Tulane University School of Medicine offers its students opportunities to study away from the Medical School which are called externships. This is especially convenient for most students during the fourth year. While Tulane offers several exciting options for externship study, Tulane students are not restricted to these official sites and are encouraged to research and organize their own externship rotations.

Basic Requirements

Where have people gone lately?

Timeline/Checklist

Basic Requirements

1. A detailed proposal- this must include a daily schedule of activities, expected housing and as well as an outline for any projects you hope to complete while onsite. Activities must be some combination of community medicine and clinical rotations.
2. A site sponsor - an onsite MD who will vouch for the feasibility and completion of the schedule of activities that you propose.
3. Site safety - sites that have been designated as unsafe by the US State department will not be approved.
4. Ability to fund your participation in the rotation - Tulane does not provide funds for any aspect of the rotation, including but not limited to flights, housing, fees charged by international institutions, etc.

Once you have picked your site, you must present your proposal to Dr. Hamrick or Dr. Theis and meet with one of them to finalize your travel plans and site specifics. Also, you must check with Charlotte Steger in the Office of Student Affairs to ensure that your paperwork, including scheduling and travel insurance (which Tulane covers), is in order. See the timeline and checklist below for more details.

Where have people gone recently?

You'll notice that the number of people going abroad has declined in recent years. This decline coincides with the curriculum committee's decision to make the externship (domestic and international) optional rather than mandatory as it had been until 2000.

Timeline and Checklist:

NB: The following lists refer to a "country", but are equally applicable to domestic sites, especially rural sites or reservations, that differ significantly in their population or culture from Tulane or more urban sites.

First and second year

It's never too early to start researching the fourth year externship. Starting early allows you more time to:

• research sites that most appropriately fit your interests,
• identify foundations and organizations that may fund your trip (and project)
• get involved in research or projects that you can continue while on your rotation
• learn languages that may be spoken at your site
• be more aware of the specific populations, needs, cultural customs and general practices at your site

Third year: Fall/Early Spring

1. Narrow down your site choices and make sure that the rotation you want will be available/viable the following year. This includes checking current State Department warnings as well as finding out the latest update on conditions in your country and site of interest. Also you may want to contact students who have gone to your site before (their contact information and evaluations of the site will be kept in the F&C Med office - some of the info they provide on their evaluations will be posted on this site).
2. Contact Dr. Jim Theis in the Family and Community Medicine Department to discuss your chosen site and make sure that you will be able to receive credit for your rotation.
3. If you are an MD/MPH student hoping to complete a capstone or project during your externship, contact your advisor and discuss the what he or she requires in order to approve credit.
4. Contact your site to ensure that you will have a sponsor MD and a good idea of the daily activities and expected duties.
5. Write a proposal that includes a daily schedule of activities, expected housing and as well as an outline for any projects you hope to complete while onsite. The activities you list must be some combination of community medicine and clinical rotations (but not necessarily 50/50).
6. Start approaching organizations/foundations/individuals for financial assistance and/or grants (see the Funds page for more info, including a basic outline of how to write a grant proposal).

Third Year: March/April - Scheduling for Fourth Year

1. Finalize your proposal and turn it in to the Family and Community Medicine Dept.
2. Meet with Charlotte Steger in the Office of Student Affairs at your designated time to schedule your electives. Remember that the prime time for interviews is from November through the first two or three weeks in February; the prime time for "audition" extramurals is from October through December. Fourth year is broken up into
   • 2 months of Core Courses (must be done at Tulane or affiliates)
   • 6 months of selectives (can technically be done anywhere, but special permission is required to study away from Tulane for more than 2 months. Also the MD/MPH rotation, which is required for joint degree candidates and must be done locally, counts as a selective).
   • 2 free months (generally used to study for the boards)
3. Confirm with your site that you are coming.
4. Confirm that you will receive any funds that you have obtained before you leave. If necessary, speak with Mike Goodman in the Financial Aid office to reorganize your budget.

In The Months Before You Go

1. Buy your plane tickets, get all necessary immunizations, apply to embassies for visas, ensure that you have the proper paperwork with you for travel insurance/MEDEVAC, and buy clothes/equipment appropriate for the environment/culture in which you will be living. If your site does not have much funding, it may be helpful to look into getting unused or almost expired drugs from local pharmacies/hospitals and bringing them with you (if interested see a related article on drug recycling by AID for AIDS).
2. Buy a sturdy journal to record the important medical cases, stories, events, anecdotes of your externship (the journal is a program requirement and some version of it must be turned in to the F&C Med dept. on your return in order to get credit for your rotation.)
3. Get a decent camera and lots of film - the pictures make a nice addition to your journal when you turn it in to the F&C Med Dept. You may even consider giving us some pictures for this website!
4. Buy a Lonely Planet or Rough Guide to your chosen country - you will generally have a day or two off per week to get out and explore the country - make the most of it.
5. Get people's addresses so that you can send postcards (especially donors who have helped fund your externship - they love getting notes from the people they sponsor).
6. If the language of your site is not English or another language in which you are fluent, learn at least a few key phrases and vocabulary words, and don't be afraid to practice them when you arrive. People will appreciate your efforts to learn about their culture.

While You Are There

1. For the first week or so, go with the best rule of travel - keep your eyes open and mouth shut. This will help avoid any cultural faux-pas situations or misunderstandings. You are an individual, but you are also a representative of Tulane Med, America, and the first-world in general. Try to live up to your "titles". Always be flexible and open-minded.
2. Get involved in the community. The people you meet are often the most amazing part of the trip.
3. Be proactive. Let your sponsor MD know that you are interested in learning as much as possible in the brief time that you are there. Demonstrate the skills that you have learned at Tulane and allow the people you work with to show you how things may be done differently in that country.
4. Keep writing in your journal and taking pictures (when appropriate). You will be happy to have a record of all the things that you experienced when you are back in the States.
5. Send postcards. Keep in touch with people at home - because you are in that country, they now have a connection to it as well and will want to know more about it.
6. Be adventurous. Take advantage of the time that you have to really get to know the country and people because you will be considered an expert on the subject when you get home, regardless of how much you actually know.

When You Get Back

1. Meet with Dr. Theis or Dr. Hamrick to debrief and turn in your journal.
2. Meet with your MD/MPH advisor if necessary to present your project or capstone.
3. Fill out the F&C Med evaluation (we are hoping to put this online in the future for your convenience as well as ours - we would like to put excerpts of your evaluation on this site so that other students might have easy access to the information).
4. Keep in contact with the friends that you made on your externship. It helps you to readjust if you still feel a connection to this very important part of your life. You may also want to get involved in raising awareness of the issues facing that country.
5. Tell people about your trip. Some donors may request a presentation or slide show, but even your friends will want to see pictures and hear stories. You will probably have tons, so it may be a good idea to compile all your favorite photos and stories into one photo album that you feel captures the essence of your externship (this may be your journal or a separate book if you chose to take out the purely clinical anecdotes).
6. If you had a good experience, encourage others to go to your site. Make sure that CMIG and the F&C Med departments have an updated address for you, especially once you graduate, so that students interested in going to your site will be able to contact you and ask questions.
7. Survive residency and become a great doctor!!