Your Final Year Elective

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

Your MBBS studies are designed to equip you with the skills and experience necessary to become a practising clinician. The aim of the elective is to deepen knowledge of subjects relevant to the MBBS curriculum, that are of particular interest to you and may not have been covered in detail, in different clinical and cultural environments.

Your elective must be with an organisation whose primary goal is healthcare, in a specialty or area that requires an MBBS (or equivalent) qualification, and under the general supervision of someone medically (MBBS or equivalent) qualified in a senior (non-training grade) position.

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. We strongly encourage you to consider how your elective will provide further experience relevant to you becoming a practising 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.  You will be invited to submit your elective block preference and students will have the opportunity to arrange swaps amongst themselves once allocations are released.

Elective approval – why and what 

Satisfactory completion of a minimum 6-week on-site elective placement, approved in advance by the Medical School and signed off by a named clinical supervisor prior to the Medical School’s June Board of Examiners is a programme requirement for the award of a UCL MBBS degree. The approval process is designed to assess the health and safety aspects of elective placements as required by UCL, and to ensure that the proposed placement can reasonably be expected to offer an experience that fulfils the MBBS programme requirements.

The process has been designed to be pragmatic, enabling most students to pursue an elective of their choice overseas. Given that the Medical School cannot inspect each placement directly, we rely on students filling in the approval forms 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 Stages to mitigate this, for example take post exposure prophylaxis with them. We also take account of the UK Government’s Foreign, Commonwealth and Development Office (FCDO) travel guidance and do not approve elective placements in locations where the FCDO cautions against travel.

With regard to the experience a placement offers, we require the host institution to state that they will provide an on-site supervised elective placement that fulfils our MBBS programme requirements.  Where UCL medical students have not previously been to a particular placement, we ask the student to provide additional evidence that it is a locally recognised healthcare institution. 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 approval process, we recognise that plans may not work out as expected. During the placement, students are specifically advised to contact the travel insurance provider (for emergencies or incidents) and 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 the Medical School if they have concerns during their placement.

Summary of Elective Approval Process PDF:

Elective Bursaries to help with elective costs 

The Medical School is fortunate to be benefit from gifts and bequests from graduates, staff, patients and other benefactors who have donated funds to support medical student electives.  

A list of benefactors and the bursaries offered through their generosity can be found below.

Elective bursaries PDF:

Applications for these bursaries are invited from students who have demonstrated financial need through previous successful application to Access to Learning funds, Medical School Hardship Funds or Bursaries.  The application process opens at the beginning of September of Year 6 and is managed through the UCLMS Electives bursaries Moodle site (select the Elective bursaries tab). Awards are determined by our Scholarships and Bursaries Committee after the deadline for submission of elective documentation for approval (Stage 3). Please not that bursaries will only be awarded to students who have completed their Stage 3 elective approval form.

Elective bursaries are classified as ‘general’ or ‘subject specific’ according to the benefactor’s wishes. Payments are made to successful applicants from the fund which aligns most closely with elective plans set out in the bursary application form. Please be sure, therefore, to give a detailed description of your elective to help us to identify funds for you.

UCL supports students with applications to the Turing Scheme when government public funding is made available. UCL’s publishes details at Turing Scheme at UCL. Notes for medical students can be found at Turing Scheme for Medical Electives on our A-Z Policy page. Students from the devolved nations and international students are eligible for nomination. Please note that students funded by the NHS (England) Bursary Scheme are not nominated because elective expenses can be claimed under the NHS Bursary Scheme and financial rules for public funding preclude claiming the same expenses from two sources.

External Bursaries

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

Elective Placement Reimbursement - NHS Bursaries

The main source of help with elective costs is the NHS Bursary Practice Placement Reimbursement Scheme, which currently is open to all UK students who have claimed an NHS Bursary and provides a contribution towards accommodation (up to a daily maximum) and other expenses (excluding travel except for students who stay in their parental home). Please note that there are some differences between what the English and Wales NHSBSA will reimburse whilst on electives. Please refer to the guidance on the NHS Bursary website for details and contact the NHS Bursaries Office if you have queries about your eligibility or how much you can claim. 

