To the Editor:

We read the commentary “Student Doctors: Learning from the Front Line” with great interest and would like to expand on this, with emphasis on overseas medical electives: a front-line clinical experience the COVID pandemic has critically affected [1].

The medical elective has long been regarded as the highlight of medical school. Students experience the clinical environment in a foreign country, oftentimes in a profoundly different healthcare system and culture. This offers students first-hand experience of global health, an area neglected within the medical school curriculum, despite its importance in our increasingly connected world and as showcased by the pandemic [2]. Furthermore, as Checkley and colleagues discuss, typical medical school placements limit a student’s team involvement and autonomy [1]. Electives may provide students more responsibility and experience within clinical environments.

Historically, most UK medical students undertook electives abroad [3]. The COVID pandemic has stolen this opportunity from a generation of medical students worldwide. Will their future clinical practice suffer as a consequence?

The UK’s General Medical Council (GMC) states that graduates must “evaluate the determinants of health and disease and variations in healthcare delivery and medical practice from a global perspective and explain the impact that global changes may have on local health and wellbeing” [4]. However, there is variability in global health teaching and no standardised curriculum that all UK medical students cover [5]. Without international electives, a key opportunity to meet this outcome is lost.

Less developed nations are popular elective destinations [6]. Many medical students have taken up roles as vaccinators and clinical assistants in the UK — why not utilise them abroad to help roll out vaccines where they are needed most? As Checkley and colleagues mentioned, during the pandemic, medical students have felt more valued in working clinical roles. Furthermore, the great responsibility of these roles was also considered to increase students’ readiness for practice [1]. This degree of responsibility could be offered in overseas electives.

Will the international elective return to its former glory as a rite-of-passage at the climax of undergraduate medical education, or will the uncertainty posed by virus variants and unpredictable travel restrictions continue to stand in the way? Given the correct precautions are taken with respect to vaccination, testing and PPE use, we must consider this an essential aspect of medical education and encourage front-line international electives once more.