• training
• overseas

As our small plane approached Kismayu airport, Somalia, my more experienced colleague lent forward to the pilot and said “if they start shooting at us, turn back.” They didn't but, when we landed, the plane was quickly surrounded by angry looking, young Somalis bearing Kalashnikovs. It was then I realised that Casualty at Moorfields wasn't so bad after all. A shouting match developed between their leader and the Médecins Sans Frontiéres escort sent to meet us, in Somali—unfortunately my Somali is not all it should be. The shouting got louder and louder and I got tenser and tenser, until suddenly huge smiles broke out and the leader thumped my colleague on the back: “Don't worry he said” grinning “Shouting is part of our culture.”

That trip was part of a three month placement in the eye unit of the Christoffel Blindenmission (CBM) supported Presbyterian church hospital at Kikuyu, Nairobi, in Kenya, which I undertook during my second year of specialist registrar (SpR) training. Later I spent a further two years (out of SpR training) doing a research fellowship based at the International Centre for Eye Health (ICEH) and sponsored by Sight Savers International, which involved living and working in the Gambia, west Africa, for 18 months, conducting operational research on trachoma control. I became involved with these projects because I have an interest in working in developing countries in the longer term, but even for trainees who intend to concentrate their career in the United Kingdom there are definite benefits available from spending some period of their training abroad.

In 1995, the NHS executive wrote to trusts and health authorities alerting them to the opportunities of overseas experience for NHS staff.¹ The royal colleges seem to be in general agreement …