IFMSA-Morocco Pre Departure Exchange Manual - 2021. by IFMSA-Morocco

Pre Departure Manual

Abbreviations

IFMSA NMO LC SCOPE SCORE NEO NORE LEO LORE CP OG IC

International Federation of Medical Students’ Associations National Member Organization Local Committee Standing Committee on Professional Exchange Standing Committee on Research Exchange National Exchange Officer National Officer on Research Exchange Local Exchange Officer Local Officer on Research Exchange Contact Person Outgoing Incoming

PET PDT UAT AF CoD CA CC IL EF ECs

Pre Exchange Training Pre Departure Training Upon Arrival Training Application Form Card of Documents Card of Acceptance Card of Confirmation Invitation Letter Evaluation Form Exchange Conditions

AQ SOGI SP EAs UHC DL

Academic Quality Sexual Orientation and Gender Identity Social Program Educational Activities Universal Health Coverage Deadline

Preface Dear Outgoing, It is with a great pleasure that the Exchange Team worked on this Manual for you. The aim of this document is to complete the PDT in order to prepare you for your exchange. You will find tips on how to do a budget friendly and safe exchange, how to overcome the culture shock, how to prepare for your clinical or research internship, what to pack for your exchange and an introduction to Global Health and Universal Health Coverage. Blue hugs from the Exchange Team.

Table of contents

Finances...5

What to pack...33

Travel Safety, Security, Personal Health and Visa Issues...9

Culture Shock, Intercultural learning and intercultural competency...17

Clinical Internship (SCOPE) Clinical Projects (SCORE)...37

Research Projects (SCORE)...43

Global Health and UHC...47

Finances

Finances Fees paid by the hosting NMO Lodging : Lodging is paid by your hosting NMO.

Boarding :

Take note that your hosting NMO pays for at least one meal per working day. This can be offered as a card to eat at the hospital or an equivalent amount of pocket money. Make sure to ask your CP before your arrival so you can establish your budget before the exchange starts. Here are other tips and tricks to lower your expenses on food. Curb your dining expenses by cooking at home. If you’re looking to embrace the culture of your destination while also saving money on food, some people suggest booking an EatWith experience online, where locals give you an authentic dining experience, offering a meal that’s often cheaper than a restaurant frequented by tourists.

Transport Most countries have transport cards which allow a monthly subscription to use transport at a lower cost. Ask for a student's discount. Make sure to ask your CP directly.

General Establish your budget before your departure. Have an ISIC card if available in your hosting country. Find a credit card that doesn’t charge a foreign transaction fee Don’t waste your money on ATM fees. If you need cash, you’re better off using a debit card that refunds ATM-operator fees and doesn’t charge a foreign exchange transaction fee. But don’t take out too much money at a time. Make sure to ask your bank before your departure.

Finances

Visa and plane tickets Visa : Visa fees are set by the consulate of your host country and are unchangeable. Neither the sending nor the hosting NMO pays for your visa and it is purchased by the exchange student. However, the hosting NMO sends you an IL with your CA in order to join it to your application documents. NOTE : Schedule a visa appointment as soon as possible for a date that is 2 months or less prior to the exchange start (after you get the CA).

Plane tickets : Transportation is neither paid for, nor arranged by IFMSA and it will be your responsibility to arrange it. We recommend that you do not buy any tickets before you have confirmation about the city and the period of your exchange. This confirmation should be received online at the latest 8 weeks prior to your exchange. Due to unforeseen circumstances, your confirmation may be delayed, in which case you should contact your LEO/LORE-Out as soon as possible. This does not automatically mean that your exchange is cancelled. Here are some helpful tips to spend less on your plane tickets : Take a ticket from a low-cost company. Use a flight comparator in airplane or private navigation mode to get the cheapest ticket (Google Flights and Kayak are helpful tools with flexible search parameters, and can send you different price alerts for the destinations you're interested in). Take tickets to secondary airports, book the ticket early enough. Find stopovers (that are suitable for you). NOTE : Don't book your plane tickets before your receive your CA.

Finances

Social Program Ask your CP before your departure if the SP exists or not, if it’s paid by the hosting NMO or by the IC and if any payment must be done before your arrival. If the hosting NMO doesn’t organize any social program and you wish to plan one yourself, then make sure to do so before your departure in order to establish your budget properly, book cheaper train/bus tickets/hotel rooms and to make your calendar much more organized. Do ask your CP to help you with this.

Get Rail Passes : Rail passes (like the Eurail Pass in Europe or the JR Pass in Japan) are a great way to save money when it comes to train travel. If you’re traveling around the region for a while, rail passes will likely be much cheaper than just booking individual trips. If you are booking individual trips, booking ahead of time can usually save you about 50% of the cost of a train ticket. Get City Tourist Cards: If you plan on seeing a lot of sights in a city, you should get a city tourism card. It will offer you discounted and/or free access to the major attractions and museums, as well as free public transportation. Just head to the local tourism office to find out what cards are available. Not every city has them, but most major destinations do and you’ll save a lot of money if you plan on seeing the major sights. If you plan your trips with other incomings, you can split the costs of transportation (if you rent a car) and of lodging (if you squeeze into a small hotel room or rent an entire home on Airbnb if it’s less expensive per person) Book hostel rooms (cheaper than hotels) and preferably the ones that offer free meals, better close to the city center so you won't have to pay for transportation to go sightseeing if possible. Look for dancing/cooking/crafting/language free classes around the city online (or ask your CP)

Travel Safety, Security, Personal Health and Visa Issues

Travel safety You cannot enjoy your exchange if you don't feel safe; so please pay close attention to this part. PS: Tips are included but not limited to.

