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Your Final Year Elective - Planning and Approval

Year 6 provides the long-awaited the opportunity to spend an 8 week period undertaking a clinical elective of your choice.  

Early planning is key to a successful elective and the Medical School’s formal application process for elective approval begins in the first term of Year 5. 

 

Aims and objectives

The aim of the clinical elective is to deepen knowledge of subjects relevant to the MBBS curriculum, that are of particular interest to you, in different clinical and cultural environments.

Your elective must include a clear clinical element, under the general supervision of a medically (MB BS or equivalent) qualified senior (non-training grade) clinician within the service in which you will be embedded, over a minimum 6 week period. Satisfactory completion of the elective, and submission of all related sign-offs, is a requirement for the award of the MBBS degree.

The objectives of the elective are to: 

  • Develop organisational skills, and as an independent learner formulate a well thought out self-directed period of study.
  • Witness medical practice, and enhance professional skills, preferably in an environment not already encountered during previous MBBS studies.
  • Increase relevant clinical experience in an area of particular interest to the student.
  • Broaden cultural experience in the UK or further afield

The specific programme of study, and scope of experience, will be developed by you in discussion with your elective host institution. The elective counts towards MBBS clinical requirements and so must principally be patient-facing and hands on, although observational and non-clinical elements may be included where they are clearly clinically relevant, and alongside a clinical placement form a coherent 8 week elective. We strongly encourage you to consider your elective for the experience it will give you as a clinician rather than as an exercise in building your CV.

Electives are taken in one of two blocks after Finals. Your elective block will be allocated during the first term in Year 5.

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Elective approval – why and what 

The GMC licenses UCL’s MBBS degrees as a primary medical qualification for the purposes of provisional registration on the basis of programme requirements which include satisfactory and documented completion of an 8 week elective approved by the Medical School. 

For your elective to be approved and for the Final Exam Board to confirm your degree award in June, your elective must satisfy the conditions set out on this website and detailed in the online elective approval application forms, and you must submit evidence of satisfactory completion of an approved elective and of your post-finals SSC by the deadlines given.

The pre-elective forms, and the administrative process underlying them, are designed to assess the heath and safety aspects of elective placements as required by UCL, and reasonably to ensure that the placement will offer an experience that can be counted towards the MBBS programme requirements.

The process has been designed to be pragmatic, enabling most students to pursue an elective placement of their choice overseas. Given that the Medical School cannot inspect each placement directly, we rely on students filling in the pre-electives honestly and as accurately as they can, along with information available to us in the UK, and any reports by previous UCL Medical Students.

The health and safety elements focus on risks beyond those that students may encounter in a clinical placement in the UK. Where additional risks are identified, for example HIV exposure without ready access to post exposure prophylaxis, students are required to take steps to mitigate this, for example take post exposure prophylaxis with them.

Beyond the placement itself, we also take account of Foreign and Commonwealth Office travel guidance, and do not approve elective placements in locations where they have cautioned against travel.

With regard to the experience a placement offers, we require the host institution to state that they will provide a clinical elective placement (or equivalent). Where UCL medical students have not previously been to a particular institution, we ask the student to provide additional evidence that it is a locally recognised healthcare provider. Where UCL Medical School has previously been made aware of concerns about experience provided by a placement, we will either discuss this with the student and or decline approval of the placement.

Despite the pre-elective process, we recognise that plans may not work out as expected. Students are specifically advised to contact either the travel insurance provider (for emergencies or incidents) and or UCL Medical School (for non-emergency concerns or general advice about your placements).

As UCL medical students undertake their elective after their final examinations, and are about to enter clinical practice, we anticipate that they will behave professionally and seek advice from UCL Medical School if they have concerns.

 

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Elective Bursaries

UCLMS Elective bursaries - The application process for our internal Medical School bursaries opens from April/May of Year 5 to the end of September of Year 6. Our Scholarships and Bursaries Committee meets in October to determine the awards.  

Medical Schools Council - External Elective bursaries - The application process and timelines for these bursaries varies and details are published against each award.  

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Elective Placement Reimbursement - NHS Bursaries

The main sources of help with the costs of electives are UCL Medical School’s Elective Bursaries, external elective bursaries which are advertised nationally and posted on our moodle site as we hear about them, and the NHS Bursary Practice Placement Reimbursement, which is the only scheme through which expenses can be reclaimed.

If you are eligible for NHS Practice Placement reimbursement, you will be eligible to claim back some of your elective expenses. Please note that NHS Bursary guidance changes year on year and is subject to change at any point – so please check the NHS Guidance on the NHS Bursary website regularly. 
 
Please read the guidance in full. It contains important information of what you can claim and any Terms and Conditions that may restrict you from claiming.  
 
You will need sufficient evidence to support any declared costs. For example, if you share accommodation with another student both of your names will need to be on the invoice. 
 
It is highly advised that if you are unsure if you are eligible to claim, please call NHS Bursaries direct so they can confirm how much you can be reimbursed for. For example, Airbnb’s are assessed on a case by case basis and The Medical School are unable to confirm at what rate you will be reimbursed.
 
Please also note that although many students will book accommodation in advance, students can only submit expenses after they have returned from placement. Over the last couple of years, we have had an increase in the submission of practice placement expense forms, in particular elective expenses. Consequently, the processing time of documents has also increased significantly. We are in the process of reviewing our procedures of how students submit their elective expenses and will update students in a timely manner of the outcome.  

