Student Transmissible Disease Policy

Policy Manual

  • Policy Number: ASA 13-007
  • Effective Date: 08/01/2013
  • Last Revised: 08/01/2013
  • Department: Office of Admissions and Student Affairs
  • Originator: Kristine Nelson, Director of Admissions and Student Services
  1. Purpose and Background
    1. The purpose of this policy is to develop a framework in which to evaluate students who have infections caused by the Human Immunodeficiency Virus (HIV), Hepatitis B (HBV), Hepatitis C (HCV), and/or any other potentially transmissible disease. This policy of the University of Nevada, Reno School of Medicine (UNR Med) is used to identify how to review, evaluate and respond to (on a case-by-case basis) any instances of HIV, HBV, HCV, or other transmissible diseases among students engaged in patient-care activities, according to the guidelines provided herein.
  2. Revision History
    1. 8/1/2013: 1.0: New Policy
  3. Stakeholders
    1. Students
    2. Residents
    3. Faculty
    4. Other institution(s)
    5. Preceptors
    6. Healthcare facilities personnel
    7. Patients
  4. Policy
    1. Students who are infected with HIV, HBV, HCV, and/or any other potentially transmissible disease will not be excluded from participating in patient-care activities, or restricted in their access to patient-care services or facilities because of their health status, unless medically-based judgments in individual cases establish that exclusion or restriction is appropriate for the welfare of patients, the welfare of other members of the patient-care community, or the welfare of the individual. Any and all rights and actions described herein will comply with the Americans With Disabilities Act of 1990.
    2. Students engaged in patient-care activities are encouraged to know their HIV, HBV, HCV, and/or any other potentially transmissible disease status.
    3. Any student engaged in patient-care activities who knows, or has reasonable basis for believing, that he/she is infected with HIV, HBV, HCV and/or any other potentially transmissible disease is expected to seek expert advice about his/her health circumstances and is obligated, ethically and legally, to conduct himself/herself responsibly in accordance with such knowledge for the protection of patients and other members of the community.
    4. Any student who knows, or has reasonable basis for believing, that he/she is infected with HIV, HBV, HCV, and/or any other potentially transmissible disease, and who may perform, in connection with his/her education, patient-care procedures that may have the characteristics of exposure-prone procedures, is required to share that information, on a confidential basis as provided within this policy in Sections 6.3, so that UNR Med can act to protect the welfare of the student, patients and other members of the UNR Med community and can respond appropriately to the student's health and educational needs.
    5. The UNR Med Transmissible Disease Expert Panel shall make recommendation(s) on whether or not a student may continue to perform exposure-prone, patient-care activities related to the educational process, and/or whether any other modification and/or restriction to the student's academic activities is necessary.
    6. A student who does not share that information as provided in this policy may be subject to disciplinary action, up to and including dismissal from medical school.
  5. Definitions
    1. ASA: ASA stands for the Office of Admissions and Student Affairs at the University of Nevada, Reno School of Medicine.
    2. CDC: CDC stands for the U.S. Centers for Disease Control and Prevention.
    3. UNR Med Transmissible Disease Expert Panel: An expert panel made up of various individuals appointed by the UNR Med Dean whose purpose is to determine, if applicable, whether the student may continue to perform those procedures and whether any other modification or restriction to the student's academic activities is necessary
    4. Exposure-prone procedures: As outlined by the U.S. Centers for Disease Control and Prevention (CDC), characteristics of exposure-prone procedures may include, but are not limited to: digital palpation of a needle tip in a body cavity or the simultaneous presence of a student's fingers and a needle or other sharp instrument or object in a highly confined anatomic site or a site where visibility is poor.
    5. HBV: HBV stands for Hepatitis B, which is one type of Hepatitis. HBV is a liver disease caused by the Hepatitis B virus. HBV spreads by contact with an infected person's blood, semen or other body fluid and can be either "acute" (short-term illness) or "chronic" (long-term, ongoing illness). A woman who has HBV can transmit the virus to her baby at birth.