Transport and Travel Safety

At the airport, watch for your suitcase as it appears on the carousel. Don't hang back and wait for the crowds to disperse - you might find that someone else has already taken your bag in the meantime. Avoid changing money at airports, as thieves could be watching you. Consult with your CP or tourist information center about the public transport in your area. Make sure you know what official taxi cabs look like. A thief may pose as a taxi driver to lure you into their car. Don't share taxis with strangers. Carjacking is a problem in some cities. When driving, keep all doors locked and windows up. Make sure your boot is locked too. Keep your travel plans, including accommodation details, to yourself. Don't hitch hike. Try not to travel at night.

Hotel Safety If possible, choose accommodation that has unmarked 'swipe cards' rather than numbered keys for each room. If you lose your swipe card or if it is stolen, the thief won't know which room to rob. Take note of emergency exits, stairwells, fire escapes and emergency plans, just in case. Always lock your hotel door when retiring for the night. If there is a chain included, use it. When arranging to meet people you've never met before, wait for them in the lobby. Don't ask them to come up to your room.

Travel safety Security Travel Advisory Warnings: check for any travel advisory warnings regarding their desired placement site prior to departure. This can be done by reviewing your destination information provided by the Department of Foreign Affairs of your country. Protecting Key Documents: make copies of your key documents in the event of loss or theft. leave one set of copies with an emergency contact at home and travel with another set of copies, separate from the originals. key documents: passport, visa/travel permit, money (credit cards, traveller cheques), Health Insurance card, Emergency contact, etc. Emergency Preparedness: prepare a list of emergency contacts in their home countries, if you face an emergency, contact your contact person if she/he could not find a solution, the CP will contact the LEO/LORE (The hosting and/or sending NEO/NORE will only be contacted in complicated situations). Avoid 'seedier' areas of the cities you visit, especially at night. Ask your CP for advice on 'safe' versus 'unsafe' local areas. Carry with you at all times the contact details of the Moroccan embassy. If your city doesn't have one, find out which other country's embassy is available to help you. Keep a photocopy of your passport. Keep all important documents in a safe place. Use ATMs during the day, when there are people around. Try to rely more on credit cards and travelers' cheques than cash. If you are mugged, don't fight back. It is better to lose a few dollars and a wristwatch than getting injured. Avoid incidents such as fights, riots, or civil disturbances at all times. Even if you're not sure where you're going, walk like you've got a purpose. Match your dress style to that of the locals. Don't wear an obvious 'tourist' outfit like a loud shirt with a camera slung around your neck. Be discreet when map reading. Notice the people around you. Be wary if someone seems to be taking more than a passing interest. Don't make yourself an attractive target when traveling. Don't wear expensive jewelry on obvious displays.

Travel safety Wear valuables (such as traveller's cheques and credit cards) on a belt worn under the clothes and next to the skin. Consider carrying a 'dummy' wallet holding a small amount of cash. If you are directly confronted by a mugger, you can hand over the dummy wallet and avoid further distress. Beware of scams when travelling. Thieves devise inventive ways to rob you: Posing as a police officer and asking to check your money for counterfeit bills. Posing as a tour guide and offering to show you the sights of the city. Slipping sedative drugs into your food or drink. Thieves in different cities tend to favor different scams. Ask your CP or local tourist information officer for more information.

Protect your data and device Leave your data and/or device at home. Backup your data: in case you lose your data along with your device or some malware corrupted your data during the trip, you can be sure you have a good copy from which you can recover your data. Install and configure encryption software: in the unfortunate scenario where your device is lost or stolen, disk encryption software can help encode your data such that only you and people you authorized can decode and read the encrypted data. Some foreign countries restrict the use of imported encryption software, so please research the software import laws of your destination country. Do NOT leave your device unattended. Do NOT enter your credentials into public computers. Connect only to known wifi networks. Turn off your wifi when not in use. Use VPN Software to establish a secure network connection. Practice safe web browsing. Take note of the credentials you are using during the trip.

Travel safety

Things to remember Research the safety of your intended destination with the Department of Foreign Affairs. Carry with you at all times the contact details of the Moroccan embassy. For up-to-date information on 'safe' and 'unsafe' areas of the city, consult with your CP or local tourist information officer. Try to blend in with the locals and avoid looking or acting like a tourist. If you are mugged, don't fight back. It is better to lose a few dollars and a wristwatch than get injured.

Where to get help? Travel agents Local police Department of Foreign Affairs and Trade Embassies Here is a map of Moroccan embassies abroad.

If needed, you can find the contact information of the moroccan embassy/consulate on the following website.