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Planning your elective

Early planning is key to a successful elective;  to maximise chances of securing places at popular destinations; to allow for delays in communications with remote destinations in developing countries; and to allow time to gather the support documentation requested by host institutions.

The Medical School discourages students from using commercial companies who arrange electives on behalf of healthcare students. In any event, any elective arranged through a commercial company must fulfil all the Medical School's academic and health and safety requirements.

Please note that the Medical School will not approve elective placements that have been organized via Medics Away due to concerns regarding their validity.

Students can apply to more than one institution but should accept only one offer of a placement.  It is also important that when you receive the first offer of a placement that you either accept or decline this as soon as possible.  A “back-up” elective should not be arranged. Declining an elective placement at short notice is considered highly unprofessional and inappropriate and, importantly, it disadvantages future UCL students who may apply to that institution.

Here is some information related to some destinations: 

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Gathering documents likely to be required by your host institution 

Your host institution will ask for various documents as part of their offer process and we advise you to check early what you’re likely to be asked to provide. We will generate letters confirming your student status and Medical School recommendation routinely as we approve each stage of your elective approval submission.  Should you need additional documentation, please request the documents below from medsch.elective-approval@ucl.ac.uk or follow the guidance relating to DBS and OH clearances as soon as you can.

Our list of commonly requested documents is below and we ask when you request documents from us that you specify as much detail as possible about your host institution’s requirements so that we can be sure that our letters cover everything you need.

Documents can be collected from the Student Offices or scanned and sent to you by email. Please allow a 2 week turnaround time for your documents to be produced.  

1)    Verification of student status / letter of good standing / letter of recommendation.

Our standard document includes: 

  • confirmation that you’re a full time registered medical student at UCL with your year of study and expected date of qualification
  • confirmation that the elective is a compulsory component of the course
  • confirmation of proficiency in written and oral English and that the MBBS at UCLMS is taught entirely in English
  • confirmation of completion of core clinical placements in medicine and surgery and your final exams
  • confirmation that you will be covered by UCL’s public liability insurance and UCL’s travel and personal health insurance
  • a note that you will be required to take out separate professional indemnity insurance if required 
  • confirmation of good standing and our recommendation 

2)    Academic reference

  • for many institutions, the verification of student status letter is sufficient, however if your institution requires an academic reference, we will ask the Divisional Tutor or a Student Support Tutor to provide one for you.  If you have been asked to provide a reference concerning your clinical skills and experience, you should contact a consultant who has supervised you on an attachment or check whether our standard letter below about Basic Life Support and Universal Training covered is sufficient.

3)    Academic transcript

  • institutions which ask for an academic transcript require a certified copy with the Medical School stamp on each page, rather than the version that you can generate yourself from Portico.

4)    Basic Cardiac Life Support, Universal Precautions and Use of PPE

  • this sets out the training attended in the Clinical Skills Centre and the skills acquired, including Basic Cardiac Life Support, Paediatric Cardiac Life Support and observation of universal precautions.

5)    USLME step 1 exemption letter

  • this is usually required for electives in the US and explains that UCL medical students have exemption from taking the USLME step 1 exam as the first 2 years of our undergraduate medical degree programme are equivalent to USLME step 1.

6)    Visiting electives programme

  • some institutions require evidence that UCLMS operates an incoming electives programme as a condition of making an offer to a UCL student

7)     UCL Insurance Policies confirmation letter

  • Some institutions (eg Australia) require a separate letter confirming UCL's public liability insurance and travel and personal insurance cover stating the provider and policy number. This sets out these details.

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Host Institution Application Forms:

Some host institutions require an application form for an elective placement to be completed and which will require the signature of either the Dean or a Designate and the Medical School stamp.  Please complete your part of the form and email it to medsch.elective-approval@ucl.ac.uk or bring it to the Student Office.

 

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Host Institution Agreements

  • Some institutions ask UCLMS to sign and certify application forms or agreements or other certification.  Please submit these as early as possible so that we can advise whether or not we’re able to sign these documents for you and please be aware that sometimes we’re not in a position to sign all that’s asked. 

DBS

  • Many institutions require evidence of DBS clearance and you may be asked to submit your DBS certificate issued on entry to Medical School. If you no longer have your certificate, we can provide a letter certifying your DBS status on admission. 
  • A small number of institutions require a DBS certificate issued within 12 or 24 months of the date of your placements. Please check with your destination whether this is necessary BEFORE requesting a new check and then you will need to follow UCL’s guidance and download an authorisation form.  The authorisation form will need to be signed by the Head of Medical Student Support and taken in person to the DBS signatory in UCL’s Student Centre.  

Occupational Health

  • Some institutions require completion and certification of their own OH form or evidence of OH clearance by UCL and you will need to liaise with UCL Workplace Health for these documents. Please email uclstudentoh@ucl.ac.uk or refer to Workplace Health
  • You may need to have some serological tests done as evidence of immunity.  You can arrange this with UCL Workplace Health who can also arrange Chest X Rays and MRSA swabs.

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UCLMS approved destinations

This list sets out all elective destinations approved by the Medical School to-date for reference and ideas. The list sets out whether each destination is considered to be low (Group A) or medium/high (Group B) in terms of clinical risk and high, medium or low in terms of personal safety risk, which is important when you submit your application for your elective to be approved as it determines health and safety requirements and whether approval can be granted. The list also sets out destinations which have a requirement for a mandatory appointment with the Electives Lead to discuss your plans. New destinations are added to the list as and when approved.

