives, reflecting on experiences through a written project was most common (9/11; 82%).

Conclusions The authors identified 22 educational objectives for IMEs in the published literature, some of which were consistent across institutions. These consistencies, in conjunction with future research, can be used as a framework on which institutions can build their own IME curricula, ultimately helping to ensure that their medical trainees have a meaningful learning experience while abroad.

Supplemental Digital Content is available in the text.

Dr. Cherniak is a family medicine resident, Scarborough Hospital, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada.

Dr. Drain is instructor of medicine, Massachusetts General Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts.

Dr. Brewer is professor of medicine, David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, California.

Funding/Support: Dr. Drain was supported by the Harvard Global Health Institute, the Fogarty International Clinical Research Scholars and Fellows Program at Vanderbilt University (R24 TW007988), and a Program for AIDS Clinical Research Training grant (T32 AI007433).

Other disclosures: None.

Ethical approval: Not applicable.

Previous presentations: Data presented at the Canadian Conference for Global Health in October 2012.

Supplemental digital content for this review is available at

Correspondence should be addressed to Dr. Cherniak, Department of Family and Community Medicine, 3000 Lawrence Ave. East, Building A, 2nd Floor, Scarborough, ON M1P 2V1; telephone: (647) 929-9791; e-mail:

© 2013 by the Association of American Medical Colleges