Travel safety

Personal Health

Understand the prevention and management of common diseases in the region in which you will be working. Visit a travel clinic at least 2-3 months before departure or as soon as possible. It is also important to educate yourself about basic precautions regarding water and food safety, injury prevention, vector-borne illness prevention and HIV exposure. Bring immunization records with you when you travel. Ensure that you have appropriate health insurance for the duration of your exchange (it’s mandatory). First-aid kit/Carry-on medications are optional. Personal Liability insurance If you cause an accident and someone is injured or if you damage someone's property, you are responsible for paying all the costs of the accident. You might, for example, break something in your rented room. Or, on a more serious note, you might cause a road accident. Professional Liability Insurance (e.g. Malpractice insurance / Professional Indemnity insurance) covers claims that arise from a breach of the duty that you owe as a professional or an expert. In the medical field, malpractice insurance is a form of compulsory professional indemnity insurance that protects practitioners from civil claims arising from negligence resulting in physical or mental harm to their patients. Note : Liability and Malpractice insurances can be bought by your hosting LC, bought by the IC before their departure or bought by the incoming after their arrival. Make sure to ask your CP before your departure about these insurances. Further information about personal health : US Centers for Disease Control Travelers’ Health Site – This site has a wide variety of resources on travel health, as well as country-specific information http://wwwnc.cdc.gov/travel/ WHO International Travel and Health Site – Provides information on health risks for travelers - http://www.who.int/ith/en/ IAMAT – The International Association for Medical Assistance to Travelers has a well-organized website with travel health information – http://www.iamat.org

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Travel safety

Visa Issues Entry and Exit requirements (Visa): It is important to check visa requirements for your host country well in advance of departure and to make necessary arrangements. In addition, your passport must be valid for at least six months after your date of arrival. Visa guide: Step 1: To obtain a visa, an Invitation Letter is needed. The invitation letter will be issued by the Hosting NMO. If you face problems with getting the invitation letter from the Exchange platform, make sure to contact your LEO-Out/NEO. Step 2: Check the documents you need (Passport- Passport Photo- Other types of ID - Proof of enrollment and / or letter of support from your university - Proof of membership within your NMO- Bank statements …) Step 3: Collect all your documents Step 4: If a single document is missing you have to repeat step 3 or worst case your visa will be denied.

Travel Safety, Security, Personal Health and Visa Issues

References used

Pre Exchange Booklet

Manual on Visa Issues

Culture Shock, Intercultural Learning and Competency & SOGIEs

Culture Shock "There is wisdom in turning as often as possible from the familiar to the unfamiliar: it keeps the mind nimble, it kills prejudice, and it fosters humor" - George Santayana : The Philosophy of Travel

Culture Shock

What is culture shock ? Simply put, it refers to a whole flurry of emotions that someone experiences when they move to a completely foreign location.These includes the anxiety and feelings (such as surprise, disorientation, uncertainty, and confusion) felt when a person must adapt to a different and unknown cultural or social environment. The cultural iceberg: parts of culture are visible when you first meet someone, such as the way they dress and their behaviors. However, the majority of how culture influences a person is not visible at a first glance, much like the majority of the iceberg - people’s values and customs are also regrouped by their culture. People tend to be unaware of their own values and attitudes until confronted with values and attitudes that differ from their own. With this being said, students affronted with new cultures may develop what is called culture shock. Though the immediate consequences of culture shock appear negative, the process of being immersed in another culture allows for personal development as one comes to understand how perspective and identity are shaped by culture, and that many realities may exist simultaneously.

Culture Shock

Symptoms of Culture Shock Questioning your decision Conflicts with others Hostility and Stereotyping Boredom Unexplained crying depression, or feeling out of control Feelings of loneliness, confusion, irritability, frustration, and helplessness Unstable temperament Paranoia Criticism of local people and cultures Changes in eating and sleeping habits Excessive concern over drinking water, food, or bedding Overreaction to minor difficulties

Cultural Adjustment Imagine that you’re a toddler again, in the process of learning how to navigate your environment. You’re unsure of what to say and how to say it. You’re unsure of how people will react to what you will do. You’re unsure of what people expect from you in terms of etiquette. That’s sort of what it’s like being in a completely new culture - you’re going to be acutely aware of everything you say and do for a little bit, and feel negative emotions when people find you odd because you say or do the wrong thing. But don’t worry, it gets better! Cultural adjustment comes in phases:

Culture Shock

1. The Honeymoon Phase: you will arrive to your destination and be enchanted by the novelty of the fact that everything is “new” and “exotic”. At this point, you may focus more on similarities between your culture and your host country’s culture rather than differences. 2. The Crisis Phase: differences between your culture and the host culture will become more apparent, and you may begin to feel alienated from locals. You may find yourself clinging onto other people from your own culture on exchange with you as a way of coping, but this will only prolong the Crisis Phase. This is the period during which the symptoms of culture shock (irritability, criticism of locals, etc) will be manifested. 3. The Recovery Phase: without realizing, you will begin to form a routine in your new culture as you become more familiar with it. As you become more able to understand and work in your new culture, you will be more and more able to read social cues and successfully navigate your social environment. You will simultaneously become less critical of the local culture and more open to integration. 4. The Adjustment Phase: you will become able to function within the new culture and regain self-esteem by doing so. Since you are now able to participate in the new society more fully, you may feel integrated into the host culture and identify with it. 5. Re-entry Phase: when you arrive back to your home country, it is possible that things will not be as you remember them. It is possible that you go through “reverse culture shock”, in which you have difficulty adjusting back to your home country and your home routine.

