International Electives (Policy for Residents Requesting)

Requests for electives outside of Canada must comply with the following:

1. The resident complies with any requirements outlined by their program beyond those sited in this policy,
2. The resident complies with the requirements outlined in the International Health Office/Postgraduate Medical Education Office International Elective Instruction Sheet,
3. Any elective that is completed by a trainee who does not fulfil the above requirements will not be counted towards his/her residency training.

In addition, electives taken in an unaccredited setting may be accepted towards specialty or subspecialty training requirements if all the following conditions are met:

1. In Royal College programs, the total duration of unaccredited elective rotations must not exceed six months of the total training for the specialty or subspecialty. 
   In Family Medicine programs not more than 4 weeks should be taken outside the Maritime Provinces. Exceptions for extending this time beyond 4 weeks include the following: 1) compassionate grounds, 2) training in areas that are not available at Dalhousie (eg. International electives);
   
   
2. The resident must be enrolled in a recognized program at the time the elective is taken.
   
   The program direcror and the resident, that is then accepted by the program director as meeting the specialty training requirements, plan the elective period.
   
   
3. There is a clearly designated elective supervisor.
   
   
4. There are clearly defined and understood educational objectives.
   
   
5. There is a well defined in-training evaluation system to include evaluation of the resident during the elective period that is based on the educational objectives of the elective and that is clearly understood beforehand by the resident, the elective supervisor, and the program director.

The Global Health Office provides support to Residents participating in a global health elective. If you are planning on doing an international elective please follow the steps in the pre-departure section of our Residents’ Page

Note that this information is part of the approval process for your elective.  Please be sure to check with your department to ensure that you have met all of their requirements as well.

Also, please note that electives in countries where Foreign Affairs Canada has issued a Level 3 “Avoid Non-essential Travel” advisory or higher will not be approved. For up to date travel reports, please visit the Foreign Affairs Canada website  

Approved by PGME Committee April 8, 2021

Guidelines on Residents Education Abroad  - [PDF-68kb]

1. PURPOSE

The Office of Postgraduate Medical Education (PGME) at Dalhousie University provides opportunities, support and guidance for residents in postgraduate training programs to facilitate their engagement in education activities abroad.

The PGME Office recognizes the great potential of international educational experiences to enhance local clinical training, and to generate insights that will guide residents’ career development. At the same time, travel abroad may expose a resident to certain risks.

Dalhousie’s Global Health Office collaborates with the PGME Office and Program Directors to recommend, facilitate and administer international global health activities including resident education abroad. Resident education abroad must be in approved clinical settings that fulfill elective or core requirements of the Royal College of Physicians and Surgeons or College of Family Physicians of Canada for post graduate training programs. Information relating to international opportunities can be found on Dalhousie’s Global Health Office website (https://medicine.dal.ca/departments/core-units/global-health.html) and by contacting the office directly.

This document outlines the PGME Office’s policies and recommendations for residents seeking to participate in medical education abroad. It also presents reasonable precautions to be taken for the safety of Dalhousie residents planning to travel on University related activities.  Dalhousie residents participating in international electives are subject to the terms of Dalhousie’s International Travel Policy as well as the terms of the Faculty of Medicine Guidelines on medical education abroad. While residents are unique from graduate students in the university environment, for the purposes of policy coherence, residents are classified as graduate students under Dalhousie’s International Travel Policy.

2. SCOPE

These guidelines pertain to all Dalhousie residents, including visa trainees.  These guidelines outline specific procedures residents must follow to receive approval to travel abroad in association with PGME program and departmental policies.

The Global Health Office will work closely with Program Directors and Program Administrators to support residents engaging in international electives and implementing the guidelines.

The Global Health Office will provide an annual update to the program directors and program administrators on international electives and progress related to the implementation of the guidelines.

3. INTERNATIONAL ELECTIVES

Strong institutional partnerships contribute to effective monitoring and evaluation of international resident electives.  The Global Health Office will have a list of partner institutions with active memorandums of understanding (MOUs), which will be reviewed on an annual basis.

