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Background: An integral part of the training for many UK medical undergraduates involves a period of elective study abroad. There is concern about the health risks this poses to the students, and uncertainty regarding the responsibility this places on medical schools.

Methods: Annually since 1992, medical undergraduates at Glasgow University have been asked to complete and return a confidential questionnaire on return from their elective studies. This records personal demographic details, the countries visited, and information about illnesses experienced. Analyses were conducted on the students' health experiences, lifestyle, the health precautions taken, and the climates experienced.

Results: Global statistics were compiled on 750 respondents. A subset of 267 completed a more extensive, post-1996, questionnaire enabling detailed study of comparative illness rates. A majority took pretravel health advice, visited only one country, stayed for 1 to 2 months, and experienced a tropical climate. Forty-five percent reported symptoms of illness, and alimentary symptoms predominated (77% of those ill). Higher illness rates were reported in those who experienced a hot desert or tropical climate compared with those who did not. There was correlation between taking professional pretravel health advice and exposure to a more hazardous climate.

Conclusions: The attack rate for medical students on electives compares favorably to that for package holidaymakers; similarly the attack rate for students staying in the tropics compared with other travelers. A preexisting health problem did not predispose to a higher attack rate. Attack rates can be minimized by avoiding climatically extreme locations. This surveillance provides a focus of interest to the students, insight on minimizing avoidable health problems, evidences social responsibility by the Medical Faculty, and has the potential for expansion to other medical schools. Current Scottish medical school policies on HIV risk management would be strengthened by a more coordinated approach.