Personal safety risk is assessed against FCO travel warnings: low risk - no FCO warnings; medium risk – some parts of the country are unsafe; high risk – most if not all of the country is covered by an FCO travel caution.  

Students seeking to travel to medium risk and high risk countries are recommended to discuss their choice with the Electives Lead before finalising their decision, students seeking to travel to high risk countries are required to discuss their choice with the Electives Lead. 

If your proposed destination doesn’t yet appear, you will need to submit additional information to enable the Medical School to determine whether the destination is safe and whether plans to take an elective there can be given approval.  The elective approval process will guide you through the additional requirements, which for medium/high risk countries will include a statement from your proposed host institution that standard precautions in healthcare are observed. If your new destination is approved, you will be required to confirm when you take up your placement that the experience is satisfactory and that the placement can be recommended to other students.

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UCLMS’ elective approval process – 4 steps 

The requirements for elective approval depend on the country and institution in which you are organising your elective. Destinations which have been approved by the Medical School are divided into two groups depending on the level of clinical risk as set out in the list of approved destinations above.

  • Group A - Low Clinical Risk
  • Group B - Medium / High Clinical Risk

Please refer to the Approved Destinations Country List to see whether your planned destination appears, to which group it belongs and whether there is a requirement for a mandatory appointment. If your destination does not appear in this list, you will be asked in step 2 of the approval process to provide information about the institution to enable the Electives Lead to assess whether the destination can be approved. 

4 steps guide you through the elective approval process, with information submitted and documents uploaded via Application Form on the MBBS Electives Moodle Course.

The 4 steps must be completed by the given deadlines to allow time for the Medical School to process everyone’s application and for approval to be granted before the first departure date. 

Step 1 (Year 5): Student acknowledgement of elective regulations and initial plans

  • Student acknowledgement of elective regulations and initial plans – this step guides you through the regulatory requirements necessary for your elective to fulfil the programme requirements for your MBBS degrees to be awarded 

Step 2 (Year 5): Student submission of provisional plans

  • Student submission of provisional plans – this step asks you to set out your proposed plans so that we can confirm that your elective will fulfil programme requirements and health and safety requirements. We do not require you to submit any documentation from a host institution at this stage. This step alerts us to your plans, and allows us to discuss with you any approval or planning issues we may foresee.
  • If you subsequently decide to change your plans before the deadline for submitting Step 3, please email medsch.elective-approval@ucl.ac.uk to ask us to re-activate your Step 2 details so that you can enter your new plans for Step 2 approval

Step 3 (Year 6): Medical School approval of placement

  • Medical School approval of placement – this step asks you to confirm your plans and to upload a letter from your host institution confirming that you have been accepted for 6 weeks of clinical placement time.  If your destination is in a medium/high risk country and has not previously been approved by the Medical School, you will also need to upload confirmation that your host institution observes universal precautions. 
  • If, for exceptional reasons, you need to change your destination after the deadline for submitting Step 3, please contact medsch.elective-approval@ucl.ac.uk asap and please note that at this stage you will be required to arrange an elective in the UK unless you can demonstrate that you have an opportunity for a 6 week clinical placement at a previously approved destination which can be put in place very quickly.

Step 4 (Year 6): Medical School approval of elective (Travel Arangements, Risk Assessment and Declaration)

Medical School approval of elective  – this step asks you to confirm your travel dates and to complete a risk assessment to ensure that all regulatory and health and safety requirements are met so that UCL travel insurance can be put in place for you.  This step requires you to confirm compliance with control measures including:

  • Ensuring that you are fully immunised either via your GP, travel clinic or UCL Occupational Health Service
  • Undertaking to check the FCO website for travel advice for your approved destination and changing your plans if a travel advisory is issued
  • Subscribing to FCO travel advice alerts or following FCO Travel on Facebook and Twitter during your elective for travel advice updates

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Elective approval deadlines 

Deadlines for students taking electives in 2020-2021

  • STEP 1     13th December 2019, 5pm
  • STEP 2     31st August 2020, 5pm
  • STEP 3     1st December 2020, 5pm
  • STEP 4     6th January 2021, 5pm

Deadlines for students taking electives in 2021-2022

  • STEP 1     15th December 2020, 5pm
  • STEP 2     31st April 2021, 5pm
  • STEP 3     1st December 2021, 5pm
  • STEP 4     6th January 2022, 5pm

These deadlines are in place to give all students the opportunity to arrange a placement which complies with the MBBS regulations and to allow the electives approval team time to process all submissions and required documents in time for electives to be signed off before departure.

If your elective plan does not comply with the standard elective requirement but you feel you have an exceptional case, we recommend that complete Step 2 as soon as possible, as you may need to amend your plans should your initial proposal not prove suitable and in time to meet the Step 3 deadline.

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Duration of your elective and definition of a clinical placement 

Your elective is taken in an 8 week block after Finals. You must spend a minimum of 6 weeks in placements, usually as a single centre hands-on clinical placement in a single specialty, with 2 weeks allowed for travel to and from your elective destination and for completion and submission of elective coursework, and an elective report form to be signed by your educational supervisor. We may exceptionally approve split or non-hands on clinical elements to your elective, however you may be required to use more of the elective block for placements.

Entirely Hands-On Clinical Placements

The Medical School’s baseline definition of a clinical placement is that: “Under the general supervision of a qualified clinician, students are able to take a history and perform a physical examination, participate in the clinical team meetings and patients’ case discussions/conferences, and have the opportunity to observe specialist procedures”. Where this is unclear from the information you submit, you will need to provide written confirmation from your host institution that the placement fulfils this definition.

