Drug Screening Requirements

All residents and fellows participating in UNR Med-sponsored training programs are considered members of the clinical workforce and are subject to institutional (University of Nevada, Reno/UNR Med), hospital, and affiliated training site drug and alcohol screening requirements as a condition of appointment, credentialing, clinical participation, and continued training.

Pre-Employment/Initial Drug Screening

Residents and fellows are required to complete all pre-employment and credentialing drug screening requirements prior to the start of training and/or prior to receiving clinical privileges or credentialing approval at participating training sites.

Failure to complete required pre-employment screening may result in:

• Delay in onboarding or credentialing
• Delay in clinical participation
• Withdrawal of institutional appointment or training offer for failure to meet conditions of employment

A positive drug screen for prohibited substances without appropriate medical documentation or lawful prescription disclosure may result in:

• Removal from clinical duties
• Delay or denial of credentialing
• Referral for assessment or treatment
• Academic or disciplinary action under institutional policies, up to and including dismissal
• Withdrawal of appointment or contract offer when applicable

Marijuana/Cannabis Use

Residents and fellows should be aware that:

• State legalization of marijuana does not exempt residents/fellows from employer, hospital, federal, or training site drug screening requirements
• Participating hospitals and training sites may continue to prohibit marijuana use regardless of state law
• A positive marijuana test may still be considered a positive drug screen under institutional or clinical site policies

Residents and fellows are responsible for understanding that:

• Federal regulations
• Hospital credentialing standards
• DEA registration requirements
• Patient safety obligations

may supersede state legalization laws.

Prescription Medications

Residents and fellows using prescribed medications that may affect drug screening results should:

• Maintain appropriate documentation
• Follow occupational health or testing vendor instructions
• Disclose medications when required during the testing process

Failure to appropriately disclose prescribed medications may delay the verification process. Inability to provide proof of prescription medications relevant to a positive screening result may result in:

• Removal from clinical duties
• Delay or denial of credentialing
• Referral for assessment or treatment
• Academic or disciplinary action under institutional policies, up to and including dismissal
• Withdrawal of appointment or contract offer when applicable

Rotations at Affiliated Clinical Sites

Residents and fellows rotate through multiple hospitals and clinical training environments, each of which may maintain independent:

• Drug and alcohol screening policies
• Occupational health requirements
• Random testing policies
• Reasonable suspicion or for cause testing policies
• Credentialing standards

Residents and fellows throughout training may therefore be required to complete:

• Additional drug or alcohol screening
• Random drug or alcohol screening
• Site-specific occupational health clearance
• Repeat screening prior to rotations

Failure to comply with affiliated site requirements may result in:

• Inability to rotate at the site
• Suspension from clinical duties
• Delayed progression in training
• Academic or disciplinary action under institutional policies, up to and including dismissal

Reasonable Suspicion Drug or Alcohol Screening

Residents and fellows may be required to undergo drug and/or alcohol testing for reasonable suspicion as required by institutional or hospital policies when there is reasonable concern regarding:

• Impairment
• Patient safety
• Workplace safety
• Diversion concerns
• Unprofessional behavior
• Fitness for duty

Supervisors must document the observations and reasons for referring a resident or fellow for drug and/or alcohol screening.

Failure to comply with required reasonable suspicion screening within the timeframe designated by hospital or institutional administration may be treated as:

• A refusal to test
• A positive test result
• Non-compliance with institutional policy

and may result in:

• Immediate removal from clinical duties
• Administrative leave
• Suspension
• Referral for evaluation
• Academic or disciplinary action under institutional policies, up to and including dismissal

Reporting and Follow-Up

Positive drug or alcohol tests may require:

• Occupational health review
• Referral for substance use assessment
• Fitness-for-duty evaluation
• Participation in monitoring or treatment programs
• Reporting obligations under applicable law or licensing requirements

Institutional responses will be determined based on:

• Patient safety considerations
• Clinical site policies
• Licensing requirements
• Applicable institutional procedures

This policy is in addition to any training site drug and alcohol screening policies, and NSHE, University, or UNR Med policies in effect, such as UAM 2,010 University Alcohol and Drug Free Workplace Policy and Reasonable Suspicion procedures.