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Clerkships are based on BILATERAL and UNILATERAL agreements of National Member organizations.
- Bilateral contract: Two students are exchanged, but not necessarily at the same time or in the same university. The student going on exchange pays the bilateral fees to his own student organization, who then uses that money to accept the student from the other country free of charge and vice-versa, to make sure students are not limited by their financial resources to have international exchange opportunities all around the world. Bilateral exchanges are the basis of the IFMSA exchange Programme.
- Unilateral contract: an NMO sends or hosts a student without a form of reciprocity from the other NMO. Student should pay all expenses to the host organization.