Claims are submitted via the Medical School on return from the elective as receipts are required as evidence of costs and payments made. Any joint receipts for shared accommodation must include the names of all people sharing. Please note that approving and processing claims is time-consuming at an already very busy time of year and the team will work through in date order.
 

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, as this can disadvantage students who cannot afford the additional fees charged by companies. In any event, any elective arranged through a commercial company must fulfil all the Medical School's academic and health and safety requirements, and confirmation of the placement must come from the host institution not the company.

Students can apply to more than one institution but should only accept 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 "plan B" elective should not be arranged, except where this is specifically designed to reduce the risk that you will not have a placement if overseas plans are disrupted. If arranging such a contingency placement, this must be in the UK and you must tell your potential host from the outset that they would be your reserve placement.

Declining an elective placement at short notice, without them being aware of your other plans from the outset, is considered highly unprofessional and inappropriate and, importantly, it disadvantages future UCL students who may apply to that institution. It may also lead to you receiving a CoPB.

Here is some information related to some destinations: 

• Additional information for students planning electives in the UK
• Additional information for students planning electives in North America
• Additional information for students planning electives in the Australia and New Zealand

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. 

Verification of Student Status/Letter of Recommendation and Reference issued automatically during the approval process

Two documents which all elective destinations will require will be sent to you automatically when we approve Stage 1 and Stage 2 of your elective approval application. The content of these letters is set out below and covers all the details routinely requested by host institutions. Please keep these two documents safely so that you can use them as and when needed, particularly the first which can be used for multiple different destinations as you approach different institutions to secure an elective. 

• Approval of Stage 1 generates a Verification of student status/letter of recommendation which confirms your status as a UCL medical student and confirms that the elective is a required part of your UG medicine programme of study. This letter is ‘open’ in having no specific elective destination details, which means the same letter can be used in your initial communications with as many destinations as you wish to approach. 
• Approval of Stage 2 generates a similar letter of recommendation/reference, but this time addressed to the destination you have named in Stage 2. Many destinations will ask for a specific letter/reference with your details addressed specifically to them before making an offer, in addition to the "open" letter of introduction issued at Stage 1 approval.

Should you need additional documentation, please request other documents from medsch.elective-approval@ucl.ac.uk or follow our guidance relating to DBS and OH clearances.

A list of commonly requested documents is below. Please 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 at least a 2-week turnaround time for your documents to be produced, and keep in mind that there may be times when the administration team cannot achieve this due to their other duties, for example around elective approvals deadlines.

Please note that the electives administration team can only supply you with two sets of bespoke paperwork for applications. You are welcome to make more applications if you can reuse this bespoke paperwork, or use the documentation that has been issued to you automatically.

These letters are accepted by most institutions as the Medical School reference and include: 

• Confirmation that you are 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 

Additional documentation required by some institutions

1)   Academic reference/Dean’s letter

• The majority of institutions accept the verification of student status letter issued as part of our approval process as the academic reference they require from Medical Schools or Medical School Deans/Directors. However if your institution indicates to you that they require a further academic reference, you should request this from medsch.elective-approval@ucl.ac.uk. These references are typically signed by the Lead for Electives or the Divisional Tutor and you should not approach the Director of the Medical School. If the reference letter needs to be submitted via a web portal, if possible, please give as the contact address for the request medsch.elective-approval@ucl.ac.uk. If a named individual is required, please give Dr Declan Chard as the Lead for Electives at medsch.elective-approval@ucl.ac.uk.
• If you are asked to provide a ‘reference’ certifying your clinical skills and experience, our standard letter (below) certifying your Basic Life Support and universal precautions training is almost always sufficient. However, if your institution indicates to you that they require a personal reference about your clinical performance, you should contact a consultant who has supervised you on an attachment. As a courtesy, please let whoever you are citing as a referee that you have done so, and if in doubt ask them in advance.

2)    Academic transcript

• You can generate an interim transcript yourself from Portico.
• If your institution asks for a certified academic transcript, please request this from the team and we will provide a formal transcript with the Medical School stamp on each page.

3)    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.

4)    USLME Stage 1 exemption letter

• This is usually required for electives in the US and explains that UCL medical students may be exempted from taking the USMLE Stage 1 exam as the first 2 years of our undergraduate medical degree programme are equivalent to USMLE Stage 1. Please note that acceptance of this is at the discretion of the host institution, and some will not accept an exemption letter and will require you to have taken USMLE Stage 1.

