Many physicians (including me) have found satisfaction in providing care to people who live in countries with extremely limited resource.  The ability to care for those who were born in low-income countries is one of the most impactful things a doctor may do in an entire career.  There is no better way to get to know the amazing people who live in these locations that to work with them side by side and help them with their needs and the needs of their children.  The experience is personal and fulfilling in a way that normal tourism travel can never replicate.  My life has been forever changed by these experiences and I have formed lifetime friendships with people I have met in these locations.  I would want every physician to have this type of fulfilling and impactful experience. That being said, there are many potential pitfalls and there are some unscrupulous organizations and dishonest people that have made a bad name for international medical trips in some areas. One poor experience can ruin the relationship of trust that has been forged with vulnerable communities throughout the world. If you decide to pursue a medical service trip, I would want you to have a beautiful and fulfilling experience, similar to what I have been able to experience. Here are five important considerations for any physician considering the donation of time or resources to international medical service.

1. International service trips are expensive– In the trips I have planned most participants can expect to pay around $4000 – $6000 for the experience. This includes airfare, lodging, medications, hiring local medical professionals in the country of service, and usually includes a safari or other excursion to finalize the event. In some instances, the money would have been better spent as a donation rather than a trip.  I can see the point of this argument, but in my experience making the trip and being on site in these unique locations brings a level of connection that leads to long term funding relationships and advocacy. Also, most organizations need volunteers and they desire to serve alongside international partners in the work they are doing.
2. The organization MUST have a frequent or continual presence in the communities being served.   Long gone are the days of dufflebag medical service trips with no continuity and no follow up. Successful organizations have deep long-lasting partnerships with community leaders and local medical professionals who reside in the country where service is being rendered.  There are too many layers of bureaucracy and potential theft to allow funds to be transferred through government organizations in these countries. It is much better to directly interface with the people who live and work in the communities being served and work with non-profit organizations that have transparent finances.
3. International service organizations usually will not have money for expensive ad campaigns.  Outside of a few highly organized and reputable organizations such as Doctors Without Borders, most legitimate service organizations require all available resources to provide care for those they are serving.  In other words, you are much more likely to come across legitimate organizations through your peer network, church, or medical school.  It is far less likely that organizations with a large social media presence or direct to consumer email or telephone marketing campaigns are using resources efficiently to provide patient care.  Instead, many of these “charitable” organizations are financially supporting a list of investors or board of directors.
4. International service trips are (usually) not tax deductible. There are so many different circumstances, and this is a question you should definitely ask to your tax professional. However, most of the time the IRS would see a service trip simply as a trip you took. You made the journey, derived personal satisfaction from the experiences, and returned home to your regular life – just like if you went on an interesting European vacation.  The exception to this is the items or money you specifically donated for the trip. For example, in the trips I have helped organize we have given volunteers an itemized trip receipt including the medications and supplies purchased for the trip. That portion is tax deductible because it was donated to a 501c3 registered charitable organization. Similarly, if you choose to donate to a registered charitable organization the funds donated would be tax deductible, just like any other charitable given you may choose to do.
5. You can’t practice outside the scope of your training.  This seems like common sense, but there are plenty of stories of doctors or other health professionals doing this.  Perhaps it is from a need to feel wanted and important or from some other self-indulgent psychological need, but no matter what the motivation it is wrong. Performing surgeries or other procedures outside of your scope of training or administer medications without proper knowledge is a form of abuse and potentially leaves very vulnerable people with permanent injuries. This behavior can completely ruin the trust granted by communities and governments.  Because of these abuses, most countries now require an Apostille from the secretary of your home state, indicating that your license is certified in a manner that is recognized by other governments. The best way to provide medical care in these settings is to work in your area of specialty alongside health professionals from these countries. This is professionally satisfying to both you and the local professional. I have gained significantly in both medical knowledge and contextual understanding by working alongside healthcare professionals in multiple countries.

If you haven’t done so already, I hope you will have the opportunity participate in an international medical service experience some time in your life.   When done properly, these trips can be mutually beneficial for both you and the community being served.  The best way to avoid trouble is to follow the advice listed above and remember that you are simply there to serve and try to help another human being born at in a different location and different circumstance that you have experienced.  As a physician you are uniquely blessed with a skill set and an education base that can be of great benefit to humanity, no matter where you are.

What do you think of international medical service?  What advice would you offer to another physician who may be interested in doing this?  Please leave responses in the comments.