The anticipated criticism is that medical students are not doctors and cannot act as health workers from an ethical or medicolegal perspective. At present, Western medical schools take most of the responsibility, but some of that responsibility is shared by the host university/medical institution. The student is expected to follow the same guidelines that they would in their home countries. The proposed scheme uses the existing infrastructure, and so liability will remain unchanged. Properly prepared students, acting within the limits of their knowledge and competency, will not compromise their or their patients' safety.
Lack of continuity of any scheme based on medical students may be a concern as placements last 6–12 weeks. If programmes are developed so that there is overlap between cohorts of students of at least one week, then handover is possible. Additionally, local health workers will be involved in supervision of the programme and ensure that services are provided throughout the year. As pressures on time increase in postgraduate training, clinicians wanting to engage in IH may have to concentrate on shorter placements abroad.
To most students, electives are an opportunity to leave the rigid curriculum. However, there is no need for coercion; a substantial proportion of UK medical students already choose to spend their elective at their own cost in rural areas of developing countries. The above arguments would hopefully convince enough students to participate.
Critics will question the utility of a few extra medical students in countries with complex systemic problems. However, in the above example, if 600 UK students are involved in coordinated, local schemes, then the use of current human resources could be optimized. If the scheme is successful in the UK, it can be extended to tap into the pool of international elective students, leading to much greater potential numbers of health workers.