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Configuration of your elective

6 to 8 weeks in a single centre is the normal expectation for an elective placement, however split electives as set out below are approved in certain circumstances. It is understood that there will be a period of settling into a placement, and this will be longer for placements overseas than in the UK.  You may also choose to split your elective into 2 specialties, providing that the period of time spent in each is sufficient to gain meaningful experience.

The split elective configurations have been designed so that they can all reasonably be considered equivalent to a single centre 6 week placement. You may use the full 8 weeks of your elective block for placements, but the following configurations are the minimum.

6 weeks at a single host institution and associated hospitals in a Group A or B country, normally in a single specialty or with 2 specialties divided 3+3 or 4+2

or

4 + 2 or 3 + 3 weeks at different institutions in the same Group A or B country (i.e. same healthcare environment), or in a Group A or B country and the UK (i.e. a familiar healthcare environment) where the primary institution does not offer a full 6 week placement.  The 2 parts of the elective may be in different specialties.

4 + 3 weeks at different institutions in different countries (Group A or B) where the primary institution does not offer a full 6 week placement.  The 2 parts of the elective may be in different specialties.

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Observational, non-hands-on clinical and research placements

Please note that these possibilities are withdrawn for 2020/21 because of the disruption to placements caused by coronavirus

Any student considering an elective of this nature must make an appointment to discuss their plans with the Academic Lead for Electives, Dr Declan Chard, by emailing medsch.student-support@ucl.ac.uk before submitting Step 2 of their elective approval process as these electives require exceptional approval.

These types of placements will only be considered where the placement is clearly relevant to clinical medical or surgical practice. Examples that will be considered are clinical observerships, placements in non-hands-on medical specialities such as Forensic Medicine, Public Health, Radiology and Histopathology, clinically relevant research, and medical leadership and management.

Mindful of the goals of your MBBS studies, which are to help you become a “highly competent and scientifically literate clinician”, placements with commercial organisations whose primary goal is not the provision of clinically indicated care, such as financial institutions or management consultants, will not be considered.
 
You will be required to use the full 8 weeks of your elective block, in the following configurations:
 
4 week observational, non-hands-on clinical, or research placement, in a Group A or B country + 4 weeks of a hands on clinical placement in the same Group A or B country.

or

6 week observational, non hands on clinical, or research placement, in a Group A or B country + 2 weeks of a hands on clinical placement (either in the same group A or B country, or in the UK) + 2 weeks of an additional hands on clinical experience normally credited during the preceding year or by the end of year 6 term 1 at the very latest.

This additional hands on clinical credit must be approved in advance by the Electives Lead, taken with the permission of your named educational supervisor responsible for each MBBS placement during which you wish to take additional clinical experience and who accepts responsibility for supervising the additional experience, recorded and signed off in your ePortfolio, and you must have accrued the necessary amount by the time you submit stage 3 of your elective approval application.

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Other types of placement

Please note that these possibilities are withdrawn for 2020/21 because of the disruption to placements caused by coronavirus

In instances where an individual student has very specific reasons for wishing to include some non-clinical experience in their elective which fits in with well-established career intentions, including health care management or leadership in a health care setting (e.g World Health Organisation, Large NHS Trust or Clinical Commissioning Group, but excluding commercial organisations whose primary work is not the delivery of healthcare), or where a student has identified a research placement that will provide an exceptional and unique experience and fits in with well-established career intentions, as demonstrated during their previous MBBS studies, the student must make an appointment to discuss their plans with the Electives Lead to ascertain whether the School can justify making an exception.

For an exception to be granted, the student must have an excellent academic and clinical record throughout the course; must have completed all preceding clinical placements at institutions which are quality assured by UCLMS (so excluding SSCs abroad); must have undertaken clinical SSCs (so excluding PALS).

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Language requirements

If you are planning to arrange your elective in a country where the main language of medical communication is not English, you will need to investigate with your elective supervisor the level of language needed for you to be able to participate fully in a clinical placement.

For your elective to be approved, you will need to declare that both you and your host supervisor are satisfied that your language skills are sufficient. 

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Evidence of satisfactory completion of course requirements

You will need to provide evidence of satisfactory completion of your approved elective, as set out in your declaration for final approval, by the deadlines given by in order for the Final Exam Board to be able to confirm your degree award. You will need to have submitted your:

Elective Clinical Attachment Report form, graded and signed by your named Elective Supervisor and Post Elective Report

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Departure dates

Students in Elective Block 1 should not plan their departure until after 5pm on Friday of the week that finals results are released.  This is because they will be required to attend to attend a compulsory Student Support Appointment if  they fail. 

If you fail to attend your meeting you will be issued a Concerns over Professional Behaviour(s) form (CoPB) which will be reported to the Final Examination Board in June. Students with two or more CoPBs will be in Group 2 for discussion at the Board.

Students in Elective Block 2 should not plan to depart until after they have completed and been signed off from Prep For Practice.

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Penalties for breaching undertakings in your elective approval submissions   

For the MBBS degrees to be confirmed, students must fulfil the elective requirements as set out and as declared in their application for final elective approval submissions.

Any student who is found to have breached the elective requirements or undertakings given in the approval process or to have made false declarations about their elective will be issued a Concerns over Professional Behaviour(s)   form which will be reported to the Final Examination Board in June, and may be investigated under the Medical School’s Fitness to Practice procedures and reported to the GMC.

