How will an international medical experience affect my medical school application? Should I spend several thousand dollars for a 1-4 week trip to participate in medical care in a third world country?
A number of years ago, such experiences were uncommon among applicants and represented a unique way for an applicant to stand out and have something to write about and talk about. More recently, these experiences have become commonplace among applicants and serious questions are being raised about the nature of the experience, what is gained by it and contributed by it, and whether such experiences enhance or detract from a medical school application.
First, it is absolutely necessary to be clear that a short-term medical care mission by an untrained premedical student in a developing country has much more to do with the personal development of the individual going on the trip than enhancing the health of the citizens where the trip is occurring.
Although such trips, when part of a well-established clinic or other international group, do lead to provision of care in poorly served areas, this care is primarily being given by trained professionals, not by pre-professional students. By coming, you are supporting the clinical/project, but you are not the primary health care provider and your financial support is a key aspect to what you are providing.
No student should attempt to provide care for which they are not thoroughly trained and have been properly certified to give. Certainly, it is possible to take an introductory history, assess vital signs and the like, but pre-professional students without specific training (more than a see one, do one type of training) should not be doing physical exams, drawing blood, starting IVs or holding retractors in surgery. You wouldnt do those things without training in the US and you shouldnt do them elsewhere except in a true emergency.
In evaluating possible overseas experiences, one should carefully consider how much money you are paying and how that is being used. Evaluate the security and living conditions carefully. Do not rely only on the glowing reviews by others who have gone there. Read the US State Department statements about the country you are going to and think about the implications for your health and safety. Visit a well established travel medicine clinic or physician before going and get your immunizations. All of them. Dont forget the malaria and travel sickness (and possibly altitude sickness) medicines.
What these trips do provide is an opportunity to experience medical care in a system in which many of the backups and safety nets we take for granted (WIC for food, EMS services for transport, 24-hr ER availability) are not available. Seeing how the poor live can be done in the US, but in some areas of the world, the poor have virtually no medical care available. If an international experience expands ones insight into this and into the needs of the global community, it can be valuable. Think about why this community needs to rely on an American to provide their health care needs.
In putting this experience into an application, students should be extremely cautious about overstating what they did, what they saw and how they interpret things. Avoid blanket statements about health care in countries in which you only spent a few weeks. Indicate how the experience caused your personal growth, not that you will now be committed to this as a career. Avoid political statements indicating that the US should do more or is not doing enough in these areas unless you have a good understanding of the whole range of US foreign policy in this area.
Is it worth doing? Well, I would say that it is not much of a benefit to your application. Sure, 2 weeks spent in Africa beats 2 weeks spent on the beach as something to talk about on an interview. However, I am just as impressed by someone volunteering 2 weeks in a nursing home, or an inner city setting in the US than someone who went to Latin America for 2 weeks. Save the money (or give part of it to UNICEF!) and stay home. If you want the experience, want a chance to travel, thats fine, but dont be surprised when it has little or no positive effect on your application.
I realize that popular wisdom is that adcoms swoon over these experiences. Popular wisdom is wrong in this case. Any adcom with a year of experience has heard this story a lot and will take it in context. They may ask some very tough questions about why you went, what was accomplished and what it means for your career.
