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Pre-Departure Trainingfirstdonoharm

Winner of 3rd Place in the IFMSA's Rex Crossley Best Global Health Project Competition 

Pre-Departure Training (PDT) focuses on preparing medical students to participate in low resource setting international electives.


During the Canadian Conference on Medical Education in April 2012, PDT became a part of LCME accreditation standards. The revisions were released June 2012 and all schools notified. As of the 2013/2014 academic year PDT will become part of the accreditation review at medical schools.


The precise wording of the accreditation standards is as follows:

MS-20. If a medical student at a medical education program is permitted to take an elective under the auspices of another medical education program, institution, or organization, there should be a centralized system in the dean’s office at the home program to review the proposed extramural elective prior to approval and to ensure the return of a performance assessment of the student and an evaluation of the elective by the student.


Information about issues such as the following should be available, as appropriate, to inform the program's review of the learning experience prior to its approval:

·       potential risks to the health and safety of patients, students, and the community;

·       the availability of emergency care;

·       the possibility of natural disasters, political instability, and exposure to disease;

·       the need for additional preparation prior to, support during, and follow-up after the elective;

·       the level and quality of supervision; and

·       any potential challenges to the code of medical ethics adopted by the home institution.


Medical student participation in global health electives in low-resource settings is growing rapidly. Approximately 30% of Canadian medical students participate in a global health clinical elective experience by graduation. Although such experiences have numerous benefits for students, there is concern about potential harm inflicted by ill-prepared students untrained to deal with settings and situations that differ radically from their home institutions/countries. The CFMS established the Pre-Departure Training (PDT) project in 2007 to address these concerns. PDT is defined as ‘any training that students complete before taking part in a global health elective that has as its goal building trainee competence and the skills necessary to maximize learning while also minimizing harm to themselves and the communities in which they study.’

The aim of our project is to ensure that all medical students are prepared for safe and fruitful global health elective experiences. Our goal is to see that sustainable quality PDT becomes part of the culture in all Canadian medical schools.

In collaboration with the Association of Faculties of Medicine of Canada (AFMC), we published a set of national guidelines for PDT in 2008, outlining the five core competencies for PDT:

  1. Personal Health
  2. Travel Safety
  3. Cultural Competency
  4. Language Competency
  5. Ethical Considerations

Working with our local student representatives and faculty collaborators, we are implementing PDT at all Canadian medical schools. The results of our work have been very encouraging, and were recently published in the journal Academic Medicine.

In 2008, 65% (11/17) of Canadian medical schools offered PDT. This increased to 94% (16/17) in 2010. In addition, the number of schools with mandatory PDT nearly doubled (6/17 [35%] versus 11/17 [65%]). There is still little institutional funding for PDT, with 10 out of 16 programs operating on budgets less than $500 in 2010. To increase institutional support for PDT, we have applied to the Liaison Committee on Medical Education (LCME) to have PDT become part of the accreditation criteria for North American medical schools.

At the national level, PDT has been formally supported by the Canadian Medical Association (CMA) and the Canadian Society for International Health (CSIH). The project was endorsed by the International Federation of Medical Students’ Associations (IFMSA) in 2010 and we have collaborated with our colleagues at IFMSA-Québec to develop new resources for PDT delivery. We hope to share our experience in PDT implementation with other countries through the IFMSA to encourage a culture of safe, sustainable and ethical global health electives.

For further information, please contact the National Officer of Global Health Education (Mary Halpine and Irfan Nizarali Kherani) at This email address is being protected from spambots. You need JavaScript enabled to view it. .