Fast-Track Your Integration: How to optimise your internship experience abroad 

For younger generations born after 1990, mobility and flexibility, in both professional and personal settings, have become core values. Personal development, among other social and personal motivations, has surpassed financial incentives as the primary motivation behind mobility¹. Furthermore, relaxed regulations and widespread recognition of medical degrees across Europe, coupled with increased financial support for international exchange programmes such as Erasmus, have resulted in a significant increase in interest of medical students and medical professionals in international exchange initiatives². 

Although evidence is still sparse, studies consistently show that, whilst a large proportion of trainees show interest in taking part, only a small proportion of them actually go on to participate in international exchange initiatives. A study led by Dr Dow on behalf of the Trainees Committee of the ESAIC reported that only 12.5% of interviewed trainees had engaged in international exchange programs^3,4. Among respondents, more than 67% viewed these exchanges both as an opportunity to develop clinical skills in renowned hospitals and as a chance to experience a different culture. However, the main barrier remains the associated costs, despite an increase in the number of financial support scholarships and funded programmes currently available³. 

At the same time, a growing number of anaesthesia trainees are keen to undertake placements in low- and middle-income countries, which can offer both professional development and personal fulfilment.^5,6

Regardless of where one goes to gain new knowledge and skills, there are always ways to ensure a smooth transition, quicker integration into a new healthcare system and culture and improve the overall internship experience. After all, showing up is just the first step, but proactivity is key to successfully integrating into a new professional setting. 

1. Do Your Homework 
Before your first day, spend some time learning about the institution, its mission and values, the team you’ll be joining, and the expectations of your role. Reviewing procedural documents, organisational culture guides, or pre-onboarding materials can reduce uncertainty and boost confidence, allowing you to hit the ground running from day one. 

2. Start by finding a mentor or buddying up. Identify and connect with a mentor, supervisor, or peer “buddy” as soon as possible. Formal mentoring and buddy systems are proven techniques that help newcomers build social networks, avoid personal and professional “faux pas” by shedding light on unwritten norms, and accelerate cultural and systems integration. Mentorship contributes positively to satisfaction and professional growth during internships. 

3. Start by Observing Team Dynamics 
Observation is a key integration strategy. Newly onboarded professionals should spend the first days understanding unwritten expectations, communication styles, and team hierarchies⁷. Observing how colleagues interact, make decisions, and respond to challenges helps you align your behaviour with prevailing expectations and build credibility more quickly. 

4. Set Clear and Realistic Expectations 
From the outset, establish a shared understanding of your role, deliverables, and learning objectives with your supervisor. Clear expectations not only reduce ambiguity but also improve engagement and performance outcomes. Co-creating measurable goals and checkpoints helps both parties stay aligned and fosters a structured learning process.

5. Demonstrate Positive Willingness and Proactivity 
Show enthusiasm for learning and contributing, but balance initiative with responsiveness to team norms. Proactive newcomers who seek information, ask thoughtful questions, and engage respectfully with colleagues tend to integrate more successfully and are perceived as motivated and adaptable members of the organisation.⁸ 

We hope these tips allow you to fully maximise your internship experience, but first and foremost, remember to enjoy the experience and make the most out of this unique opportunity to learn, network, and discover a whole new country and culture! And once the internship is over, sharing your experience locally may just lead to more trainees making the decision to participate themselves in an exchange, so don’t forget to take the opportunity to become a champion and advocate so others can benefit from these experiences. A worldly workforce leads to increased international cooperation, knowledge sharing and ultimately improved patient care, which is always the pivotal goal of good anaesthesia practice. 

Author

• Iulia Crisan, Chairperson of ESAIC Trainees Committee, Intensive Care Trainee, Institut for intensive medicine, University hospital of Zürich, Switzerland 

Co-Author 

• Ana Sofia Da Costa Rosas, Member of ESAIC Trainees Committee, Anesthesia Trainee, Wishaw General Hospital, UK 

Reference

1. Butler, S. (2025). Generational differences: Motivations and values of younger and older workers. Strategic HR Review, 24(5), 210–214. 
2. Leijen, I., et al. (2022). Individual and generational value change in an adult population: A 12-year longitudinal panel study. Scientific Reports, 12, 17844. https://doi.org/10.1038/s41598-022-17844 
3. Dow, O., et al. (2024). Challenges in professional development of anaesthesiology trainees: A cross-sectional survey by the European Society of Anaesthesiology and Intensive Care Trainee Committee. European Journal of Anaesthesiology and Intensive Care, 3(5), e0062. 
4. Gauthier Willemse, J., Raymenants, J., Clement, C., & Herijgers, P. (2021). Surgical residents’ opinions on international surgical residency in Flanders, Belgium. International Health, 13(5). 
5. Pieczynski, L. M., et al. (2013). Analysis of field reports from anaesthesia volunteers in low- to middle-income countries. Medical Education, 47(10), 1029–1036. 
6. Dohlman, L., et al. (2019). The impact of an international elective on anesthesiology residents as assessed by a longitudinal study. Journal of Medical Education and Curricular Development, 6, 2382120519873940. 
7. Bandura, A. (2004). Observational learning. In J. H. Byrne (Ed.), Learning and memory (2nd ed., pp. 482–484). Macmillan Reference USA. 
8. Bauer, T. N., Perrot, S., Liden, R. C., & Erdogan, B. (2019). Understanding the consequences of newcomer proactive behaviors: The moderating contextual role of servant leadership. Journal of Vocational Behavior, 112, 356–368.