Abstract:

Introduction:
The medical elective forms an integral part of the curriculum for medical students, offering the opportunity to explore the way healthcare is delivered in different settings, usually away from their locality. Prior research has explored medical electives choices in isolation of the COVID-19 pandemic, which invariably caused a paradigm shift in the way medical education is delivered and clinical exposure is achieved. We sought to understand how choice of medical elective from medical students at The University of Manchester, UK, have been influenced and what major determinants have contributed to varying preferences.

Methods:
We conducted a cross-sectional study analysing elective destinations of 998 fourth year medical students from the 2018/2019 and 2021/2022 academic years. Statistical analysis was undertaken. A survey was circulated to 467 students, consisting of seven multiple choice questions intended to understand the reasoning for the choice of elective and factors considered when planning.

Results:
In the 2018/2019 academic year, 70.2% of medical students undertook an international elective, compared to 45.4% in the 2021/2022 academic year. Quantitative analysis revealed a statistically significant decrease in the number of students opting for an international elective as opposed to a domestic elective (χ2 = 50.8, df = 1, P < 0.01). The surveys highlighted considerations of current students when planning their elective; this includes: financial limitations (77.3%), ease of planning (72.7%), uncertainty of travel restrictions (72.7%), time permitted to plan elective (36.4), interest in a specific specialty (22.7%), personal contact (18.2%), original plans intended cancelled (4.5%), timeframe of elective period available (4.5%).

Conclusion:
The COVID-19 pandemic has prompted a larger discussion in the way medical education can incorporate new adjustment to mitigate educational deficit, and by extension, increase medical exposure on a global platform. Cost and ease of planning remain one of the largest factors when choosing destination, though our findings suggest that this was compounded by the difficulties surfaced from the pandemic, such as the uncertainty of travel restrictions. Further research into the way the post-pandemic elective landscape transforms will enable students to make the most of a valuable and exciting component of the curriculum.

Keywords:

COVID-19, medical students, medical elective, medical education, international elective.