Electives outside of this list may be approved based on compliance with the institutional partnership criteria:

• The partner has a shared vision or principles with Dalhousie University
• An education and/or research relationship between Dalhousie University or the health authority and the partner institution is emerging, established, or ongoing
• The partner institution meets Dalhousie’s recommended legal requirements and this is confirmed in an appropriate written agreement between the parties
•  Infrastructure for visiting residents at the partner institution can accommodate the resident’s learning objectives without straining institutional resources
•  There is mutual benefit for both institutions and the relationship is sustainable
• Any other criteria, which may be relevant to the specific elective being proposed

The following information will be assessed by the Global Health Office and/or Program Directors and should be made available, as appropriate, to inform the program’s review of the learning experience prior to approval:

           a.   Level and quality of supervision
           b.   Any potential challenges to the code of medical ethics adopted by home institution

4. ACADEMIC CRITERIA

The following criteria must be met for each resident’s elective to be approved by the program director, notwithstanding any requirements outlined by their program beyond those cited in these guidelines.

I. Elective Definition and Length

Eligibility to undertake an elective for specialty or subspecialty training must comply with international elective criteria defined by the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada.

II. Language

Additional language criteria must be met for each resident’s elective to be approved. The working language of the resident should match the partner institution. The partner institution may provide interpretation only when it does not strain institutional resources. 

5. REGISTRATION AND TRAVEL REQUIREMENTS

After receiving approval for an international elective from their residency program director, the following criteria must be met for each resident’s elective to be approved by Dalhousie University.  A step-by-step guide to pre-departure procedures, including these requirements, will be provided to program directors and administrators.

I. Registration

After receiving approval for an international elective from their residency program director, residents are required to register with the Global Health Office at least 6 weeks in advance of the proposed elective for institutional approval.

II. Security Status

Dalhousie’s International Centre and the Global Health Office monitor the travel advisory reports from Global Affairs Canada (GAC) (https://travel.gc.ca/travelling/advisories). 

Circumstances beyond the control of the University may arise including pandemics, war, civil unrest, or natural disasters that may require a modification or termination of the elective. As per Dalhousie’s International Travel Policy, international electives will not be approved in locations where GAC has issued an elevated travel warning. Exemptions to this (for example, a resident traveling to their home country) must be approved by the Dean, as per Dalhousie’s International Travel Policy.

III. Risk Management

All electives must meet the university-wide risk management policy, which entails submitting a risk management plan when registering for the elective with the Global Health Office. It is a shared responsibility between Dalhousie and the resident to minimize personal risk and maximize safety. The resident must keep this in mind throughout the preparation for travel and during the travel experience.   

IV. Travel Health Requirements

The resident is responsible for obtaining any vaccinations or inoculations that are recommended or required by the government of a foreign country in which the resident will be traveling, or by the Canadian government for persons entering Canada from a foreign country. A visit to a travel clinic or family physician who advises on vaccines, medications and appropriate health measures for travel abroad is highly recommended.

V. Travel Requirements

• The resident is required to obtain, at the resident’s expense, extended medical travel insurance (including Evacuation Insurance) that will cover medical or hospital expenses that the resident may incur during the elective and any travel period before or after the elective. 
• The resident is responsible for obtaining any visas or permits that may be required to travel to foreign countries.   
• The resident is responsible for obtaining appropriate permits (licenses) required to provide clinical care and for providing proof of malpractice insurance. Please be aware CMPA does not cover residents for international electives.
• The resident is responsible for making all travel arrangements associated with the elective and, notwithstanding that the University or PGME may provide information with regard to travel arrangements, neither the University nor PGME warrants the safety of any carrier and neither is responsible for the acts or omissions of any carrier. 
• The resident is responsible for making all arrangements for accommodation during the elective and, notwithstanding that either the University or PGME may provide information to the resident with regard to accommodations, neither the University nor PGME warrants the quality or safety of any accommodation and neither the University nor PGME is responsible for the acts or omissions of the operators of any place of accommodation. 

VI. Travel Registries

Prior to travel, Canadian Residents are required to register their presence within the destination country using the Canadian government’s online Registration of Canadians Abroad (ROCA) system at https://travel.gc.ca/travelling/registration.

Travellers who are citizens of countries other than Canada are required to register their travel with the foreign office of their country of citizenship, where possible.

All Dalhousie travellers must also register with International SOS via Dalhousie’s International Centre.

VII. Post Elective Debriefing

Debriefing may be needed upon return from an international elective. Residents should schedule a post-trip debriefing with a faculty member in their department and/or the Global Health Office.