More than 2 million people each day move across international borders as a consequence of increases in international travel, trade and immigration. Medical electives are an important and expected part of the medical curriculum in many medical schools and many students travel abroad to do their electives. This part of the course has not been subjected to the rigorous analysis of learning processes and expected outcomes that have been matters of course for other components of the medical curriculum. This paper explores issues around the elective period in the UK describing the current status of medical electives in medical schools and presenting the experience of an innovative programme in which a 4-week module on International Health was linked with the elective period. The paper describes how it is possible to incorporate into the medical curriculum a preparatory module for students planning to take an overseas elective, with potential positive outcomes. © 2004 Elsevier Ltd. All rights reserved.