Objectives: To estimate the proportion of students in Australian medical schools who undertake international medical electives (IMEs), particularly in developing countries, and to ascertain which medical schools provide predeparture training and postelective debriefi ng. Design, setting and participants: Extraction of data on the number of students undertaking electives from the Medical Schools Outcomes Database (MSOD) for the years 2006 to 2010; and interviews with the directors of each medical school in Australia in May to July 2012 to ascertain the availability of predeparture training and postelective debriefi ng. Main outcome measures: The proportion of medical students undertaking IMEs overall and within developing countries and the proportion of medical schools with optional and mandatory predeparture training and postelective debriefi ng. Results: Fifty-three per cent of graduate-entry (GE) program students and 35% of high-school entry (HSE) program students undertook IMEs. Fifty-nine per cent of electives undertaken by GE program students were in developing countries, compared with 56% for HSE program students. Predeparture training was off ered by 12 of the 16 Australian medical schools, but it was mandatory in only six. Only eight schools off er postelective debriefi ng. Conclusions: A large proportion of Australian medical students undertake IMEs in developing countries. However, a considerable proportion of students do not undertake formal preparation for, or refl ection on, their experiences. Predeparture training and postelective debriefi ng should be scaled up across Australian medical schools to provide students with the guidance and support to maximise the benefi ts and minimise risks associated with undertaking IMEs in developing countries.