Over a two-year period, eight medical students from four U21 universities spent their electives at hospitals in Pakistan, Papua New Guinea and Sri Lanka. They made a total of 49 e-referrals which resulted in 67 queries in a wide range of specialties. The median response time was 20h (interquartile range 5-85). Follow-up data were obtained in 14 of the 30 cases from one hospital (47%). The major categories of the 67 queries were internal medicine, paediatrics and surgery, and in very similar proportions to the 785 queries managed by the Swinfen Charitable Trust over the same period. The presence of a medical student facilitated e-referrals by relieving the pressure on the local doctor to undertake the necessary clerical and technical work. The students reported a rewarding elective experience which appears to have the potential to increase the ease with which heavily burdened medical staff in developing countries can make use of e-referrals.