5)    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. They can be directed to our incoming electives webpage for details of this.

6)     UCL Insurance Policies confirmation letter

• Some institutions (eg many in Australia) require a separate letter confirming UCL's public liability insurance and travel and personal insurance cover stating the provider and policy number. The required letter and a copy of UCL’s insurance policy can be downloaded below. If your elective destination needs a personalised version, you can request this via the elective approval email address. 

Documents

UCL Insurance Policies Confirmation Letter:

Insurance Policy:

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.

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 are able to sign them. Please be aware that UCLMS is not able to enter into legally binding agreements for elective placements or undertake anything beyond the routine monitoring and assessment of your performance, and so sometimes we are not in a position to sign all that is 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 6, 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 read UCL’s guidance.  Once you have read the guidance, please email the Head of Medical Student Support to request that an authorisation form is completed. 

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
• The UCL Workplace Health team have finite capacity, and so please contact them as early as you can. At busy times they may not have capacity to help you as quickly as you would like, and for UCLMS electives they will be increasingly busy as the Stage 3 deadline (when you submit your paperwork to UCLMS for approval) approaches, and towards the start of the elective blocks.

UCLMS approved destinations

Destinations which have previously hosted UCL medical students and have been assessed and approved on the basis of documentation submitted in previous years are listed here:

• Approved Destinations List:

• Map of Approved Destinations

If your planned destination does not appear in the Approved Destinations List, you will be asked in Stage 2 of the approval process to provide information necessary for the Electives Lead to assess whether the destination can be approved. You are advised to make an appointment to discuss your plans with the Electives Lead before submitting Stage 2.

As part of the approval process, destinations are assessed for perceived clinical risk and personal health and safety risk. Higher risk destinations have specific requirements which are set out in the Approved Destinations List; these may include a mandatory appointment with the Electives Lead to discuss your plans.  Please check the Approved Destinations List carefully to be sure that you comply with the additional requirements set out for your chosen destination.

Appointments with the Electives Lead can be made via this link.

Clinical risk is categorised into two groups:

• Group A – low clinical risk
• Group B – medium/high clinical risk.

Personal health and safety risk is categorised low, medium or high. These levels are assessed against FCDO travel warnings:

• low risk - no FCDO warnings
• medium risk – some parts of the country are unsafe
• high risk – most if not all of the country is covered by an FCDO travel caution

Please note that your elective plans will not be approved, or approval will be revoked, if your host institution is in a location where the FCDO caution against travel. This applies even if you are an overseas student planning an elective in your home country, as you undertake your elective in your capacity as a UCL medical student and UCL is expected to take reasonable steps to minimise risks to you during your studies.

Students seeking to travel to a medium-risk country are advised to discuss their choice with the Electives Lead before finalising their decision. All students seeking to travel to high-risk countries are required to discuss their choice with the Electives Lead. An appointment can be booked with the Electives Lead via this link.

If your proposed destination is not listed in the Approved Destinations list,

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 include a verifiable way to confirm that your placement will be with a recognised healthcare institution (e.g. their website, or a government website, in English), and for medium and high-risk countries, or countries with any Group B clinical risk institutions, 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 in the first week after you take up your placement that the experience is satisfactory, and that the placement can be recommended to other students. 

UCLMS’ elective approval process – 4 stages

The requirements for elective approval depend on the country and institution in which you are organising your elective. Four stages guide you through the elective approval process, with information submitted and documents uploaded via Application Form on the MBBS Electives Moodle Course. The four stages 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. 

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

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

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

• Student submission of provisional plans – this Stage 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 Stage 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 Stage 3, please email medsch.elective-approval@ucl.ac.uk to ask us to re-activate your Stage 2 details so that you can enter your new plans for Stage 2 approval

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

• Medical School approval of placement – this Stage 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 on-site placement time.  If your destination is in a medium/high risk country, or country with Group B institutions, 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 Stage 3, please contact medsch.elective-approval@ucl.ac.uk as soon as you can. Please note that at after the Stage 3 deadline you will be required to arrange an elective in the UK. The electives team may exceptionally allow you to try to arrange a 6-week clinical placement at a previously approved overseas destination, if this can be put in place quickly, but please keep in mind that in all cases, students granted such leeway must have a UK-based placement arranged by the end of January if their overseas plans have not been approved by then. However, you may still be allowed to swap for an overseas placement after this, where exceptional approval has been granted by the electives team to proceed. Overseas placements organised after the stage 3 deadline has passed, and without prior approval from the electives team, will not be approved:
  • After the Stage 3 deadline the electives administration team are very unlikely to be able to turn-around documentation within 2 weeks (due to other duties);
  • Ultimately you are responsible for arranging your placement and failure to do so will mean that you cannot complete your MBBS requirements, so potentially jeopardising your graduation that year.

