Undergraduate Medical Electives
: A cross-paradigmatic exploration of their role in undergraduate Medical Education and Global Health Education, and implications for Global Health

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Introduction: Undergraduate medical electives are short periods of self-directed learning in a professional setting undertaken by medical students towards the end of their undergraduate studies. A significant number of students go abroad for their electives, including to low and middle-income countries (LMICs). Current debates in the literature include the value of electives in their current form, and whether the benefits, burdens and risks associated with electives are equitably distributed. Host perspectives are underrepresented and there is a dearth of studies focusing on the UK, so this study aims to address these research gaps.

Methodology: This is a qualitative study conducted from a critical constructivist epistemological paradigm, guided by a conceptual framework that draws on elements of Critical Theory, emancipatory, and postmodern thought. A meta-narrative literature review informs the empirical research, which includes semi-structured interviews with a purposive sample of hosts worldwide, and observational research with multiple stakeholders in the UK.

Findings and implications: Key themes that have emerged include: participants’ objectives and motivations for electives, including explicit objectives and implicit motives; the process of crossing over, including crossing over into a different role or function, crossing over into a different context - and whether this crossing over requires physical movement into a different environment – and crossing over into a different mindset; identity, including which identities are privileged and de-privileged, how participants inhabit multiple identities, moral identity and the identity of doctor; and struggle, including the ramifications of students witnessing patients’ struggles, struggles encountered by students, struggles to implement best practice guidelines, and struggles to reconcile conflicting views about electives. 
 
This research is exploratory and makes a series of recommendations to the medical and global health education communities – including educators, hosts and students - to inform discussion and debate.

Conclusion: This study seeks to bring new insights to the future development of electives both in theory and practice. In keeping with the epistemological and conceptual framework, the methods chosen for the research enable the exploration of multiple perspectives and subjectivities. This research contributes new empirical data and theoretical insights to the literature, to inform thinking and practice about electives, with broader relevance to wider medical education and global health partnerships.
Date of Award1 May 2022
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorPaula Baraitser (Supervisor), Carwyn Hooper (Supervisor) & Christopher Willott (Supervisor)

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