Culture Shock

Ways to cope Acknowledge that these impacts exist. Know that the symptoms of culture shock are temporary. Be humble and assume nothing. Learn the rules, body language, and social norms of your host culture. Learn the language of your host culture. Watch TV shows and movies from this culture. Involve yourself in the new culture in some way (take up a class, go out with locals, etc). Develop friendships. Keep contact with people back home. Do something that reminds you of your home country. Avoid idealizing your home country (ethnocentrism). Go out with your Local Exchange Officer (LEO), Local Officer on Research Exchange (LORE) and contact person as much as possible. Participate in the Social Program if one is organized. Email your contact person before your exchange and ask them for advice about your host country before you arrive - do not be afraid to ask them questions, as it is their job to answer you! If you ever have questions or need a cultural perspective, do not be afraid to ask them. Attend the Upon Arrival Training if your host country organizes one.

Culture Shock

It's important to realize that you will need time to get use to your new home, and that this is a normal part of adjustment. The physical and psychological impact varies from a person to another, so pay close attention to your overall wellbeing, particularly in the first few days.

Culture, intercultural learning and intercultural competency

Definitions Culture : can be defined as “the sum of a way of life, including expected behaviour, beliefs, values, language and living practices shared by members of a society. It consists of both explicit and implicit rules through which experience is interpreted”. Geert Hofstede, the most famous researcher in the field, refers to culture as a “programming of the mind”. Intercultural Learning : refers to the acquisition of knowledge and skills that support the ability of learners to both understand culture and interact with people from cultures different from their own. It is developmental in the sense that learners advance through stages of progressively more sophisticated levels of understanding. This understanding includes that of different cultures as well as their own. Specifically, to develop cultural awareness, it is important for a learner to have this sense of cultural self-awareness, which will form the basis for comparisons that are inevitably made by the learner. Intercultural training can be designed to be culture specific by dealing with a single target culture, such as Japanese, or culture general by focusing on universally applicable skills, such as perspective taking and active listening. Intercultural Competency : is the ability to function effectively across cultures, to think and act appropriately, and to communicate and work with people from different cultural backgrounds – at home or abroad. Intercultural competence is a valuable asset in an increasingly globalised world where we are more likely to interact with people from different cultures and countries who have been shaped by different values, beliefs and experiences.

Culture, intercultural learning and intercultural competency

Intercultural Competency Intercultural competence refers to a set of cognitive (thinking), affective (feeling), and behavioral (doing) skills and characteristics that support effective and appropriate interaction in a variety of cultural contexts. The three Keys to Intercultural Competence are:

Curiosity

Empathy

Cognitive Complexity

Exploring what we don’t understand

Understanding and adapting to different cultural styles

Seeing through many perspectives

The components of intercultural competency : Knowledge : Cultural self-awareness: articulating how one’s own culture has shaped one’s identity and world view Culture specific knowledge: analyzing and explaining basic information about other cultures (history, values, politics, economics, communication styles, values, beliefs and practices) Sociolinguistic awareness: acquiring basic local language skills, articulating differences in verbal/ non-verbal communication and adjusting one’s speech to accommodate nationals from other cultures Grasp of global issues and trends: explaining the meaning and implications of globalization and relating local issues to global forces

Attitudes: Respect: seeking out other cultures’ attributes; value cultural diversity; thinking comparatively and without prejudice about cultural differences Openness: suspending criticism of other cultures; investing in collecting ‘evidence’ of cultural difference; being disposed to be proven wrong; Curiosity: seeking out intercultural interactions, viewing difference as a learning opportunity, being aware of one’s own ignorance Discovery: tolerating ambiguity and viewing it as a positive experience; willingness to move beyond one’s comfort zone

Skills: Listening, observing, evaluating: using patience and perseverance to identify and minimize ethnocentrism, seek out cultural clues and meaning Analyzing, interpreting and relating: seeking out linkages, causality and relationships using comparative techniques of analysis Critical thinking: viewing and interpreting the world from other cultures’ point of view and identifying one’s own

Culture, intercultural learning and intercultural competency

Intercultural learning and competency during exchanges : Cultural competency and gender sensitivity are essential to creating an environment of professionalism and respect while on elective. You are encouraged to research the culture of the area you will be visiting prior to departure. It is also essential to recognize that the medical culture in your host country may be radically different from that which you are used to in your home country. Travel guidebooks, novels, nonfiction accounts and online sources may provide a gateway to learning about the country you are visiting. You may also want to contact people with prior experience living/ working in the country of your elective. Key questions to research include: 1. What is/ are the spoken languages? Learn some simple phrases such as “hello” and “thank you”. You may also want to learn some basic medical terms in the local language. 2. What is the history of the country and how does this affect its status today? 3. What is the current political situation? Are there any dangerous areas that you should avoid? 4. Do foreigners have a good/ bad reputation in the area that you will be staying? What are the reasons? 5. What is customary dining etiquette? Greeting etiquette? Etiquette surrounding business? 6. What are the norms of male/female relations? 7. What is the cultural perspective on privacy? Personal space? 8. What is the accepted form of dress? What is appropriate for casual/formal situations? 9. Are there any religious customs that you should be aware of? 10. When are the national, local holidays? What are the significance of these days? 11. Are there special rituals, customs to observe when entering government buildings? Places of worship?