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

Medical School approval of your elective – this Stage 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 Stage 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
• Your undertaking to check the FCDO website for travel advice for your approved destination and changing your plans if a travel advisory is issued
• Subscribing to FCDO travel advice alerts or following FCDO Travel on Facebook and Twitter during your elective for travel advice updates.

Communications with the electives team - The Electives Team will try to support your applications in a timely way, but please keep in mind that they will be helping many other student, and have other duties. Documents can be collected from the Student Offices or scanned and sent to you by email. Please allow at least a 2-week turnaround time for your documents to be produced, and keep in mind that there may be times when the administration team cannot achieve this due to their other duties, for example around elective approvals deadlines. Please plan ahead and do not send emails requesting documents urgently (specifically anything requiring a less than 2-week turnaround time) unless it is for reasons beyond your control. Requests for urgent documentation that are for reasons within your control, or where no reason has been offered, will be treated as routine. If you do need documentation urgently, please keep in mind that despite the team’s efforts it may not be possible to supply them with the hoped for speed.

When contacting the Electives Team, all communications should be sent to the medsch.electives-approval@ucl.ac.uk address, not staff members personal inboxes. Please be mindful that sending emails to multiple addresses at the same time (e.g. copying in the Year 6 or MB BS Tutor administration team), or the Electives Lead (unless specifically advised to do so) causes unnecessary additional work. Similarly, please request all references (e.g. Dean’s, Director’s or other letters of support) via the electives administration email address, rather than directly to members of the Medical School team, as these will typically be forwarded to the administration team anyway, so slowing responses.

If you foresee any issues completing any of the electives approvals stages, please contact the Electives Team before the deadline has passed, and if needed agree a deadline extension. If you do not do so, then you will be issued with a CoAE. Similarly, if you fail to respond to repeated communications from the Electives Team, a CoAE will be issued, and you will be asked to meet with the Electives Lead to discuss progress with your elective planning

Elective approval deadlines 

Deadlines for submitting elective approval forms:

• STAGE 1     14th March 5pm
• STAGE 2     15th May, 5pm
• STAGE 3     15th December, 5pm
• STAGE 4     31st January, 5pm

These deadlines are in place to give all students a reasonable opportunity to arrange a placement of their choice which complies with the MBBS regulations, while allowing the electives approval team time to process all required documents in time for electives to be signed off before departure.

For Stage 3 only, you may request a deadline extension if you are awaiting the outcome of an application or can only make an application to your preferred destination after the deadline has passed. This will only be granted if the electives team can be confident that should your preferred plan not come to fruition, you will still have time to arrange a placement in the UK.

Elective Timing and Content

Your elective must be completed within your allocated 8-week block after Finals. You must spend a minimum of 6 weeks in placements and may use 2 weeks for travel to and from your elective destination and to submit your elective report signed by your educational supervisor. The expectation is that you complete your elective in a single placement, however you may undertake two placements each of at least 3 weeks in duration at the same institution or another institution in the same country (or longer if you wish to use the full 8 weeks of your elective for placements).  Electives split across two different countries are not permitted other than a single overseas placement and another in the UK except where this is a requirement for employment post-qualification and you seek prior approval from the Elective Lead.

Elective Content

Your elective must be on-site and:

• Supervised by someone medically (MBBS or equivalent) qualified in a senior (non-training grade) position.
• With an organisation whose primary goal is healthcare related.
• In a specialty or area that requires an MBBS (or equivalent) qualification.

