Omar Selim
Introduction
For many medical students, the elective represents one of the few opportunities during medical school to choose not only where they want to work, but also what they want to experience. For me, it was an opportunity to explore two interests: ophthalmology and working abroad.
Australia had long appealed to me as an elective destination, but finding an ophthalmology placement proved less straightforward than I had anticipated. What eventually became five weeks in Perth began several months earlier with university elective catalogues,
conversations with previous students, internet searches and a considerable number of emails. It also very nearly did not happen at all.
The experience ultimately taught me as much about creating opportunities and responding to setbacks as it did about ophthalmology itself.
Finding an ophthalmology elective
I began planning my elective in September of my final year of medical school. My first step was the conventional one. I enquired with my university and explored its catalogue of established elective opportunities. Although this provided a useful starting point, I was unable to find an ophthalmology placement that matched what I was looking for.
I therefore decided to widen my search.
Before studying medicine, I had worked in finance, and I found myself returning to skills that I had developed during my previous career: researching opportunities, networking and being comfortable approaching organisations directly.
I started by making a list of the Australian cities and hospitals in which I would be interested in spending my elective. I also made a list of people I knew who had previously undertaken electives in Australia and contacted them for advice. I searched online for hospitals and ophthalmology departments, identified relevant contact details and began sending direct enquiries.
There were inevitably enquiries that led nowhere, but persistence eventually produced opportunities.
An ophthalmology department in Melbourne responded and explained that I would need to apply through their institution’s formal elective process. I did so and subsequently arranged a placement. Around the same period, I had also received a positive response from a rota co-ordinator in Perth who was willing to accommodate me.
With Melbourne arranged, I believed the difficult part was over.
It wasn’t.
When the plan fell apart
Approximately two months before I was due to begin, I was informed that my Melbourne elective had been cancelled.
After months of planning, the news was extremely disappointing. Flights, accommodation and the practicalities of spending several weeks on the other side of the world require considerable preparation, and two months is not a particularly long time in which to start again.
Then I remembered Perth.
Several months had passed since my original correspondence, but I still had the contact details of the person who had previously offered me an opportunity. I emailed again, explained what had happened and asked whether it might still be possible to arrange a placement.
Fortunately, the department was extremely accommodating. We resumed our correspondence, finalised the elective and organised a clinical rota.
A placement that I had initially regarded as my alternative option had rescued the entire elective.
There was an important lesson in this before I had even set foot in Australia. University elective catalogues and established programmes are valuable resources, but students should not necessarily regard them as the boundaries of what is possible. If you have a particular specialty or destination in mind, politely approaching departments directly and speaking to students who have previously undertaken similar electives can reveal opportunities that are not immediately visible.
Just as importantly, it taught me the value of maintaining contacts and not closing doors prematurely.
Arriving in Perth
I arranged accommodation independently through Airbnb and was able to offset some of the cost through the NHS Bursary Travel and Dual Accommodation Expenses (TDAE) scheme. TDAE provides eligible NHS Bursary students with reimbursement towards excess travel and accommodation costs associated with clinical placements, including eligible overseas placements.(1) For anyone considering an international elective, I would strongly recommend investigating financial support early. The combined costs of travel and accommodation can be substantial, and available funding may make an elective considerably more achievable.
Once in Perth, I entered a clinical environment very different from the relatively limited exposure to ophthalmology that most medical students receive during their undergraduate training.
The ophthalmology department was exceptionally busy, where well over 100 patients could be seen in a day. Despite this workload, I found the department welcoming. Doctors were approachable, comfortable involving me in their working day and willing to explain the clinical reasoning behind what I was seeing.
That combination of volume and accessibility made the placement particularly valuable.
Seeing the breadth of ophthalmology
My timetable allowed me to experience several different aspects of the specialty. I spent time in ophthalmic casualty, uveitis and glaucoma clinics, as well as in theatre, where much of my surgical exposure involved cataract surgery.
Ophthalmic casualty was particularly useful because of the variety and immediacy of presentations. It demonstrated how a symptom that can initially sound relatively simple – a painful eye, visual disturbance or sudden change in vision – requires a structured assessment to identify patients at risk of sight-threatening disease.
The specialist clinics provided a different perspective. The glaucoma clinics demonstrated the importance of longitudinal monitoring, with management incorporating intraocular pressure, optic nerve assessment and serial visual field testing.(2) Uveitis demonstrated the relationship between ophthalmology and systemic medicine and reminded me that the eye cannot always be considered in isolation from the rest of the patient.
Theatre offered yet another side of the specialty.
