International experiences are increasingly popular among medical students, but few have been rigorously evaluated. We used ESM to characterize the experience of medical students participating in the one-month University of Chicago Geographic Medicine Scholars Program (GMSP) in Hyderabad, India. Participants wore watches programmed to randomly beep eight times daily, during the first and third weeks. When alerted, students reported their activity and rated their level of engagement and emotion in booklets. All 11 student participants responded to 59% of 816 alerts. 41% of beeps occurred during GMSP formal structured activities (i.e., lecture, clinic). Students reported structured activities to be more interesting (6.05 versus 4.14; P 0.001 ), more important to their future goals (6.48 versus 5.71; P 0.001 ), more challenging (3.75 versus 2.48; P 0.001 ), and more enjoyable (6.08 versus 5.36; P 0.001 ) than unstructured activities. Our results show that future global health efforts should augment the use of structured activities.