Resources : IFMSA UNESCO PDT Manual Reflections based on ideas from Intercultural Competence What is intercultural competence ? Developing intercultural competence through education Interactive Methods for Teaching about Cultural Differences

Ethics during internship

In order to be a doctor who is able to treat patients with beliefs different from your own, you must be culturally competent, and have sufficient medical knowledge and skills for the activities performed. Being culturally competent means to avoid making assumptions or generalizing, to ask questions and to learn about the individuals within the context of their culture. Your exchange in another country may be your first encounter with people whose approach to health and medicine differs from your own - don’t be afraid to immerse yourself into this new environment and understand health from a new perspective. Hopefully, this experience will allow you to become aware of your own culture and its potential to bias you in your treatment of patients who do not share the same culture as you. You must always keep in mind the impact that socio-cultural determinants have on a patient’s relationship with health, and propose medical interventions that are acceptable to a patient given their cultural background. More than this, you must try to understand health from your patient’s perspective, and try to actively involve them in their healthcare decisions. Exceeding Level of Skill: Do Not Do Things You Wouldn’t Do To Your Grandmother Since medicine is practiced and taught differently across the world, you should not be surprised that the roles and responsibilities of clerks vary between countries. As such, clerks in one country may be expected to perform certain procedures and assess patients alone, while clerks in other countries may only shadow during their rotations. Despite this, it is extremely important that you never perform procedures that you would not be comfortable performing in your host country, even if clerks in that country do and even if your supervisor expects you to do so. Burdens on the Host Country International medical exchanges can be extremely enriching experiences for students and host communities. Nevertheless, the fact that you are a medical student can impose certain burdens on the host country’s medical system.

If you want to learn more about ethics and culture shock during your internship, kindly ask your LORE/LEO Out to organize a session on Ethics within Exchanges in your LC.

Ethics during internship Basic Ethics Basic Ethics: “First, Do No Harm” As a medical practitioner, your first duty towards a patient is to not cause harm. This is especially true as a medical student, when your ability to help can be limited by your lack of experience, and your lack of experience has the potential to make you dangerous to patients. It can often be difficult to make ethical decisions, which is why it is important to have a few principles in mind when considering ethical situations. Autonomy: the patient has the right to make their own decisions, regardless of whether they conflict with the doctor’s own recommendations, personal beliefs, and desire to help. Beneficence: the doctor has the responsibility to act in the best interest of the patient and with good intentions. Non-maleficence: the doctor must not cause harm to the patient. Justice: demands that the burdens and benefits of new treatments be distributed equitably among all groups of society. Free and informed consent: In order for consent to be considered free, it must come from the patient without any coercion or external pressure. In order for consent to be considered informed, the patient must be well aware of the nature of his illness, of the risks of accepting treatment, and the consequences of not accepting treatment. Confidentiality : It is a patient’s confidence in the integrity of their doctor not to reveal what is said in the medical interview that permits him or her to be completely truthful about his situation, without fear of any backlash.

Ressources used for this part : IFMSA and UNESCO PDT

SOGIEs SOGIEs during exchanges Every year, more than 17.000 students from all over the world go on a professional or research exchange, living for one month in a completely different culture with different values and norms.

Education about SOGI and SOGI-related issues is lacking in most medical curricula. This gives way to discrimination and stigma against members of the LGBTQIA+ community even among the medical field. When thinking of SOGI discrepancies across the globe combined with the potential cultural shock of an exchange, education and awareness on the topic of Sexual Orientation and Gender Identity (SOGI) in Exchanges seems a unique opportunity to build a more inclusive future within IFMSA but also in our communities and local environments.

Definitions Gender Identity: One’s internal sense of being male, female, neither of these, both, or another gender(s). Everyone has a gender identity, including you. For transgender people, their sex assigned at birth and their own internal sense of gender identity are not the same. Female, woman, and girl and male, man, and boy are also NOT necessarily linked to each other but are just six common gender identities. Gender Expression/Presentation: The physical manifestation of one’s gender identity through clothing, hairstyle, voice, body shape, etc. Most transgender people seek to make their gender expression (how they look) match their gender identity (who they are), rather than their sex assigned at birth. Sexually Attracted To: Sexual Orientation. It is important to note that sexual and romantic/emotional attraction can be from a variety of factors including but not limited to gender identity, gender expression/ presentation, and sex assigned at birth. Find out more on : Gender Unicorn - TSER LGBT Glossary Sexual Orientation and Gender Identity (SOGI) Terms and Definitions SOGI – The Most Important Terms to Know

SOGIEs SOGI in different cultures & in my NMO Before your departure, do a research on the situation of SOGI in your country and how much it can differ from your destination and in general how many differences exist globally. Look for answers for the following questions : Is homosexuality legal in the hosting country? Are there any laws protecting LGBTQIA+ people? Are transgender individuals recognized by the state based on their gender identity? Are there any legal implications for individuals involved in same-sex relationships? Is it legal to refuse health care to patients based on their sexuality?

Possible problems concerning SOGI in an exchange Gender based stigmatization and Sexual stigma and discrimination. Sexual stigma: is a form of social stigma against people who are perceived to be non-heterosexual because of their beliefs, identities or behaviors. Social stigma : is the disapproval of, or discrimination against, a person based on perceivable social characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to culture, gender, race, intelligence, and health. Homophobia : encompasses a range of negative attitudes and feelings toward homosexuality or people who are identified or perceived as being lesbian, gay, bisexual or transgender (LGBT). It has been defined as contempt, prejudice, aversion, hatred or antipathy, may be based on irrational fear and ignorance. Gender-based violence. Physical violence. Sexual violence. Psychological violence. Economic violence. Violence against individuals who challenge traditional gender norms and expectations. Sexual harassment. → Find out more on Forms of gender-based violence | EIGE

SOGIEs Safe Words & Safe Spaces Safe words : When talking about sexuality, sexual orientation and gender identity, never use vulgar words, but use appropriate terminology instead (example : use homosexual instead of “fag”). Any usage of inappropriate or offending terms may imply the cancellation of your exchange, your deportation and your participation in IFMSA exchange programs and activities.