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Students re-sitting finals in June 

Students who fail Finals in March will be advised to shorten their elective placement and to follow an adjusted post-finals programme of study comprising a 4 week elective, a 4 week Prep for Practice SSC, and a 4 week Preparation for Examinations placement designed by MBBS academic leads and hosted at an associated Trust. 

Details and arrangements will be provided nearer them time by the Year 6 team, but you should let the elective approval team know of any changes to the dates or location of your elective.

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Travel

Your elective block is 8 weeks long, of which 2 weeks are allocated for travel to and from your elective destination, and 6 weeks for the placement itself. You should not plan your outbound or return journey outside of your elective block, and you will be required to sign a register on the last and first days of your preceding and ensuing blocks.

Depending on your destination, the 2 weeks allocated for travelling time may be taken prior to the start of your 6 week placement, at the end of your 6 week placement, divided between the start and finish of your 6 week placement, or to travel between placements where a split elective has been approved, providing that your travel arrangements allow you to complete your preceding UCLMS placement before travelling, to take up your elective placement and complete a full 6 weeks and to arrive back in the UK in time to take up your next UCLMS placement on the 1st Monday.

If it is logistically very difficult for you to travel to or from your elective placement in time, or where you have another good reason for travelling slightly before or after the elective block (for example prohibitive travels costs), then you may be allowed to do so but only if you request and receive authorised absence approval for this.

If you travel outside your elective block without approval, then this will raise a concern over your professional behaviour.

It is also important that we are fully and accurately informed about your travel plans so that we may contact you if necessary should an emergency situation arise. Please note that UCL’s travel insurance only covers you for your approved elective, and not unauthorised early or late travel.

Finally, please be aware when planning your return journey that the MBBS Graduation Ceremony is usually held in the first or second week of July. The date for the ceremony is determined by UCL in February each year, which means that block 2 students will need to book their return flights before the date of the ceremony has been set.  This is outside the control of the Medical School and we’re not able to provide the date until UCL releases it. 

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Travel health and occupational health requirements

Travel 

Your personal travel health requirements will depend on your destination and you must ensure that you are fully immunised via your GP, a travel clinic or UCL Workplace Health and meet any costs yourself.  You will be asked to confirm that you have taken travel health advice and list the immunisations taken for your approved destination in Stage 4 of the elective approval process. 

Providers

UCL Workplace Health undertake to provide services and immunisations at a non-profit price, however you may approach any provider of your choice. (The Medical School does not hold information about providers or costs).  Please be aware that UCL Workplace Health charge a cancellation fee for failure to attend an appointment unless notice is given on a working day at minimum 24 hours’ before the scheduled appointment time and failure to pay charges by their deadline is reported to the Medical School. 

PPE and PEP

All students taking electives in Group B countries are required to take their own PPE and a starter pack of PEP.  For PEP, UCL Workplace Health advise that OH guidelines require a 1 hour consultation with a full travel risk assessment, explanation of PEP and what do to in the event of exposure.  

OH record

Some host institutions require visiting elective students to submit a copy of their OH record and you will need to obtain this from UCL Workplace Health. Please contact uclstudentoh@ucl.ac.uk.
 

 

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Insurance

UCL Public Liability Insurance:

  • UCL’s insurance provides public liability cover for fully registered medical students during supervised clinical electives which have been approved by the Medical School, within and outside the UK

Host Institution Insurance - Clinical Negligence

Host institution clinical negligence insurance provides cover, at many elective destinations, for clinicians who act as supervisors for visiting elective students, but this is not always the case and students should check with their individual host institution and take out personal clinical/medical malpractice insurance where supervision of elective students is not covered by the institution.

Personal Insurance - Professional Indemnity Insurance/Medical Malpractice/Medical Negligence:

  • Is strongly recommended for all students for all destinations outside the UK
  • Is available free of charge for student members through the MDU and the MPS, but through policies which are essentially advisory and which rely on electives being properly supervised and so are of use only to students whose elective supervisor is covered by the institution’s clinical negligence insurance
  • Is a requirement where the host institution’s clinical negligence insurance does not extend to visiting elective supervision or is stated as a condition of the elective, in which case students need to purchase personal medical negligence insurance appropriate for their chosen destination.  Students visiting the US should take advice from their host institution.  Students visiting countries other than the UK or US may find suitable cover via the International Helpers Trust

Access to the Online Enrolment Form is via the following login:  

  • Click on the "Participate" button
  • Click on the “Enrol” button Username: medmissions
  • Password:  mpl and click "Next"

Personal Insurance - Travel and Health Insurance

  • Is required for all destinations outside the UK
  • Is provided through UCL’s insurers and paid for by UCL
  • Applies to approved electives and during the elective approval process if you have a valid claim (e.g.your host institution cancels your elective after you’ve booked flights or an FCO travel advisory is issued and you cannot get a refund from the airline 
  • Is valid for ‘UCL business only’, which means travel to and from your approved elective destination plus travel within the same country during your elective period. Travel to other countries or outside your elective block is not covered and you must arrange your own travel and health insurance.
  • Includes a 24 hour helpline which is your first point of contact in the event of a medical emergency

Please check the UCL Study Abroad Insurance website for full details. 

Information about how to apply for your insurance certificate will be sent with your stage 4 elective approval. You should download a copy of your certificate and take it with you when you travel. The certificate includes guidance for accessing help access help in case of an emergency.