    6. HCV: HCV stands for Hepatitis C, which is one type of Hepatitis. HCV is a liver disease caused by the Hepatitis C virus. HCV spreads by contact with an infected person's blood, semen or other body fluid and can range in severity from a mild illness lasting a few weeks to a serious, lifelong illness. HCV can be either "acute" (short-term illness) or "chronic" (long-term, ongoing illness).
    7. HIV: HIV stands for Human Immunodeficiency virus. It is the virus that can lead to Acquired Immunodeficiency Syndrome (AIDS).
    8. Patient-care activities: The activities that a medical student participates in within the course of a student's medical education that have a direct influence on the care of a patient.
    9. Transmissible disease: An infectious disease that can be transmitted to others.
    10. Universal Precautions: As outlined by the U.S. Centers for Disease Control and Prevention (CDC), including the appropriate use of hand washing, protective barriers and care in the use and disposal of needles and other sharp instruments. All students must also comply at all times with current guidelines for disinfection and sterilization of reusable devices used in invasive procedures.
    11. UNR: UNR stands for the University of Nevada, Reno.
    12. UNR Med: UNR Med stands for the University of Nevada, Reno School of Medicine.
  6. Responsibilities & Procedures
    1. Students Responsibilities
      1. Any student engaged in patient-care activities who knows, or has reasonable basis for believing, that he/she is infected with HIV, HBV, HCV and/or any other potentially transmissible disease is expected to seek expert advice about his/her health circumstances and is obligated, ethically and legally, to conduct himself/herself responsibly in accordance with such knowledge for the protection of patients and other members of the community.
      2. Any student who knows, or has reasonable basis for believing, that he/she is infected with HIV, HBV, HCV, and/or any other potentially transmissible disease, and who may perform, in connection with his/her education, patient-care procedures that may have the characteristics of exposure-prone procedures, is required to share that information, on a confidential basis as provided within this policy in Section 6.3, so that UNR Med can act to protect the welfare of the student, patients and other members of the UNR Med community and can respond appropriately to the student's health and educational needs.
      3. A student who does not share that information as provided in this policy may be subject to disciplinary action, up to and including dismissal from medical school.
    2. Notification and Reporting Requirements
      1. Upon knowledge of, or forming a reasonable belief that he/she is infected with or is at high risk of developing HIV, HBV, HCV, and/or any other potentially transmissible disease, a student must desist immediately from performing such exposure-prone procedures as outlined by the U.S. Centers for Disease Control and Prevention (CDC) and must comply with the following notification protocol:
        1. The student must notify, in writing, the UNR Med Associate Dean of Admissions and Student Affairs (ASA).
      2. The Associate Dean of ASA presents all pertinent information to the UNR Med Transmissible Disease Expert Panel (Section 6.5) for discussion and, if necessary, the formation of a recommended action plan(s).
      3. If an individual other than the student has reason to believe that a student is infected with HIV, HBV, HCV, and/or any other potentially transmissible disease, said notification and reporting requirements outlined above are applicable to that individual.
    3. Confidentiality
      1. UNR Med recognizes the importance of protecting, to the greatest extent possible and within the bounds provided by the law, the confidentiality and privacy of any student infected with HIV, HBV, HCV, and/or any other potentially transmissible disease. Accordingly, such information will be handled by the UNR Med and university employees who come into possession of this information with the same degree of care and sensitivity accorded to other types of highly confidential medical information.
      2. Due to the responsibility that UNR Med also has to protect patients, employees, and students from the harmful acts and/or conditions of its students, there cannot be a guarantee of complete confidentiality that may interfere with this responsibility.
      3. It is a condition of enrollment that students subject to this policy agree to the disclosure of information regarding their HIV, HBV, HCV, and/or any other potentially transmissible disease infection as provided hereafter and for the purposes set forth herein.
