Practising beyond one’s scope while working abroad

This article in The Lancet Global Health addresses the large numbers of health-care professionals and trainees from high-income countries traveling to low-income and middle-income countries as participants in short-term experiences in global health (STEGHs), which last from a week to several months. STEGHs encompass various types of clinical and non-clinical professional activity and raise many ethical issues, the management of which is key to successful programmes.

A particular ethical concern arises when participants are asked to practise outside their scope of training. Although health professionals and trainees might exceed their scope of training in their day-to-day work at home, low familiarity with clinical, cultural, and health-care system contexts, as well as emergencies, perceived deficiency of available resources, or time constraints, could make practising outside scope more likely in STEGHs. Despite ethical practice guidelines recommending against practising outside scope, anecdotal evidence indicates that it continues.


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