In addition to conventional hands on clinical elective placements, within this definition, non-patient facing specialties (e.g. forensic medicine, radiology and histopathology) are acceptable, as are clinical observerships, clinical research (research that requires oversight by a person with a primary medical qualification). Similarly medical management and leadership (e.g. a placement with an NHS Clinical or Medical Director, in a hospital or NHS Integrated Care System), and public health placements (including WHO internships), are also considered acceptable. Placements with commercial organisations whose primary focus is not patient care, e.g. management consultants, will not be approved.

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 placement, such that you and your supervisor are confident that this will not prevent them from being able to sign off satisfactory completion of the placement (which is required for you to fulfil your MBBS requirements).

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. 

Evidence of satisfactory completion of course

You will need to provide evidence of satisfactory completion of your approved elective, as set out in your declaration of Stage 4, by the deadlines given for the Final Exam Board to be able to confirm your degree award. You will need to have submitted your Elective Report on your ASR ePortfolio which has been graded and signed by your named Elective Supervisor.

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 Concern over Professional Behaviour (CoPB). 

Students re-sitting finals

In 2024, students will be advised to shorten their elective and offered the opportunity to join a Preparation for Exams revision programme at one of our associated Trusts. This placement will be tailored to individual needs in discussion with the local MBBS leads and will fulfil your MBBS elective placement requirement. This programme is only offered to students who have failed finals in March. Students who take up this opportunity are asked to update the elective approval team with changes to dates or destinations. 

For students in Elective Block 1, the programme of study becomes: 

•    4-week Elective (or 3 weeks for students who have arranged 3+3-week placements) 
•    4-week Preparation for Exams (tailored to your revision needs)
•    4-week Preparation for Practice (unchanged)

For students in Elective Block 2, the programme of study becomes:

•    4-week Preparation for Practice (unchanged)
•    4-week Preparation for Exams (tailored to your revision needs)
•    4-week Elective (or 3 weeks for students who have arranged 3+3-week placements)

Travel and Departure

Your elective block is 8 weeks long, of which 2 weeks are allowed for travel to and from your elective destination, and 6 weeks for the placement itself. 

Elective Block 1: The earliest students can depart is after 5pm on the Tuesday after finals results are released on Monday morning. This is because students who fail finals are required to attend a compulsory post examination appointment at the time notified with their result. Appointments are held on the Monday afternoon and all day Tuesday and can be in person or online, and failure to attend triggers a CoPB. To ensure availability to attend, elective plans submitted with an earlier departure date will not be approved. At the end of the elective, students must arrive back in the UK in time to take up their Preparation for Practice SSC at 9am on the first Monday.

Elective Block 2: students must plan to travel after 5pm on the last Friday of their Preparation for Practice SSC. This is because sign-off for the full 4-week placement is an MBBS course requirement. If travelling to your destination, or other very good reason (for example institutionally fixed start and end dates, or prohibitive travels costs in time to start your placement) requires you to set off earlier on the last Friday, you must discuss this with an MBBS Tutor and you must request and receive authorised absence before booking your flights. CoPBs are issued for failure to comply.

The 6-week placement must be within your elective block dates. UCL’s travel insurance is only valid for your approved placement, travel to and home from your destination as set out in your elective plans and approved by the Medical School, and travel within the same country within your approved travel dates. Separate insurance must be taken out for any other travel, and for extreme sports during your elective as these are excluded from UCL’s travel policy. Please note that in the event of an emergency, the Medical School will contact you via your UCL email and mobile number if held in Portico.  

Depending on your destination, the 2 weeks allowed for travelling 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.

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 decided by UCL in February each year. This is outside our control and we are not able to provide the date until it is published by UCL. 

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. Where additional precautions need to be taken for your chosen destination, the associated costs should be considered alongside the other expenses you will incur. 

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, however UCL Workplace Health can provide a list of providers in the area). If you wish to book with UCL Workplace Health, you are advised to seek an appointment as soon as you are certain of your destination as they have finite capacity and may not be able to see you at short notice. If you find you cannot attend, you must cancel at minimum 24 hours before the appointment time so that the slot can be offered to another student. Concerns over Attendance and Engagement may be issued for failure to attend or to cancel.

PPE and PEP

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

You may obtain PEP from private suppliers, although UCL Medical School does not endorse any particular one. PEP should comply with BASHH and BHIVA guidelines. Private suppliers include GU clinics and GP services and can be found through an online search.