Observing cataract surgery repeatedly allowed me to appreciate the precision involved in a procedure that, because of its frequency, can easily be underestimated by someone outside ophthalmology. The movements are small, the operating field is confined and the margin for error is correspondingly narrow. At the same time, successful surgery can produce a profound improvement in a patient’s everyday functioning and independence.
Taken together, these experiences demonstrated what had attracted me to ophthalmology in the first place: a specialty combining medicine, examination, imaging, technology and microsurgery within the same career.
A different perspective on ophthalmology training
One of the most valuable parts of travelling abroad was learning not only how ophthalmology was practised in Australia, but also how doctors entered the specialty. Through conversations with doctors in the department, I learnt how competitive ophthalmology training in Australia could be. I was struck by the fact that some doctors spent several years working in non-training ophthalmology posts before obtaining a formal training position. This impression was consistent with the highly selective structure of entry into the RANZCO Vocational Training Program.(3)
As a UK medical student contemplating ophthalmology as a career, this was particularly interesting. It provided a perspective that I would have been unlikely to gain from reading application guidance or comparing training programmes online.
It also highlighted the value of speaking directly to doctors at different stages of their careers. Training structures differ between countries, but concerns about competition, building experience and demonstrating commitment to a specialty are familiar to aspiring ophthalmologists internationally.
Seeing how others had navigated a demanding pathway was both sobering and reassuring. There was no single effortless route into the specialty. Many of the doctors I met had demonstrated considerable persistence before obtaining their training positions.
More than a clinical elective
Looking back, some of the most useful lessons from the elective occurred outside individual clinics and theatres.
The first was the value of being proactive. Had I limited myself to the opportunities initially available through my university catalogue, I may never have undertaken an ophthalmology elective in Australia. The placement existed because I was willing to research departments, contact people I did not know and tolerate the fact that not every enquiry would receive a positive response.
The second was adaptability. When Melbourne was cancelled, my initial reaction was disappointment. In retrospect, however, the setback forced me to reconsider an opportunity that I had previously placed second. Perth ultimately provided exactly the kind of ophthalmology exposure I had been seeking.
Finally, the elective reminded me that skills acquired outside medicine do not necessarily become irrelevant when entering medical school. My previous career in finance might appear far removed from ophthalmology, but the ability to research, network, communicate professionally and pursue opportunities independently proved directly useful in organising the placement.
Advice for students considering a similar elective
For students hoping to arrange an ophthalmology elective abroad, I would suggest starting earlier than you think necessary. Begin with your medical school’s established elective catalogue and speak to the relevant elective team, but do not stop there if the specialty or location you want is unavailable.
Identify hospitals and departments yourself. Speak to students who have previously travelled to the country you are considering. Contact departments politely and be prepared for unanswered emails or unsuccessful enquiries. Keep a record of useful contacts, even after another opportunity appears to have been confirmed.
It is also worth considering the practicalities early. Investigate funding and reimbursement, accommodation, institutional requirements and the administrative processes for visiting medical students well in advance.
Perhaps most importantly, have a contingency plan. An elective arranged months in advance can still disappear unexpectedly.
Mine did.
Conclusion
My elective in Perth began as a backup plan following the cancellation of another placement. It became one of the most valuable experiences of my final year of medical school.
Working within a busy ophthalmology department exposed me to ophthalmic casualty, specialist glaucoma and uveitis clinics and cataract surgery, while conversations with Australian doctors gave me insight into the realities of pursuing ophthalmology training in another healthcare system.
The experience strengthened my interest in ophthalmology, but its most enduring lesson extended beyond the specialty. Opportunities in medicine are not always presented in a catalogue or advertised clearly. Sometimes they have to be sought out, and sometimes the opportunity that initially appears to be the second choice becomes the more memorable one.
My route to Perth involved research, cold emails, an unexpected cancellation and a little persistence. In the end, that uncertainty became part of what made the elective so worthwhile.
References
- NHS Business Services Authority. Travel and Dual Accommodation Expenses (TDAE) [Internet]. Newcastle upon Tyne: NHSBSA; [cited 2026 Sep 10]. Available from: NHS Business Services Authority.
- Royal Australian and New Zealand College of Ophthalmologists. Selection: Vocational Training Program [Internet]. Sydney: RANZCO; [cited 2026 Sep 10].
- National Institute for Health and Care Excellence. Glaucoma: diagnosis and management. NICE guideline NG81 [Internet]. London: NICE; 2017 [updated 2022 Jan 26; cited 2026 Sep 10].