What to consider before volunteering

It is important to consider your motivations for volunteering overseas, the impact you will make, and the needs of the community you will be working in.

Benefits to volunteering

What to ask yourself

• What are the needs and expectations likely to be where I want to go?
• What can I offer?
• How long can I go for?
• What do I want to do?
• What do I expect to get out of it?
• What will happen when I come back?

The impact of taking time out

• The effect on your pension, as members of the NHS pension scheme may cease to become pensionable during a break in employment.
• Impact on your immigration status, if you are subject to visa requirements. 
• Personal, professional and potential service impact of taking time out of employment and training.
• The GMC (General Medical Council) does not require you to retain your registration or licence to practise when you are not engaged in medical practice in the UK, such as while you are taking time out to work overseas. Read more about registration from the GMC. 

Wider considerations

Immigration and professional registration

• You may need a work or other type of visa, depending on the duration and type of work you will be doing.
• You will also need to join the local medical register before starting any clinical work.

Safety and support

• Regularly check the travel advice and alerts from the Foreign and Commonwealth Office for the area where you will be working, particularly if you are working in a conflict or emergency situation.
• Find out, in advance, what supervision arrangements will be available to you during your placement.
• Identify someone within your professional network in the UK, such as a recent clinical supervisor, who can offer additional advice and support.
• UK doctors working abroad are occasionally asked to take part in activities which violate international standards of human rights and ethical codes. If you are in any doubt about the work you are asked to perform, contact our ethics department for advice. 

Specialist training

• Specialist training may be helpful when working in challenging situations. This will depend on the context where you will be working.

Duration

• Long-term placements are often more beneficial to both the doctor and the country they are working in. It can take time to adapt, gain relevant skills, and understand which issues are most important in the community where you are working. These may be very different from what you have experienced in the UK.
• If you are considering a short placement, you should think carefully about what impact you can have and identify what you can achieve and contribute in a short period of time.

Sustainability

• Think about how you can best use your skills and knowledge to address local needs in the timeframe you have available.
• Projects that build the capacity of local healthcare professionals can have significant positive impacts long after you have returned to the UK.

Impact on the health system

• Consider the impact your work may have on the wider health system of your host country.
• Medical volunteers can make many positive contributions, but their presence can also have negative effects. These include providing an incentive not to employ enough local health workers and supporting parallel health services which undermine national health systems.
• Minimise the negative effects of the work you participate in overseas by carefully researching the organisations you are volunteering with. This includes how they are funded and their links to the local or national health service.

Finding a placement

There are many different options for arranging to volunteer overseas. The right one for you will depend on a number of factors.

If possible, discuss your plans with someone who has experience of the programme and the role you will be taking on.

Although it is possible to directly arrange a position with an initiative or institution overseas, many doctors choose to volunteer through a charity or aid agency with experience and infrastructure in the setting where they will be working.

Opportunities for NHS staff

HEE (Health Education England) and various NHS trusts support a range of fellowship programmes overseas, generally lasting between six months and two years. Many NHS institutions have also developed sustained partnerships with initiatives in low-resource settings, such as health links established under the UK Government’s health partnership scheme.

HEE’s GE (Global Engagement) directorate aims to support the NHS workforce to gain global health experience through an evolving portfolio of programmes.

There are also options specifically for NHS staff in Scotland and Wales.

Volunteering through an agency

Depending on the agency or scheme, much of the groundwork, such as registration, logistics and immigration formalities may be done for you. The scheme may also provide pastoral support and additional preparatory training on cultural issues, personal security and clinical practice in low-resource settings.

Established organisations can provide you with a professional network, which can be a key source of advice and support before, during and after your time overseas.

Placements with agencies and schemes that provide long-term support to strategic international development programmes may also have a more sustainable impact than self-arranged placements. These programmes are usually monitored and evaluated to ensure their effectiveness.

Requirements

• At least two to three years post-registration experience.
• A broad range of experience, although there are opportunities for experienced doctors in certain specialised fields, such as surgery.
• Experience in general practice, obstetrics and gynaecology, accident and emergency, paediatrics and public health is particularly useful.
• Training in tropical health and hygiene, and the ability to speak certain foreign languages, will be desirable.
• Personal characteristics include: flexibility, sensitivity, motivation, resourcefulness and personal resilience.

Specialist international aid agencies

• Medecins Sans Frontieres (Doctors without Borders)
• Doctors of the World
• RedR
• THET (The Tropical Health and Education Trust)
• UK-Med
• VSO (Voluntary Service Overseas)

Indemnity and professional protection

Some agencies have preferred indemnity providers and can advise you on suitable cover for the setting where you will be working.

However, you are responsible for arranging your own liability insurance and for fulfilling the terms of the cover, such as keeping appropriate records and only undertaking work that you are trained and experienced to do.

Am I covered?

NHS indemnity provided through a UK employer will not cover work done overseas, including for voluntary or charitable bodies.

We strongly recommend that all doctors take out supplementary insurance with one of the medical defence bodies or provide themselves with other personal indemnity insurance, including for work done in the UK.

Your current medical defence body or personal indemnity provider may cover overseas voluntary work, often at lower cost than a new policy specifically intended for volunteers.

Main medical defence bodies:

• MDU (Medical Defence Union)
• MDDUS (Medical and Dental Defence Union of Scotland)
• MDS (Medical Defense Society)
• MPS (Medical Protection Society)

If you are covered by another insurance provider, you should contact the policy provider and review the policy conditions on working abroad.

What to expect after you have applied

Once you have been recruited, you may be put on a register for future use or be placed on a project immediately. Placement length varies considerably, although you can usually expect to be deployed for between six months and two to three years.

Some agencies provide training and support both before and during the placement. Many also have established networks of returned volunteers who can assist you with reintegrating into the NHS and life in the UK.

Depending on your career stage, the process for applying to take time out differs.

Getting support

Identified contact person

It is important for all employed doctors and trainees to have an identified contact person, either at your deanery or place of employment in the UK. This contact will be responsible for dealing with any work queries, should you need specific advice or clarification while overseas.

Deans, chief executives, educational supervisors or professional mentors may be your first point of contact for information when considering taking time out to volunteer overseas. They should be aware of key contacts and able to forward any requests for information appropriately. They are also likely to play a critical role in your application process, either in an advisory or approvals capacity.

All relevant employer and deanery or LETB (local education and training board) staff should be aware of their responsibility in dealing with queries and be up to date with contractual obligations and local policies.

Employers and deaneries should also be aware of any relevant guidance or websites and advisory documentation, and be able to share this information with you whilst you are away. You should also ensure they have up to date contact details for you and advise them if anything changes whilst you are away.