When you ask colleagues why they entered medicine many say it was to help people however evidence suggests that job satisfaction is decreasing.[1] Perhaps you are becoming tired and are looking for a new challenge. Well why not use your skills and become a medical volunteer.
BENEFITS
Many volunteer programmes overseas take place in difficult clinical surroundings. Resources are scarce. Comprehensive history taking and thorough clinical examinations are vital to provide a diagnosis. This in turn increases proficiency, not simply in terms of technique, but in enhancing clinical judgement and decision making, particularly when considering how to prioritise patients based on clinical need. Medical volunteering allows for the expansion of clinical knowledge by providing unique opportunities to experience disease entities and clinical signs not common or prevalent within the UK. Furthermore, opportunities to advance personal knowledge in other medical specialities arises, a luxury rarely afforded outside of the foundation programme.Perhaps most crucially, medical volunteering is a key means of gaining experience in global health. The world has changed fundamentally in recent years, with accessible air travel resulting in the continuous movement of people and subsequently disease.[2] We, as doctors, are increasingly exposed to pandemic and communicable diseases within the NHS. Medical volunteering overseas permits first hand exposure to, and training in management of these conditions. Moreover, it provides greater understanding of the impact which non-communicable diseases have worldwide, thus providing an opportunity to examine alternative treatment approaches adopted in other healthcare systems. This acquisition of knowledge and ideas can in turn be transferred to the NHS and used to generate innovative solutions for UK patients.[3]Interpersonal skills are enhanced through engagement in overseas volunteering. Competence in areas such as problem solving develop rapidly. Reflecting on my own experience in the West Bank, I often find myself challenged when treating patients due to lack of clinical equipment or medication. I have had to adapt and learn using dose conversions to provide patients with a similar drug when their medication has not been available, and have learnt to adapt to a scarcity of resources, regularly using lemon juice as an antibacterial handwash between patients. A further issue to consider is that of communication. When volunteering overseas, communication can be troublesome due to language barriers, thus necessitating an interpreter. Whilst frequent use of an interpreter can advance certain verbal skills, including the use of simplistic language to explain elaborate concepts, it can hinder the ability to form a meaningful relationship with a patient. Therefore, the development of strong non-verbal communication skills, including; eye contact, hand touching, etc., assume even greater importance when establishing a relationship with the patient. Unquestionably, these skills are enhanced through volunteering. In further espousing the benefits of overseas volunteering schemes, Lord Crisp, in his 2007 report entitled, Improving health at home and abroad, cited leadership development as one of the most important gains for volunteers and noted that those returning to the UK were seen as having a greater understanding of how to enact change, communicate across professional cultures and work as part of a team.[2] Finally, volunteering has been linked to many positive health benefits for those who choose to take this unconventional step. Increased confidence, self esteem and lower rates of depression have been noted amongst those who have taken time to work abroad.[4]
CHALLENGES
Getting established as a medical volunteer abroad can be demanding. Companies have been created to facilitate those wishing to engage with medical volunteering however they may not provide schemes in a desired location or medical speciality. Agencies such as MSF (Medicine Sans Frontiers) have strict entrance requirements and typically seek volunteers for ‘disaster’ relief. As such responsibility to arrange contact with a volunteer programme tends to be an independent process, placing great onus on the interpersonal skills of the erstwhile volunteer.It is important to have realistic expectations of what is achievable when choosing to volunteer overseas. It can be challenging to see so many individuals in need and to have to turn people away due to a lack of resources. It is thus necessary to be aware that the assistance you provide is appreciated, however it will not help amend all the short fallings in the local healthcare system. This can have a significant impact on you as an individual and when coupled with being far from your support networks can be a challenge that needs to be carefully considered. More often than not, being paid for your work abroad is a luxury. Some organisations attempt to offset costs by providing food or housing for the volunteer but setting aside the ethical and moral dilemmas that being remunerated in developing or ‘conflict’ areas can raise, one should be aware of the fact that volunteering abroad will require significant financial reserves.Finally, if the volunteer post is for a protracted duration, it can be problematic obtaining the appropriate demonstrative information for appraisal and revalidation for re-entrance into the home setting. To date, the GMC does not have specific appraisal guidelines for volunteer medical doctors and therefore standard guidelines apply. This is an unsatisfactory situation that will require clarification moving forward. Information for appraisal must be procured by alternative means but can be achieved through the diligent work of the volunteer. With access to online BMJ webinars and continued personal development (CPD) modules available worldwide, demonstration of advancement of personal knowledge can be produced.
CONCLUSION
Medical volunteering overseas whilst challenging is an enjoyable and rewarding process. It has the dual benefit of allowing a recommitment to helping the most vulnerable whilst providing an opportunity to develop both personally and professionally. Whilst appreciating the benefits, it should also be noted that, medical volunteering overseas is not achievable, nor desirable for everyone. However, engaging in short term volunteer projects, either at an international, national or even local level, should be more readily encouraged. Volunteering can be as big or as small as you can offer, from clinical assistance, education or mentoring to equipment donation and fundraising, thus reaffirming our commitment as doctors to truly succeed in our goal of ‘helping people’.