Safe spaces : a place or environment in which a person or category of people can feel confident that they will not be exposed to discrimination, criticism, harassment, or any other emotional or physical harm. The term safe space refers to places created for individuals who feel marginalized to come together to communicate regarding their experiences with marginalization, most commonly located on university campuses, schools or even workplaces. Even though NMOs and exchange officers always organise activities in safe spaces, it is also the students’ responsibility to create a safe space for each other SOGI-wise and be aware of safe spaces in their host countries.

Consent Consent is a very necessary, but an overlooked, concept of our daily life, and during exchanges where people from different countries meet. To know more about consent, kindly watch the following videos : Tea Consent Understanding Sexual Consent The following require consent: Sharing food with a friend. Helping someone cross the road. Grabbing someone's hand. Hugging someone. Kissing someone. Dancing with someone. Comforting someone who is crying. Having sex with someone you are dating. Having sex with your married partner. Taking someone who is drunk to your room.

SOGIEs

Each individual sets their own boundaries, with which they feel comfortable. They also expect these boundaries to be respected. In addition, they don’t appreciate other people pressuring them to change their boundaries and beliefs. An exchange is already on its own an experience that takes you out of your comfort zone, so you shouldn’t press anyone to their limits, especially about their sexuality.

Ressources used for this part : Educational Activity Toolkit on SEXUAL ORIENTATION AND GENDER IDENTITY IN EXCHANGES If you are interested in knowing more on SOGIEs, kindly ask your LORE/LEO Out to organize an educational activity on SOGIES in your LC.

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What to pack

Mandatory

Upon Arrival Documents stated on the ECs of your hosting NMO

COVID vaccination proof and a negative COVID PCR test done no longer than 72 hours prior to the flight

Malpractice, Liability and Health insurances

Student’s Handbook/AQ Logbook

Student ID

Language Certificate

What to pack

Mandatory

Vaccination card

Some hardcopy pictures

Stethoscope, reflex hammer, scrubs, white coat...

What to pack

Optional

Food for you to eat and for the NFDP

Souvenirs and postcards for your tutors, CP, and LEO/LORE in

A computer if you need it

Traditional clothes to wear at the NFDP

A Moroccan flag

Bedsheets, hairdryer, towels and some utensils, depending on what’s available in your facility (ask your CP)

Clinical Internship (SCOPE) Clinical Projects (SCORE)

The Basics

Review the anatomy, physiology, history taking, clinical examination, investigations, and pathology related to the department’s specialty you’re having an internship in. And better read books in English to improve your medical terminology at the same time. Some of the book series we recommend : Lange Wiley blackwell Oxford Handbook on … Springer

Epidemiology and Health Care System The following are some goals you are expected to achieve by the end of your exchange. Nevertheless, you may do some research and have some background about the Epidemiology, Public Health and Health care system of your hosting NMO before your departure. Know the primary health concerns and basic epidemiology of the host country and how it differs from Morocco. Understand the structure of the health care system in the host country and how it is funded. Have a knowledge of the medical education system in the host country. Observe professional and doctor-patient relationships in the host country and compare them to Morocco. Identify any differences in public health regionally and nationally in the host country.

Clinical Internship (SCOPE) Clinical Projects (SCORE)

Medical terminology in English It is mandatory that you learn the medical terminology in English before your departure because your whole internship is going to be in English! Please find below some practical tips and tricks to learn medical terminology in English efficiently:

MOOCs : Clinical terminology for international and US students

Books on medical terminology: These books help you learn medical terminology in English with exercises while reviewing anatomy, histology, physiology, history taking, physical examination, pathology, investigations and treatment. If you don’t have enough time to read the whole books, we suggest that you read at least the part of the body system related to your internship. Some of the books we recommend : A Short Course in Medical Terminology by Judi L. Nath, Kelsey P. Lindsley An Introduction to Medical Terminology for Health Care_ A Self-Teaching Package Medical Language Terminology in Context by Hull M. Medical Terminology An Illustrated Guide (7th edition) by Barbara Janson Cohen, Ann DePetris Medical Terminology A Short Course by Davi-Ellen Chabner Medical Terminology for Health Professions Medical Terminology Systems A Body Systems Approach by Barbara A. Gylys, MEd, CMA-A (AAMA) Stanfields essential medical terminology by Nanna Cross Dana C. McWay Peggy Stanfield

Note: for each book, check other materials (audios for listening, the solutions to the exercises…) that might be available on the web for free.

Clinical Internship (SCOPE) Clinical Projects (SCORE) Clinical Cases: Clinical cases of the body system related to your internship. This will help you learn terminology while developing your clinical sense Some of the book series we recommend : 100 Cases in ... Case files ... Clinical cases in … Clinical cases uncovered in .... Core clinical cases in … Oxford case histories in …

The books are available for free on the following websites : Z library PDF drive

Simulation games: Simulation games on Android/IOS (just type medical simulation or clinical cases on the search engine and you’ll get a bunch of them). Some of these games : Operate now Prognosis UBC Radiology EM Cases Summaries Short cases in Medicine

Note: there are a lot of games and apps that can help you but please be wary all of these are to be taken with a pinch of salt (regarding the accuracy of the medical content).

