I was encouraged to read the article by Franey et al1 about the undoubted value of an international Time Out of Programme Experience (OOPE), particularly in a low or middle income country. In the Severn School of Primary Care (Severn Postgraduate Medical Education) we have been promoting this activity for 5 years, inspired by the Crisp report.2 The many gains3 that accrue have informed our selection criteria: how will the OOPE benefit the candidate’s career progression, general practice in the NHS, and the health of the country of the placement, and why does the OOPE need to be taken at this particular time?
To date we have had overseas OOPE doctors (OOPEs) in Uganda, Malawi, Madagascar, KwaZulu-Natal, Solomon Islands, Zambia, Northern India, Costa Rica, Nicaragua, and the Cook Islands. Short descriptions of their inspirational experiences are available on our website: http://www.primarycare.severndeanery.nhs.uk/training/trainees/out-of-programme-experience-and-opportunities-oope/our-recent-oope-trainees-and-what-they-got-up-to/
We finance placements for our intending OOPEs on a local 3-day course in overseas medicine, which is aimed at doctors and nurses preparing to work in low resource countries. We provide a series of in-house meetings where returning OOPEs share their experiences and potential OOPEs have an opportunity to discuss preparatory arrangements. We emphasise and try to ensure that all our OOPEs have clinical supervision while in the low resource country. For our OOPEs who go to KwaZulu/Natal, we have a former senior GP educationalist who is able to visit them and supply some in-country support. Importantly, we also provide individual debriefing for returning OOPEs to help with their re-integration into the NHS.
The sparsity of opportunities that Franey et al describe within GP schools is, I think, due to the perceived disruption of GP rotations in a short 3-year training programme. I would strongly argue that this a very small price to pay for the definite learning experiences for these trainees, who are high flyers and potential clinical GP leaders of the future, whether in the UK or overseas. We would encourage all GP schools to promote these OOPE placements, particularly in low resource countries.4
REFERENCES
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