Waivers

Students must not sign any statements or waivers by which UCL may become liable for damage to property, personal injury or death caused during a placement. Similarly, the Medical School cannot sign any statements or waivers as UCL insurance operates only to the 'extent' that UCL are legally liable and not 'every' potential claim will be covered by the policy wording.

If an institution asks for a waiver form to be signed, the Medical School’s advice is that you  contact the elective coordinator at your proposed host institution to explain this and ask if there are other ways in which UCL students can demonstrate that they fulfil the insurance requirements. 

Please explain that you will have in place the insurances below for which you will be able to present confirmation and copies of the following policies if needed: 

  • UCL Public Liability Insurance - This includes cover for approved elective periods outside the UK
  • UCL Personal Travel and Health Insurance
  • Professional Indemnity Insurance/Medical Malpractice Insurance (from whichever provider you choose)

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UCL Travel and Health Insurance

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Staying Safe

The elective period takes students to many different parts of the world.  In some of these you will be exposed to a variety of potential hazards and risks ranging from accidents or violence to a range of infectious diseases. There will always be an inherent tension between your own desires to explore locations more exotic than London and our and your parents’ concerns for your safety. You should take account of this and behave responsibly, know the risks to which you are likely to be exposed and guard against these hazards by taking time to prepare yourselves for your electives. 

Step 4 of the elective approval process takes you through a risk assessment which asks you either to confirm that you have complied or to give undertakings that you will comply with a series of control measures for clinical risk and personal safety.   

These control measures include an undertaking to familiarise yourself with information provided by UCL Student Support and Wellbeing and UCL Safety Services, with country-specific information published by the Foreign and Commonwealth Office (FCO) at the links below, and with our own tips drawn from experience with student electives: 

UCLMS – HEALTH TIPS

Accidents 

  • The commonest health hazards encountered are accidents. Road traffic accidents and water-related recreational activities account for most of these. 
  • Check swimming areas for hazards especially before diving. 10% of spinal  injuries result from diving into shallow water 
  • Remember that “recreational water” may be contaminated. 
  • Avoid alcohol and food before swimming
  • Avoid using motor cycles and travelling by any means of transport at night.
  • Remember that accidents are the commonest reason for requiring blood transfusion. 

Sun exposure

  • Protect yourselves against the effects of the sun by wearing a hat, sunglasses and light protective clothing
  • Use an appropriate sunblock (protective factor greater than 20) and reapply this after swimming
  • Avoid direct sunlight between 11.a.m. and 3 p.m. “Mad dogs and Englishmen go out in the mid-day sun”.

Travellers’ Diarrhoea

This is an extremely common hazard but is usually not life threatening. The following measures may help you to avoid travellers’ diarrhoea.

  • Eat freshly and thoroughly cooked food which should be piping hot. 
  • Avoid cold foods especially salads and shellfish.
  • Choose fresh fruit and vegetables which can be peeled and/or sliced open by yourselves.
  • Drinking water should ideally be canned or bottled with the seal intact. Fizzy water is preferable as it is less easily tampered with. 
  • Don’t put ice cubes in your drinks.
  • If in doubt about the purity of water STERILISE it. Take water purifying tablets with you. Those containing iodine are more effective than those containing chlorine.
  • Dishes and cutlery should be washed in purified water.
  • Wash hands before eating or preparing food and after going to the lavatory. 
  • Clean your teeth with sterilised water. 
  • Travellers’ diarrhoea kits are available.

UCLMS - PERSONAL SAFETY AND SECURITY TIPS

  • Only carry cash needed for the day’s activities .
  • Be discreet with valuables eg jewellery, cameras, credit cards, passports etc.
  • Take care when travelling alone and using local transport. 
  • Only use licensed transport.
  • Make sure you are aware of the location of fire exits and how to get out in the event of a fire.
  • Be alert and sensitive to local customs and discuss with your elective supervisor or elective contact whether there are specific issues you need to be aware of 
  • Carry UCL’s travel insurance certificate with you and keep the emergency numbers to hand (ideally put them into your mobile phone).
  • Check the emergency numbers for your Embassy /Consulate or equivalent and keep to hand (again, ideally put them into your mobile phone).
  • Check Embassy/Consulate websites for local travel advice.
  • Follow FCO guidance at all times.

UCLMS - OTHER USEFUL TIPS

  • Remember that alcohol and drugs affect your judgement.
  • Try to avoid situations where you may need medical or dental treatment.
  • Avoid ear piercing, tattoos or acupuncture.
  • Avoid blood transfusion or infusion of blood products unless essential.
  • Know your blood group in advance of going. 
  • Obtain sterile medical equipment packs if appropriate.
  • Take with you a small first aid kit containing antiseptic cream, dressings and plasters, anti-fungal powder, antihistamines, antibiotics, painkillers, anti-diarrhoeal agents, insect repellents and  scissors.
  • See that any dental treatment is completed before you leave. 
  • Spectacle or contact lens wearers should take spares. 
  • If you need to take any prescribed or over the counter medications regularly, take enough with you to cover your whole trip plus an extra 1-2 week’s supply in case of delays, and take a copy of your prescription with you.

