Part 1 of a three-part series.

Interest in practicing and teaching emergency medicine around the world has increased exponentially. Many of our colleagues now have some international experience, many others dream of following a path to remote regions, and most academic centers are considering starting, if not already running, fellowships related to international emergency medical care.

Yet, most emergency physicians don’t know how to identify and evaluate global volunteer opportunities, what to expect when they travel to remote lands, or how to prepare for their experience. This article, the first of a three-part series based on The Global Healthcare Volunteer’s Handbook: What You Need to Know Before You Go (Galen Press, Ltd., March 2014), provides some of the basic information emergency physicians need for these ventures.

Finding the Right Opportunity

“Make a difference! Visit exotic sites and impart your medical wisdom. One or two weeks. Only $5,000, plus airfare.”

You have always dreamed of working internationally as a teacher, disaster worker, clinician, or a combination of all three. Is the offer above what you imagined? Probably not.

What you want to find is an international medical position that, first, meets your personal and professional needs and, second, has a mission consistent with your goals (see Figures 1 and 2). How do you locate and evaluate these positions? No, not the Internet.

While the Internet seems like an obvious place to start, it’s best to begin with any personal contacts that you have. The Web is filled with scams, such as the trip described above, billed as international medical missions rather than what they really are: vacations. If that’s the type of trip you’re seeking, go for it. Just note that the Internal Revenue Service won’t see it as anything other than pleasure travel. It’s best to first search for specific organizations and then evaluate them through their websites.

(click for larger image)

Locating Organizations

I recommend four places to begin searching for organizations with which to work or volunteer. The first is colleagues who have worked internationally. While their experience may be limited to one or two organizations and locations, they can provide personal insight into groups with which you may wish to work. Moreover, because many international organizations prefer you have global experience before you work with them, these colleagues may provide a valuable introduction to the group if you decide you are interested in its activities.

Second, consider contacting emergency medicine and general physician professional organizations (see Table 1). Third, you may want to join professional international groups such as ACEP’s International or Disaster Medicine Sections and SAEM’s Global Emergency Medicine Academy (GEMA). While at their meetings, ask other attendees about international opportunities. You can find additional leads from religious groups with which you are affiliated; many have active international medical missions. Finally, when traveling abroad, consider contacting health care facilities or expatriate volunteer physicians directly to see if your services are needed.

Vetting the Organizations

Once you have identified potential organizations, it’s time to assess them with your personal criteria.
Organizations come in a multitude of flavors. First, look at their mission statement. That may seem boring, but it tells you a lot about what they expect volunteers to do onsite. It will also tell you whether their mission is consistent with your goals. Finally, it will indicate whether you generally qualify to work with them. For example, many nonsecular religious groups only take people of their faith, and some of these groups see proselytizing (converting others) as their primary interest.

Table 2 describes typical variations among global medical organizations. I like to distinguish between those I think of as legitimate and those that are illegitimate. Legitimate organizations strive to provide long-term, sustainable changes to a health care system, illustrating the timeless adage, “Give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime.” Within emergency medicine, that usually involves establishing and working at an international EM residency or other long-term education and research programs. In acute disaster situations, while one can occasionally teach, the goal is to provide urgently needed care. In contrast, illegitimate organizations, like the one advertising the $5,000 trip, rarely provide medical service. Similarly, some government-sponsored missions only provide superficial treatment for public relations purposes.

Dr. Iserson is a fellow of the International Federation for Emergency Medicine and professor emeritus in the department of emergency medicine at The University of Arizona in Tucson.