Responsible Electives, with support from Dundee Medical School, has been piloting an alternative arrangement since 2006 in Malawi, using a long-term partnership model. This has been going well and around 50 students have had electives through this program. Responsible Electives’ mission is to develop formal partnerships with health institutions in developing countries, link UK medical students with existing overseas partner sites, offer pre-departure training and completion of online preparatory modules, and encourage students to fundraise for the benefit of their host. We wish to optimise the learning students gain, including developing a strong sense of global citizenship, in its broadest sense. Through promoting a more considered and fairer ‘trade’ in electives we seek to ensure the host sites benefit.

Initially based at Kamuzu Central Hospital in Lilongwe and aided by a grant from the Scottish government we placed Dundee students on extended electives under the auspices of Medicine in Malawi Program. The novel ability to extend the elective to 4 months was a draw for some students but too long for others who feared missing too much teaching and there were also concerns about the consistency of suitable supervision at the hospital. At this stage we were also able to support two students each year from College of Medicine travel to Dundee for a six week UK elective placement. Twelve Malawian students have visited Tayside and their experience proved extremely positive, as evidenced by BMSc student interviews.

Since then we have established two alternative bases, both mission hospitals, one in Malawi, one Zambia. In conjunction with this we went ‘public’ and invited applications from other UK medical schools in the hope of scaling things up and creating a not-for-profit program of elective placements. As the level of interest from outside of Dundee was low we have now suspended this option temporarily whilst we explore other approaches.