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Emergencies and incidents

For emergencies and incidents of any kind, your first point of contact is UCL’s travel insurance provider on their 24 hour emergency hotline +44 (0) 208 608 4100 as set out on your travel insurance certificate.  The insurance company is best placed to give advice on actions needed locally to manage incidents, as well as to give advice about potential insurance claims.  Please also let the Medical School know by emailing medsch.student-support@ucl.ac.uk including the words “Elective Emergency” in the subject line and copying the email to medsch.elective-approval@ucl.ac.uk.

Emergency telephone contact with the Medical School may be made during working hours on +44 (0) 207 679 0859 and out-of-hours via UCL Security on +44 (0) 20 7679 2108. 

Full advice from UCL about actions to take in the event of an emergency or incident whilst studying abroad

For non-emergency concerns or general advice about your placement, please contact the Medical School by emailing medsch.elective-approval@ucl.ac.uk.

Occasionally students find it difficult to adjust to medical practice in different environments and conditions or face traumatic clinical experiences during their elective.  In such instances, students are encouraged to contact the Medical School’s Electives Lead, Dr Declan Chard in confidence for support and advice.  Please email d.chard@ucl.ac.uk in the first instance and please book an appointment on your return via medsch.elective-approval@ucl.ac.uk if you think it would be helpful to discuss any such incidents in person.  

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Additional information for students planning electives in the UK
 

If you have decided to organise your elective in the UK, the application processes are determined by each individual medical school/hospital/institution and you will need to check individual websites for information about how to apply. 
 
If you would like to arrange an elective at UCLH, the Royal Free NHS Foundation Trust or Whittington Hospital, you should write directly to the lead consultant asking if you can take an elective with them.

There is no formal application process for UCL medical students and you simply need to ask them to confirm their offer in writing, either on headed paper or by email from their NHS email address, showing the consultant’s name and the specialty and dates of the placement.

Please then upload this evidence in Step 3 of your elective approval application. There is no need to apply through UCL’s Visiting Elective Programme which is designed for external applicants only and no fees are charged.
 
Some of our associated hospital have their own separate, formal application process and you should check websites for information about how and when to apply and to find out the costs of application and placements, which you will need to pay yourself.

Associated hospitals currently known to run formal application processes and to charge fees to UCL medical students are: Great Ormond Street Hospital, NHNN and The North Middlesex Hospital. 
 
Formal application processes usually require forms to be signed or documents to be provided by the Medical School. Please email medsch.elective-approval@ucl.ac.uk giving your full name and student number and details of the documents you require and please allow at least 2 weeks for the team to prepare them for you.  
 
Some Trusts require medical students to have an honorary contract in place before taking up an elective placement and these are arranged locally by Trust Workforce teams.
 
Most application processes require students to provide confirmation of criminal record status and occupational health clearance.  Details of how to obtain these are given in the DBS and Occupational Health sections on this website. Along with most hospitals in the UK, the Royal Free, Whittington and UCLH ask for confirmation of occupational health status even though UCL students have already been cleared for placements at these Trusts.
 
UCL medical students do not need to take out professional liability / medical malpractice insurance for electives in the UK unless their host institution specifically asks for this, in which case students are advised to contact the MDU or MPS.

Students are covered by UCL public liability insurance as the elective is a required part of the MBBS programme. Clinicians in NHS hospitals are normally covered by Trust insurance and indemnity policies for supervising medical students, however students taking electives at hospitals other than RF, Whittington and UCLH are advised to check that this applies to visiting elective students.

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Additional information for students planning electives in North America

 
Students considering electives in North America are advised to come in to see the Lead for Electives early in their planning to discuss options as electives rarely match our standard elective requirements, are highly competitive and confirmation of placements is often issued after our deadlines for elective approval.  
 
Electives in North America need careful planning and you are advised to research online the application process and timetable for your chosen institutions early on in Year 5, although the applications will not be submitted in most cases until early in Year 6.
 
Some institutions only offer 4 week placements, in which case students should refer to the elective approval website for guidance about how to fulfil the MBBS regulatory and policy requirements.
 
Many North American hospitals/institutions follow their own timetables for confirming elective placements and you may not hear until shortly before your planned departure date.  For example, Harvard will only confirm placements 4 weeks in advance.   
 
Please be aware that an offer of an ‘Observership’ does not fulfil the MBBS requirement of a clinical placement.
 
Please be aware that there are institutions which will not offer placements unless there is a reciprocal arrangement with UCL Medical School. Unfortunately the Medical School is not able to enter into any affiliations / reciprocal arrangements and is unable to institute formal exchange programmes.
 
Also, some institutions do not accept exemption from the USMLE Step 1 exams. 
 
However, there are a great number of institutions which are happy to host UCL medical students.

Elective applications

Canada

Applications to all Canadian institutions are now processed through a central portal - AFMC Student Portal.  A fee is charged. 

USA

You will find this website helpful in researching US applications (though please check each institution’s official website for up-to-date requirements and fees):

Students may apply to more than one institution but should accept only one offer of a placement.  It is also important that when you receive the first offer of a placement that you either accept or decline this as soon as possible.  Declining an elective placement at short notice is considered highly unprofessional and inappropriate and, importantly, it disadvantages future UCL students who may apply to that institution.
 
For institutions in North America which are known to offer only 4 week electives, students may arrange a second 4 week elective in the same city or area. If a second 4 weeks cannot be arranged or an offer is withdrawn whilst on elective, students must return to the UK to complete their remaining 2 week requirement within the elective time period. 

Documents required to be provided with the application 

All applications require a great deal of documentation and application forms that require to be signed off by the Medical School. Please email medsch.elective-approval@ucl.ac.uk giving details of the documents you require and allow at least 2 weeks before you need to send the documents.  Please give full name and student number. 
 