    4. UNR Med Transmissible Disease Expert Panel Membership
      1. The UNR Med Transmissible Disease Expert Panel shall be appointed by the UNR Med Dean and/or his/her delegate.
      2. The UNR Med Transmissible Disease Expert Panel membership shall be comprised of, but is not limited to: the Associate Dean of ASA (chair); the Associate Dean of Medical Education; the Associate Dean of Academic Affairs, Las Vegas; a representative from the UNR Student Health Center; representatives from the UNR Med faculty and/or community that include an infectious disease specialist, infection control specialist, ethicist, compliance specialist; and, a representative from the UNR Med Years 3-4 Committee. The UNR Med General Counsel will advise the panel.
    5. UNR Med Transmissible Disease Expert Panel Responsibilities
      1. The responsibilities of the UNR Med Transmissible Disease Expert Panel are to: maximize the protection of patients from exposure to HIV, HBV, HCV, and/or any other potentially transmissible disease transmission by the individual; maximize the protection of the student from infectious exposure; and, maximize the confidentiality with respect to all matters related to the individual.
      2. The UNR Med Transmissible Disease Expert Panel shall make recommendation(s) on whether or not a student may continue to perform exposure-prone, patient-care activities related to the educational process, and/or whether any other modification and/or restriction to the student's academic activities is necessary.
        1. The UNR Med Transmissible Disease Expert Panel recommendations shall be based on and consistent with established/published guidelines as outlined by the U.S. Centers for Disease Control and Prevention (CDC) and other documented resources, information and/or research deemed appropriate by the UNR Med Transmissible Disease Expert Panel.
        2. Recommendations issued by the UNR Med Transmissible Disease Expert Panel are final and binding, and shall be followed by all parties involved including, but not limited to: students and faculty.
      3. If the UNR Med Transmissible Disease Expert Panel and/or UNR Med determines that no reasonable accommodation exists that would enable the individual to perform his/her academic activities without posing an unacceptable risk to patients or to himself/herself or others, UNR Med shall modify, restrict, or discontinuation the academic activities of a student infected with HIV, HBV, HCV, and/or any other potentially transmissible disease in accordance with applicable with this policy.
    6. UNR Med Transmissible Disease Expert Panel Protocol
      1. The UNR Med Transmissible Disease Expert Panel shall meet on a regular academic semester basis, in addition to a case-by-case basis to assess, reassess and, where appropriate, to modify its original recommendations as circumstances warrant.
      2. Upon notification as outlined in Section 6.2 - Notification and Reporting Requirements, the Associate Dean of ASA presents to the UNR Med Transmissible Disease Expert Panel any and all reports received for discussion.
        1. The UNR Med Transmissible Disease Expert Panel will review the report and, if necessary, formulate a recommended action plan.
        2. The UNR Med Transmissible Disease Expert Panel will issue recommendation(s) within a reasonable time frame.
        3. Recommendations of the UNR Med Transmissible Disease Expert Panel may include, but are not limited to: postponement of, modification of, or discontinuation of a student's educational process.
        4. The Associate Dean of ASA shall notify the student and all appropriate parties in writing of his/her determination. Said notification shall include a copy of the UNR Med Transmissible Disease Expert Panel's recommendations.
      3. The student must comply with the recommendations of the UNR Med Transmissible Disease Expert Panel. Failure to do so may result in the discontinuation and/or restriction of the student's activities related to the educational process; or, dismissal from medical school.
    7. Alternative Patient-Care and Career Opportunities
      1. Students whose practices are modified because of their HIV, HBV, HCV, and/or any other potentially transmissible disease infection status should, whenever possible, be provided opportunities to continue appropriate patient-care activities.
      2. Students, whose practices are modified because of infectious disease, should be reevaluated periodically to determine whether their infectious disease status changes are due to resolution of infection or as a result of treatment.
      3. Career counseling is encouraged to promote the continued use of the student's talents, knowledge and skills.