You should not expect NHS GU and GP services to supply these for you, although some clinicians working in NHS services may, at their discretion, be able to prescribe privately for you if they hold suitable private indemnity to do so.

You may also obtain PEP drugs via online pharmacies (pre-exposure prophylaxis (PREP) sources may also be able to supply PEP), although this may not include screening for contra-indications, and so you should exercise caution when using such services and consider these in light of BASHH and BHIVA guidance. 

UCL Workplace Health do not supply PEP directly, but rather advise students on the process of obtaining a 5-day PEP kit from the Nomad Travel clinic. After completing the enquiry form (https://nomad.formstack.com/forms/consultation) you must also email the Nomad team (pharmacy@nomadtravel.co.uk) to say you’d like to request a 5-day PEP kit and provide your preferred delivery address. The charge for the 5 day kit is £250 inclusive of delivery.

We appreciate that the cost of PEP is not insignificant but remind you that HIV infection can still be life-changing. It is only a requirement if you chose to go to a Group B destination and can be avoided if you chose a Group A one instead. As such, it should be factored into your elective planning in the same way that you consider other non-obligatory costs, such as flights, when deciding if an elective is affordable for you. Students who have claimed an NHS Bursary can apply for the costs of PEP to be reimbursed after the elective, providing that receipts are submitted with the claim.

OH record

Some host institutions require visiting elective students to submit a copy of their OH record and you can download this from the UCL Workplace Health portal. Please contact uclstudentoh@ucl.ac.uk if you need help accessing the portal.

Insurance

UCL provides:

• Public Liability Insurance for medical students taking supervised clinical elective placements which have been approved by the Medical School, within and outside the UK.

Some host institutions may request confirmation of Public Liability Insurance. You can download this from UCL’s Insurance Policies webpage.

• Travel and Medical Insurance for students travelling on behalf of UCL, including to, from and during approved elective placements and travel within your approved elective dates. The insurance covers medical expenses, cancellation or curtailment expenses, loss of or damage to any personal baggage, loss of money, travel delay and loss of deposits as defined in the policy. Details can be found on the UCL Study Abroad Insurance website and UCL Travel Insurance FAQs.

Please note that:

• UCL’s policy provides cover during travel to, from and during your approved elective placement and travel within the same country within a reasonable timeframe of the placement. You must take out your own separate insurance for any other travel.
• All students travelling outside the UK must apply and download an insurance certificate before travelling. Insurance is provided free of charge and the insurance company provide a 24-hour helpline which is your first point of contact in the event of an emergency. Instructions for downloading your certificate are provided when your elective is given final Medical School approval in Stage 4. There is no insurance cover in place for students who fail to apply and obtain a certificate before travelling.
• Flight cancellation cover only applies where there is a valid reason (e.g. your host institution cancels your elective after you have paid for flights or the FCDO issues a travel advisory and elective approval is withdrawn) and where you cannot get a refund from the airline.   

Host Institutions should normally provide:

• Clinical Negligence Indemnity for clinicians who act as supervisors for visiting elective students. This protects you as a student acting under supervision. 

If your host institution does not provide indemnity for your elective supervisor, you should take out personal Medical Malpractice/Medical Negligence insurance to protect you against potential claims.

Students taking electives outside the UK should obtain:

• Medical Malpractice/Medical Negligence/Professional Indemnity Insurance to protect against potential claims from patients.

This is a requirement where the host institution’s Clinical Negligence Indemnity Scheme does not extend to visiting elective supervision or is stated as a condition of your elective. You will need to buy personal medical negligence insurance and are advised to take advice from your host institution about suitable cover. The International Helpers Trust may be helpful in identifying suitable cover.

Free cover available to student members of the MDU and MPS is recommended for all students taking supervised elective outside the UK. This cover is essentially advisory as it relies on the elective being taken under the supervision of a clinician who is covered by the host institution’s Clinical Negligence Indemnity Scheme. It is not suitable for students whose supervisors are not covered by host institution Clinical Negligence Indemnity Schemes.

Access to the MDU/MPS 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"

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 such statements or waivers as UCL’s  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, you must contact the elective coordinator at your proposed host institution to explain that it cannot be signed, and ask if there are other ways in which UCL students can demonstrate that they fulfil the insurance requirements. You can say that you will have in place the insurances below for which you will be able to present confirmation and copies of the policies if needed: 

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

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, 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 yourself for your elective. 