The Student Support Office can provide:–

  • A Letter of Good Standing/Recommendation (which includes confirmation of student status)
  • An academic transcript
  • An academic reference
  • USMLE Step 1 exemption letter (confirms equivalent training)
  • A letter confirming English language proficiency
  • A letter confirming personal protective equipment training
  • A letter to support your visa application (confirmation of student status/elective placement)
  • A letter confirming that UCL Medical School is recognised by IMED (International Medical Education Directory)

Clinical Performance 

If you have been asked for a letter of recommendation describing your clinical performance, you should contact a consultant who has supervised you on an attachment

Criminal Record Status and Immunisation / Occupational Health Verification

You will be required to provide confirmation of criminal record status, immunisations and occupational health clearance.  Please see the information provided in the DBS section and Occupational Health section of this website.

Professional indemnity insurance / medical malpractice insurance 

This is available free of charge for student members through the MDU and the MPS, but through policies which are essentially advisory and which rely on electives being properly supervised and so are of use only to students whose elective supervisor is covered by the institution’s clinical negligence insurance. 
 
Where the host institution’s clinical negligence insurance does not extend to visiting elective supervision or is stated as a condition of the elective, students need to purchase personal medical negligence insurance appropriate for their chosen destination.
 
You can purchase personal medical negligence insurance as a visiting foreign medical student for USA institutions from:

“Academic Medical can provide visiting foreign medical students with medical professional liability insurance coverage for the specific period of time coverage is required. The quotation for cost of this coverage will be determined after a completed application is submitted. Once the quotation is accepted, proof of coverage can be issued.”
 
Students visiting Canada should take advice from their host institution.  

Visa queries

The Medical School is not give visa advice and we recommend that you contact the host institution and visit the US Embassy Visa Application website 

Health check for Canadian elective

Recently it has become the case that students organising a medical elective in Canada have been asked as part of the visa application process to complete a medical examination at a medical practice in London approved by the Canadian High Commission.  The cost of the examination is high and, unfortunately, neither the Royal Free Hospital nor UCLH are on this list of approved clinics.

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Additional information for students planning electives in Australia and New Zealand

Electives in Australia and New Zealand are popular and applications for elective placements are highly competitive. If you are planning your elective in Australia, you are advised to research the application process for each institution well in advance.  Many Australian institutions book up at least 12 to 18 months ahead and you will need to submit your applications to your chosen institutions at the beginning of Year 5.
 
Please be aware that organising an elective in Australia and New Zealand will incur substantial costs – including the elective fee, accommodation, insurance, health check for the visa application (Australia) and travel.
 
Students may apply to more than one institution but should accept only one offer of a placement.  It is also important that when you receive the first offer of a placement that you either accept or decline this as soon as possible.  Declining an elective placement at short notice is considered highly unprofessional and inappropriate and, importantly, it disadvantages future UCL students who may apply to that institution.

Elective applications

All applications require a great deal of documentation and application forms signed off by the Medical School. Please email medsch.elective-approval@ucl.ac.uk giving your name, student number and details of the documents you require and please allow at least 2 weeks for the team to prepare the documents for you.
 
Documents usually required are:   

  • Letter of Good Standing/Recommendation including confirmation of student status
  • Academic transcript
  • Academic reference
  • Letter confirming English language proficiency
  • Letter confirming training in universal precautions and use of personal protective equipment
  • Letter confirming criminal record status on admission and often within a specified period of time before the start of the elective
  • Letter confirming UCL’s public liability insurance
  • Letter to support your visa application (confirmation of student status/elective placement)

Clinical Performance

If you have been asked for a letter of recommendation describing your clinical performance, you should contact a consultant who has supervised you on an attachment.

Criminal Record Status

You will be asked to provide your DBS certificate as confirmation of your criminal record status. If you have not kept your certificate, the electives approval team can provide a letter certifying your criminal record status on admission if you request this by email.
 
Many Australian institutions require a DBS check completed within 12 or 24 months of the start of your placement.  Please check this requirement with your host institution before requesting a new check and please follow the instructions in the DBS section of this website for obtaining a new check.

Immunisation / Occupational Health Verification

Australian institutions generally require confirmation of immunisations and occupational health clearance and many ask for chest x-rays and MRSA swabs, which can be arranged through UCL Workplace Health. Please see the OH section of this website for information about how to obtain copies of your record or arrange x-rays/MRSA swabs. 

Professional indemnity insurance / medical malpractice insurance

All Australian elective placements require you to purchase ‘student medical malpractice insurance’ through one of the following companies: 

  • Medical Indemnity Protection Society (MIPS - visit the website and insurance cover can be arranged online- free of charge)           
  • MDA National                                           
  • MIGA                                                              

For New Zealand elective placements, you can arrange this through the MDU and the MPS (free of charge for student members).  Their policies are essentially advisory and rely on electives being properly supervised and so are of use only to students whose elective supervisor is covered by the institution’s clinical negligence insurance. 

Visa queries

The Medical School is not permitted to provide visa advice and we recommend that you contact your host institution and check the  official websites of the Australian High Commission and the New Zealand High Commission.

Australia - as part of the visa application process you may be required to complete a medical examination at a medical practice in London approved by the Australian High Commission.  The cost of the examination is high and, unfortunately, neither the Royal Free Hospital nor UCLH are on this list of approved clinics.

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