Health surveillance of Glasgow medical undergraduates pursuing elective studies abroad (1992-1998)

Background: An integral part of the training for many UK medical undergradu ates involves a period of elective study abroad. There is concern about the health risks this poses to the students, and uncertainty regarding the res ponsibility this places on medical schools. Methods: Annually since 1992, medical undergraduates at Glasgow University have been asked to complete and return a confidential questionnaire on retu rn from their elective studies. This records personal demographic details, the countries visited, and information about illnesses experienced. Analyse s were conducted on the students' health experiences, lifestyle, the health precautions taken, and the climates experienced. Results: Global statistics were compiled on 750 respondents. A subset of 26 7 completed a more extensive, post-1996, questionnaire enabling detailed st udy of comparative illness rates. A majority took pretravel health advice, visited only one country, stayed for 1 to 2 months, and experienced a tropi cal climate. Forty-five percent reported symptoms of illness, and alimentar y symptoms predominated (77% of those ill). Higher illness rates were repor ted in those who experienced a hot desert or tropical climate compared with those who did not. There was correlation between taking professional pretr avel health advice and exposure to a more hazardous climate. Conclusions: The attack rate for medical students on electives compares fav orably to that for package holidaymakers; similarly the attack rate for stu dents staying in the tropics compared with other travelers. A preexisting h ealth problem did not predispose to a higher attack rate. Attack rates can be minimized by avoiding climatically extreme locations. This surveillance provides a focus of interest to the students, insight on minimizing avoidab le health problems, evidences social responsibility by the Medical Faculty, and has the potential for expansion to other medical schools. Current Scot tish medical school policies on HIV risk management would be strengthened b y a more coordinated approach.