So you’re thinking of working abroad?…

I attended the ADAPT Study day on ‘So you’re thinking of working abroad?…’ on Saturday 10th March 2018. The day was based in Birmingham and involved an early start for Di and I! We both studied in Birmingham, but haven’t been back in a few years, so it was a nice return to Harborne for the day!

The study day couldn’t have come at a better time for me. Increasingly I have been unsure about how I am going to begin working overseas, and whether this is realistic. Attending the study day allowed me to speak with those who are just as motivated as I am to work and volunteer overseas, as well as gain advice from those who have already done it! The day was a joint study day, with input from OT Frontiers, and Communication Therapy International.  I left the day feeling motivated once again, and with plans already forming of what my next steps to begin working abroad will be…

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Working Abroad- Options Available
The Chair of ADAPT– Alice Edginton-Harvey spoke about the reasons why people wish to work abroad, with the most common themes being: wanting to make a difference, see the world, explore new cultures, meet new people, and gain transferable skills. I will aim to summarise the key areas Alice spoke about below.

Short Term vs Long Term

  • If planning a Short trip to gain experience overseas, consider what it is you can offer to your host. Will you be able to provide meaningful benefit during your time there? Is there a project or goal you can help with? Be realistic about the time frame you have and what you are hoping to achieve, taking into account an acclimatisation period, travel times, or illness whilst there. If planning a short trip, aim for a minimum of 2 weeks.
  • For Longer term trips, finances and funding will often be the main consideration. Begin planning how you will fund the trip, whether self-funded, or through applying for grants to assist with this. Discuss with the organisation you will be working with if there is any scope to support or help set up projects whilst there. Can you fund-raise before or during your time there?

Voluntary vs Paid

  • Working in the development sector often involves voluntary roles. The organisation you are volunteering for may offer to pay for visas or cover travel costs. Occasionally accomodation or meals may also be included, whilst other organisations may even offer a stipend were you will be paid the same as a local salary. It is important to review your personal budget carefully with voluntary roles. Consider travel costs such as outreach visits, can you afford a car and the fuel price of this, or is a bike a better option? If supplying equipment, does it need to be shipped in or is there a cheaper, locally produced alternative?
  • Paid roles abroad are often dependent on levels of experience or the qualifications and skills you have. These may be emergency based roles were accomodation, insurance, and medevac are covered by the organisation you are working for. The UKEMT work alongside the NHS to deploy experienced staff for 2-3 weeks following a disaster or emergency. Aim to have at least 5 years of experience when considering these roles.

Registration
When working abroad, you must ensure you are registered with the appropriate licencing body. In the UK, this is the HCPC. Research the professional body of the country you will be working in, and register with them too. If newly qualified, you must register with the HCPC before working abroad, otherwise you will not be legally allowed to practice.

Take into consideration your levels of experience, are you ready to work abroad yet were you may not have the support you have previously had at home? Would you benefit from completing core rotations to gain valuable skills in clinical reasoning and therefore be able to offer more to your hosts whilst there? Always be honest about the levels of experience you have, and most importantly, work within your scope of practice!

Looking for Jobs
Looking for jobs and volunteer roles overseas can feel like a daunting task, but there are lots of different options available. Research International job boards or professional associations. NGOs will often have their own lists of jobs available. Make use of social media and networking. There is also the option of working with faith based missions such as with mercy ships. If you are already working in a hospital or organisation, do they have any pre-established links you could join with? Researching jobs abroad takes time and patience to find the appropriate role, but the benefits are worth it!

Student Placements
Students completing placements abroad must be supervised by a qualified member of staff. It is important to make this clear when liaising with the organisation you will be working with, and find out who will be responsible for you whilst there. There are large organisations who can arrange placements for you, but these often come with a heavy price attached! If arranging an independent placement, research as much about the organisation before hand, and aim to speak to someone who has already been there to gain first hand experience, and decide if this is the best option for you. As a student, I organised an independent placement to Tanzania for one month. Read more on this here.

Preparation
The final topic Alice spoke about when preparing to work abroad was preparation. Research as much as you can about the country you will be working in, the healthcare structure, beliefs, culture, and common presentations you are likely to see. What language do they speak in the country? Will you have access to an interpreter? Are there other volunteers currently there or have previously worked there you can contact for advice and support? What supervision or support will you have? Consider how your hosts will prepare. Aim to establish goals or aims for your time abroad and make it specific. Ensure you both have the same ideas and understanding of what you will be doing whilst there, and the projects you will be working on.

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Teaching and Training in Less Resourced Settings
Lesley Gillon spoke about her experiences of teaching abroad, and began by explaining that from “Day one, consider what will happen when you leave. The project you work with must be sustainable and continue without you, whether you’re there for 2 weeks or 2 years.”

Lesley’s top tips for teaching abroad were:

  • Be clear and realistic about what topic(s) you want to cover. What time do you have available? Is it best to focus on one area and teach this in-depth rather than trying to cover a wider range of topics in less detail?
  • Consider the teaching methods you use. Be interactive with group work, role play, problem solving, debates, practicals, videos, or handouts.
  • Be patient and prepared. Are there any smaller items of equipment you can bring from home such as slide sheets, handling belts etc and leave there? What local resources are available as an alternative to these, think outside the box!
  • Do not accept poor practice, and don’t be afraid to challenge this in a non-threatening way.
  • Encourage reflection and evaluation to develop practice.
  • Give certificates at the end of your teaching (these always go down well!).

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Working in an Emergency Setting
Working in Emergencies is a topic often mentioned when discussing working abroad. It is a complex area and may involve working in areas of conflict, following a natural disaster, following a disease outbreak, industrial accidents, or with refugee/migrant populations. This work may involve working in areas with little/no infrastructure, or in an unstable climate amongst political unrest. Alice spoke on this topic and shared the knowledge she gained from her experiences of working in emergencies.

  • It is important to have the appropriate skill level before working in Emergencies. The UKEMT specify this as 5 years experience, plus at least 2 years experience of working abroad. Therefore this is less suitable as a first experience of working abroad.
  • Access appropriate clinical and humanitarian training beforehand. The UKEMT offer a pre-deployment course to all members they deploy before working abroad.
  • Understand the complexities of the area you will be working in. Initially you may be clinical to allow local staff to recover, or be with their families. You may be working 18 hour days, assessing 100 patients per day dependent on the scale of the emergency.
  • Gain experience in complex orthopaedic trauma, such as with amputees, external fixator devices and pin site care, blast injuries etc.
  • Often you will be co-ordinating ongoing rehab for patients. Don’t reinvent the wheel, investigate what referral pathways or rehab centres are already in place and make use of them.
  • Prioritise your safety and security. The best way of doing this is by going with an established organisation who know the area you will be working in.
  • Make time for you! You will be working in a high stress environment, therefore make sure you access any psycho-social support available, and don’t feel guilty for having a rest when needed!

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It can often feel like a daunting or impossible task when attempting to pursue working as a therapist abroad, but consider why it is you want to work in this area, and what you are hoping to achieve. I have attended ADAPT study days before, and always found them to be a great motivation and guide for how I can begin working overseas. The study day in Birmingham was no different, and has once again inspired me to continue wanting to pursue this work!

I hope you found this post useful! Feel free to leave me any feedback or email cloverseasclaire@gmail.com.

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