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worth taking time to consider.Life is life and just because it is lost more often in a certain country does not make it any less precious, or the degree of loss felt by the remaining family, any less potent. Asking whether through inexperience you may contribute to that loss of life is a question worth asking and I acknowledge, a very troubling one to consider.If you were to return to work in the developing world then I would suggest you had at least 6 12 months experience in both paediatrics and obstetrics because this is the bulk of the workload on call, even if your job is only technically meant to be in general medicine. The diploma in tropical medicine from Liverpool/London would also be extremely useful. You probably already know these things, and maybe you already done them but if not it would be great a great idea for you as it is just horrible to feel out of your depth and although there no way of guaranteeing you always make the diagnosis, or commence the correct treatment, these placements would give you a good framework.Whilst working in this position allows you to use all the skills you currently possess, and bring in skills from the UK, what will remain when you leave? Is there a programme of education for the Guatamalean staff? Does your working in this position as a foreign national allow the government to continue to not pay, or not provide conditions in which it own doctors are encouraged to remain in Guatemala, or work in the hospital system?I not suggesting I have the answers to these questions but I do believe they are worth considering, as reflecting upon them