Medical series/shows and content creators: Watching medical series/shows and content creators will help you learn the medical jargon spoken in daily life at hospitals and the correct pronunciation of the words. Some of the medical series we recommend : The good doctor Doctor House Scrubs ER

Some of the content creators we recommend : Doctor Mike Nurse Blake

Clinical Internship (SCOPE) Clinical Projects (SCORE)

Medical words in the hosting NMO's official language In addition to the terminology in English, we highly suggest that you learn the following words in the official language of your hosting country : Hospital, Doctor, Patient, Nurse, Department, The name of the project domain/the department, ER, OR, Pain (and other symptoms related to your internship), Medicine...

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Research Projects

The Basics Start with the basics, learn about basic principles in medical research, research methods and study designs, scientific papers, by attending our set of training. We also recommend the following MOOCs if you want to have more information on the subject:

Understanding Medical Research: Your Facebook Friend is Wrong Understanding Clinical Research: Behind the statistics Design and interpretation of clinical trials Study Designs in Epidemiology Validity and Bias in Epidemiology Epidemiology for Public Health Measuring Disease in Epidemiology Introduction to systematic review and meta-analysis Introduction to Statistics & Data Analysis in Public Health Improving Healthcare Through Clinical Research Critical Appraisal Techniques for Healthcare Literature People Studying People: Research Ethics in Society Thinking Critically: Interpreting Randomized Clinical Trials Thinking Critically Series: Interpreting Screening Trials

To know more about basic principles of medical research, research methods and study designs, the critical appraisal of a scientific paper and research ethics, kindly ask your LORE to facilitate a training in your LC before your departure.

And readings : Vickers AJ. Basic introduction to research: how not to do research. J Soc Integr Oncol. 2008;6(2):82-85. Munnangi S, Boktor SW. Epidemiology Of Study Design. 2020 May 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 29262004. Röhrig B, du Prel JB, Wachtlin D, Blettner M. Types of study in medical research: part 3 of a series on evaluation of scientific publications. Dtsch Arztebl Int. 2009;106(15):262-268. doi:10.3238/arztebl.2009.0262 Peh WC, Ng KH. Basic structure and types of scientific papers. Singapore Med J. 2008 Jul;49(7):522-5. PMID: 18695858. Masic I, Miokovic M, Muhamedagic B. Evidence based medicine - new approaches and challenges. Acta Inform Med. 2008;16(4):219-225. doi:10.5455/aim.2008.16.219-225 Schlegl E, Ducournau P, Ruof J. Different Weights of the Evidence-Based Medicine Triad in Regulatory, Health Technology Assessment, and Clinical Decision Making. Pharmaceut Med. 2017;31(4):213-216. doi:10.1007/s40290-017-0197-3 11.Ali Z, Bhaskar SB. Basic statistical tools in research and data analysis [published correction appears in Indian J Anaesth. 2016 Oct;790:) 10(60]. Indian J Anaesth. 669-662:)9(60;2016.

Research Projects

Outcomes Your tutor might require that you hand in a specific outcome at the end of your exchange to assess your whole work. You may use these pre-made templates.

Background Have a solid background: Read the articles your tutor recommended on the project form, and do a bibliographic search about the same topic of the project you were accepted in.

Research Skills Learn the basic skills: bibliographic search, scientific writing, SPSS, set-up/design of a scientific study, methodology, hypothesis set-up, biostatistics, critical appraisal of scientific papers by reading books, attending workshops/classes or MOOCs.

Lab Skills If your project includes lab work, then you need to have a minimum of knowledge and experience about the materials and methods the project uses because you will be using them almost all the time during your exchange: PCR, pipetting, electrophoresis, etc. It would be perfect if you manage to attend workshops or ask laboratories in your faculty to learn these skills. But since we know it is not very accessible for everyone to do so, we recommend that you at least learn about these methods by reading and watching videos to know what they're about.

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Global Health & UHC

Global Health Introduction Global health is an area of increasing interest for educators and students of medicine since health is a broad concept; it is not simply a biological phenomenon but is also influenced by various social, economic and political determinants. Diseases have no boundaries, therefore the propagation of new infectious diseases is becoming more and more common as most humans now live in constant contact within large, dense and globalized populations.

Nevertheless, public health is directly connected to the economic and social growth of a country. That is why medical students who have studied this area are better at understanding the root causes of illnesses and clarifying their vision for working and serving globally.

Definitions Health : “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” - OMS (1948) ; Epidemiology : a branch of medical science that helps identify risk factors and causes of health problems ; Public Health : all of the measures taken in order to protect and improve the health of people within a specific community or region ; International Health : “the application of the principles of public health to problems and challenges that affect low and middle-income countries and to the complex array of global and local forces that influence them” - Merson et al. Therefore it’s more focused on helping countries other that one’s own ; Global Health : “an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide” Koplan et al. & “‘those health issues that transcend national boundaries and governments and call for actions on the global forces that determine the health of people” - Kickbush Health issues that go beyond national borders and require a collective action.