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 FCDO at the links below, and with our own tips drawn from experience with student electives: 

• UCL Staying Safe
• UCL Safety Services
• FCDO Foreign travel advice for your approved destination covering Safety and security, Terrorism, Local laws and customs, Health, Natural disasters, Money, Travel advice help and support.

UCLMS – Health Tips

Accidents 

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

Sun exposure

• Protect yourselves against the effects of the sun by wearing a hat, sunglasses and light protective clothing.
• Use an appropriate sunblock and reapply as directed, for example after swimming.
• In sunny climes, avoid direct sunlight between 11.a.m. and 3 p.m.

Travellers’ Diarrhoea

This is an extremely common hazard but is usually not life threatening. It can occur anywhere but is more likely where catering hygiene requirements are not regulated and enforced.

The following measures may help you to reduce the risk of travellers’ diarrhoea:

• Eat freshly and thoroughly cooked food which should be served piping hot. 
• Avoid cold foods.
• Avoid salads and raw shellfish.
• Choose fresh fruit and vegetables which can be peeled and/or sliced open by you.
• Drinking water should ideally be canned or bottled with the seal intact. Fizzy water is preferable as it is less easily tampered with. 
• Avoid ice cubes in your drinks.
• If in doubt about the purity of water STERILISE it. Take water purifying tablets (those containing iodine are more effective than those containing chlorine) or certified equipment with you.
• 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

• Dress appropriately for the environment, in a way that does not draw additional attention to you or suggest wealth beyond those around you.
• Only carry cash needed for the day’s activities. It may be safer to use a credit card in some situations.
• Be discreet with valuables. Be mindful that items you may consider of lower value may still be targeted, e.g. an old mobile phone, sunglasses.
• Be discreet with other items critical for your travel, e.g. passports and credit cards.
• Take greater care when travelling alone. 
• 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 FCDO guidance at all times.

UCLMS - OTHER USEFUL TIPS

• Remember that alcohol and drugs affect your judgement.
• Avoid ear piercing, tattoos or acupuncture.
• Avoid blood transfusion or infusion of blood products unless absolutely 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.

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 this link if you think it would be helpful to discuss any such incidents in person 

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 Stage 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. No tuition fees are currently charged by our central Trusts.
 
Other UCLMS-associated hospitals have their own separate, formal application process and may charge a fee. You should check websites for information about how and when to apply and to find out the costs of application and placement, which you will need to pay yourself. Trusts 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.
 
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 for student member cover.

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 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. Some US institutions require student’s home institutions to be members of the VSLO scheme – UCLMS is not a member of this scheme, and as it requires payment of a regular fee, and has no plans to become one.
 
Some institutions do not accept UCLMS exemption letter for USMLE Step 1 exams. 

Elective applications

Canada

Applications to all Canadian institutions are now processed through a central portal - AFMC Student Portal.  You will be charged a fee to use this. 

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):

• US Electives

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.  
 
For institutions in North America which are known to offer only 4-week electives, students may arrange a second 3 or 4-week elective in the same city or area. If a second 3 or 4 weeks cannot be arranged, or an offer is withdrawn whilst on elective, students must return to the UK to complete their remaining 3 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 your full name and student number. 
 
The Electives Approval Team can provide:–

• A Letter of Good Standing/Recommendation (which includes confirmation of student status)
• An academic transcript
• An academic reference
• USMLE Stage 1 exemption letter (which 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 

Please see the information provided in the Insurance section of this website.
 
Some US institutions specify which provider you should use, but if not you can purchase personal medical negligence insurance as a visiting foreign medical student from several providers (UCLMS does not have a preferred provider) for example Academic Medical Professionals Insurance Risk Retention Group (RRG). You should confirm with your host institution that the company you have chosen would be acceptable to them before taking out a policy.

Students visiting Canada should take advice from their host institution.

Visa queries

The Medical School cannot give visa advice and we recommend that you contact the host institution and visit the US Embassy Visa Application website for information on this.

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.

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.  

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, MDU or MPS insurance may be sufficient, but you should check this with your host institution. 

Visa queries

The Medical School cannot 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.