162 Dr. Kiran C. Patel College of Allopathic Medicine (NSU MD) 2024–2025 The greatest theoretical risk of medical student-to-patient transmission of HBV, HCV or HIV/AIDS involves invasive or exposure-prone procedures with manipulation of needles or other sharp objects not under direct visualization. Medical students who have HBV/HCV/HIV seropositivity may not perform invasive or exposure-prone procedures unless such activity is approved in writing by 1) an expert panel duly constituted to guide and review performance of such procedures (see Centers for Disease Control and Prevention [CDC] guidelines for definition of exposure-prone procedures and recommendations for expert panel oversight), 2) the student’s personal physician (who may be a physician from the NSU Student Medical Center), 3) the clinical clerkship director, and 4) the ADASA or designee. The CDC guidelines for the Management of Hepatitis B Virus-Infected Health-Care Providers and Students (cdc.gov/mmwr/PDF/rr/rr6103.pdf) and the Society for Healthcare Epidemiology of America (Henderson DK et al. Infection Control and Hospital Epidemiology, 2010; 31 (3): 203-232.) suggest that medical students with HBV, HCV, and HIV seropositivity can continue to attend classes and participate in clinical clerkships and preceptorships. For chronically infected HBV/HCV or HIV health care providers and students who plan on performing exposure-prone procedures, an expert panel will be duly constituted to guide and review performance of such procedures (see CDC guidelines above for definition of exposure-prone procedures and recommendations for expert panel oversight). Chronically infected HBV-infected health care providers and medical students are NOT required to 1) repeatedly demonstrate undetectable HBV viral loads on a greater than semiannual frequency, 2) prenotify patients of their HBV-infection status, or 3) submit to mandatory antiviral therapy. Standard precautions should be adhered to rigorously in all health care settings for the protection of both patient and provider. Education and Training All students initially receive general information pertaining to the prevention and transmission of occupational exposures during the orientation to the M.D. program of NSU MD. During this time, students will be required to receive immunizations against hepatitis B, meningitis and varicella, and tuberculosis screening if not documented on the history and physical exam form submitted prior to registration. More formal clinical information about the prevention and pathophysiology of all infectious diseases that might potentially be transmitted in a clinical care setting is provided prior to the start of clinical clerkships. This would include education regarding hepatitis A, hepatitis B, hepatitis C, varicella, influenza, meningitis, tuberculosis, and HIV. Students will be provided with education on universal blood and body fluid precautions during orientation sessions for first-year students, and prior to the start of the clinical clerkships. Students will also receive information on infection control and prevention of the spread of communicable disease. During the first day students are assigned to work at a clinical rotation site, the faculty members at the affiliate site will provide information regarding the policies and procedures at their respective site that students must follow in the event of exposure, as described below in Student Exposure to Blood/Body Fluids Procedures. All students are required to complete training in OSHA and HIPAA. OSHA Students are required to complete two educational modules prior to matriculation: Blood-borne Pathogens and Formaldehyde Use. Successful completion of these modules is monitored by the Office of Student Affairs.
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