As GP trainees, one of us was able to do an international Time Out of Programme Experience (OOPE); a scheme which allows UK general practice trainees to undertake a period of time out from their postgraduate training scheme to gain additional experience. I spent 2 years OOP: 1 year in a HIV treatment programme in KwaZulu-Natal, 3 months completing the Diploma in Tropical Medicine and Hygiene at the Liverpool School of Tropical Medicine, and the remainder of the time working in the UK as a locum.
My year working in South Africa was a hugely formative experience, I gained invaluable clinical, management, interpersonal, and research skills, pertinent to the RCGP curriculum and used daily in work as a UK GP. I was humbled by the strength of both patients and colleagues working in a resource-poor rural setting and developed an appreciation of our NHS, with all its flaws.
We (RCGP Junior International Committee) surveyed 20 GP trainees who had organised similar OOPEs. They all reported an improvement in personal and professional skills, most significantly in adaptability, confidence, personal reflection, local community perspective, and problem-solving skills, and most said that their OOPE had a positive effect on their current practice in the UK.
The UK has much to offer other countries in terms of healthcare experience and expertise and, in return, we can benefit from broadening the education of health professionals and building stronger relationships across the world.1 The Tooke Report says that ‘such … activity enriches the skill base and professional life of doctors, as well as promoting research and development, and the global health agenda’. The Lancet’s 2010 Global Independent Commission on Education of Health Professionals for the 21st Century highlights the importance of understanding intercultural sensitivities in view of the increasing diversity of our patients, and recommends the ‘curricular inclusion of global health, including cross-cultural and cross-national experiential exposure’.2 There is growing interest in encouraging NHS health professionals to volunteer overseas3,4 and evidence of the benefits to developed countries of international partnerships.
The opportunity for a GP trainee to complete an international time OOPE is variable and deanery-dependent; something of a postcode lottery. We think that all doctors in training should have the opportunity to undertake time OOPE overseas, with equal opportunities in every deanery or training body, and preferably as part of formal training.
We advocate standardisation of OOPE overseas across all UK training bodies, beyond what is in the Gold Guide.5 Each training body should have a named OOPE director. Existing successful deanery-led OOPEs should be used as models to develop consistency across all regions. OOPE led by training bodies should include pre-OOPE training, induction, supervision, and UK GP support during placements abroad. The extension of GP training to 4 years represents a unique opportunity to support more trainees across the UK to contribute to global health development, and to benefit from such work.
- © British Journal of General Practice 2013