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Global Health

Global Health within exchanges There are some main learning objectives that IFMSA has settled in the exchange program regarding Global Health Education : 1. To know the primary health concerns and basic epidemiology of the host country and how it differs from the home country. 2. To understand the structure of the health care system in the host country and how it is funded. 3. To have a knowledge of the medical education system in the host country. 4. To observe professional and doctor-patient relationships in the host country and compare them to the home country. 5. To identify any differences in public health regionally and nationally in the host country. Exchanges are a great opportunity to become more aware of the importance of global health as students get to experience different approaches in medical research, education and treatment in other countries. With proper preparation, the student can get the most out of their exchange : Before the exchange : the student should be able to define Global Health, along with its different components and health systems around the world, especially the country you’re planning to visit. It is also important to learn about different cultures and traditions of the hosting NMO. During the exchange : the Upon Arrival Training (UAT), organized by the hosting NMO, is a great way to get in touch with other incomings IC. At this point, students can share their experiences within hospitals and discuss different healthcare systems within their sending countries. Furthermore, during this experience, the IC should learn about how the healthcare system works in the hosting country and about their different health inequities. After the exchange : the students should share their experience within their local committee and think about how to apply global health into different projects.

Resources : Global Health within Exchange Guidebook.

Universal Health Coverage (UHC)

Introduction Universal Health Coverage (UHC) means "all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship."

UHC is firmly based on the WHO constitution of 1948 declaring health as a fundamental human right and on the Health for All agenda set by the Alma Ata declaration in 1978. UHC cuts across all of the health-related Sustainable Development Goals (SDGs) yet over 800 million people (almost 12% of the world’s population) spent at least 10% of their household budgets to pay for health care.

What is a health system? The World Health Organization defines health systems as follows: "A health system consists of all organizations, people and actions whose primary intent is to promote, restore or maintain health." This includes efforts that have a direct impact on health improvements (e.g. a mother taking care of her sick child at home) to influencing determinants of health (e.g. insurance and safety legislation).

Universal Health Coverage (UHC) There are four main types of different healthcare systems: 1. The Beveridge Model : This is where the government is responsible for financing and providing health care through taxes. Examples of this include the National Health Service (NHS) in the UK. 2. The Bismarck Model : This system is financed by funds paid partly by employers and partly by employees through a payroll deduction using mainly private hospitals and private working doctors. It uses private insurance agencies, also known as “sickness funds”, and are run as non-profits. This model can be found in France. 3. The National Health Insurance Model : This system combines aspects of both Beveridge and Bismarck, with healthcare primarily paid through higher taxation. An example of this can be found in Japan. 4. The Out-Of-Pocket Model : This system is essentially market-driven, in which individuals are either covered by their employers or themselves or they go without coverage at all like India. This system can be found in places with too few resources to set

up mass medical care.

Resources : Universal Health Coverage Simulation Manual - IFMSA 2019

To know more about UHC and health care systems, kindly ask your LEO/LORE Out to facilitate a UHC simulation in your LC before your departure.

To know more about Global Health, kindly ask your LEO/LORE Out to facilitate a training in your LC before your departure.

Remember!!!

Make sure to contact your CP before your departure, as soon as you get your CA, and to ask them about :

Pick Up/Drop off

Transportation from accommodation to hospital / laboratory

Dress Code at the hospital/lab

1st day of internship/UAT Outcomes/EAs

Boarding

Social Program

Telecommunication

Survival Book

Upon Arrival Documents and Insurances

Equipment and utensils available with the accommodation

Cultural Norms/Laws/Fines Facility rules

COVID-19 and the pandemic restrictions

Remember!!! To do list Before your exchange starts I have attended the PET and the PDT. I have read the ECs of my hosting NMO. I have read the Pre Departure Manual. I have received my CA 8 weeks before the start of my Exchange. I have contacted my CP right after I received my CA and asked them the questions mentioned above. I have booked my transportation tickets after I received my CA. I have gotten my visa if required by the hosting country. I have gotten the approval of the deanship if I'm replacing my internship in Morocco with a SCOPE/SCORE Exchange. I have established my budget. I have sent my CC 4 weeks before the start of my Exchange.

I have learnt about the cultural norms of my hosting country. I have learnt about the health care system and public health in my hosting country. I have learnt medical and/or research terminology in Englich. I have gotten my Health, Liability and Malpractice insurances covered for my exchange. I have packed the upon arrival documents (hard copies, original, in English or in the official language of your hosting country) and all other mandatory items.

During your Exchange I have attended the UAT. I have met my tutor during the first day of my intership, and asked them about my tasks, entry and exit times, legal limitations and the outcome of my Exchange. I have filled in my Sutdent's handbook/AQ logbook. I have attended EAs if offered by my hosting NMO/LC. I have attended all the activities of the SP organized by my hosting NMO/LC. I have prepared the outcome of my exchange. I have filled in the EF. I have received my certificate.

After your Exchange I have presented my certificate to my LORE/LEO Out. I have shared my experience with other students who are interested in applying for an exchange in the same country.

We would like to thank Achraf Sbai, IFMSA-Morocco's NTSDD for his contribution to the design and layout of this document, and Mouad Maskini, a SCORE member for his syntax review.

Contributors

Sanae Majdouli

Zineb El Yarmani

Mehdi Megdiche

Sarra El Kaddouri

LEO Out - AEMM

AQ Assist - FeMSA

Souhail Ouardouz

Wissal El Ouahidi

LORE - FeMSA

LEO In - AEMM

LEO Out - FeMSA

LORE - Medec'IN-Casa