Be-attitudes

• Go with a Christ-like servant attitude – humble and teachable
• Be flexible
• Be quick to listen and slow to speak
• Be patient
• Don't be judgemental and criticise
• Take time to assess the situation and don't try and change things too quickly

Remember that if change is needed then to be effective it will require others seeing the need, agreeing the solution and owning the work necessary to bring it to pass. Sometimes the change needed may be in yourself and especially your attitudes.

Short termers can be a great stimulus and joy to longer-term colleagues who may have very little spare time or energy. Accept leadership and advice from nationals who, although possibly significantly less qualified than you are, will have considerably more local knowledge and experience than you will ever achieve. Remember that you are part of a team.

Seize every opportunity

to continue your medical education. Initiate or attend clinical meetings even if this means undertaking difficult journeys to centres where you can meet other colleagues. Keep accurate personal records of interesting and unusual cases. Teach and train others – an essential part of your work. Look for opportunities to impart your knowledge and skills in an appropriate practical way so that you leave something lasting and
sustainable behind you.

There may be a local medical journal to which you can contribute. Publish case reports, accurate descriptions of diseases and locally relevant management protocols that will be of use to others. You are more likely to make an original contribution to the literature abroad than at home! Talking with specialists in the UK before leaving may be useful in producing ideas for research that you can carry out while abroad.

Keep records and a journal

Note down your initial impressions and take photos of your surroundings early in your stay before everything becomes too familiar. Take photographs of interesting medical cases on camera – they could become useful teaching aids in the future. However, always be
sensitive to local culture and seek advice and permission before taking out your camera.

Ideally, written consent from patients for the taking and then use of medical photographs should be obtained. It is helpful to include the statement that the photo may be used for medical teaching purposes and this might involve including it on a CD or a website if this is a possibility. CMF are interested in appropriate contributions to include on future editions of the Developing Health CD Rom.

See GMC guidelines at www.gmc-uk.org/guidance/current/library/making_audiovisual.asp

Beware of burnout

You are highly likely to be drawn into a variety of non-clinical roles. These may include strategic planning, interviewing potential workers, financial management, writing reports and proposals, planning new buildings, pastoral care of colleagues and Bible teaching. Beware of taking on too much. There is such a thing as 'burnout'. You are not superhuman and you must learn to say 'no'.

Go intending to develop friendships. It may be that more good could come from these relationships than the medical work that you do.