POLICIES REGARDING STUDENT HEALTH, HEALTH INSURANCE AND IMMUNIZATIONS and BLOODBOURNE PATHOGENS
The College of Medicine has a long-standing commitment to protect the health and well-being of students, faculty, staff, patients and the general public. Students in the College of Medicine are required to show proof of appropriate immunity, or documented immunization, prior to matriculation and/or the onset of actual patient contact. In addition, the Office of Student Affairs offers educational programming to assist students in the attainment and maintenance of optimal physical and mental health.
Ultimately, each student is responsible for his/her health and safety in the clinical/educational setting. Therefore, it is the goal of the College of Medicine that all students learn appropriate policies and procedures to follow in the event that they are injured or potentially exposed to bloodborne pathogens or other communicable diseases. During the orientation of both first and third year students, presentations are given on universal blood and body fluid precautions, infection control and prevention of the spread of communicable disease. In addition, the Student Advocacy Committee monitors student health policies and procedures, in order to insure compliance with institutional and state health requirements.
Pre-Matriculation Health and Immunization Requirements
Prior to matriculation in the UF College of Medicine, a student must submit the following documentation:
- A screening health history form provided by the Student Health Care Center (SHCC) See website http://shcc.ufl.edu/
- A University of Florida College of Medicine Health Agreement form
Proof of current health insurance
- Certification of current health insurance is mandatory for each registered year at the College of Medicine
- Two MMR vaccinations (measles, mumps, rubella) or serologic tests that confirm immunity to each of these three viral infections
- Hepatitis B vaccine series (3 doses). If you completed the vaccination series within the last 2 months, you must also provide serologic proof of immunity (i.e., a positive serum titer for hepatitis B surface antibody).
- Two varicella vaccinations or a serologic test that confirms immunity
- Tdap vaccination (tetanus, diphtheria, and pertussis)
- Vaccination for meningococcal infection or documentation that you opted out of this vaccination
- Two tuberculin skin tests within the last year
- If you previously received the BCG vaccination, an interferon-based TB test is preferred (Quantiferon-Gold or T-Spot assay)
- If you have a positive tuberculin skin test or interferon-based TB test, you must provide documentation of a negative chest x-ray within three months of the start of school.
- Please also note that all students will be required to have a seasonal influenza vaccination in the fall of each year.
Students should submit documentation of these immunizations to: Ms. Vicki Busseno, P.O. Box 100216, University of Florida College of Medicine, Gainesville, FL, 32610. You will not be able to start classes until all documentation is received, so please do not delay in confirming these immunizations.
Health and Disability Insurance
The College of Medicine requires all UF medical students to be covered by major medical insurance. It is not sufficient for the student to seek care through the Student Health Care Center, for the SHCC can offer only primary outpatient care. Insurance may be acquired through a family major medical policy, through a private insurance agency, or by purchasing the University of Florida Student Government Health Insurance (https://www.uhcsr.com/SelfServiceSupport/Students/CollegeHome.aspx). The insurance plan should offer comprehensive coverage in Gainesville and Alachua County, and not simply at a distant city/county/state. Students must realize that medical expenses for care provided by Shands Hospitals and hospitals affiliated with the College of Medicine, including laboratory procedures and emergency care, are the responsibility of the student and not the College of Medicine or the University. Coverage should also include maternity benefits and coverage for an occupational injury that might put the individual at risk for a bloodborne infection such as hepatitis B, hepatitis C, or HIV infection.
The College of Medicine also requires all medical students to acquire disability insurance, to provide protection in the event of a long-term illness or injury. This insurance plan is offered by the College of Medicine through Compass Consulting Company at a nominal cost to the students. More information regarding the insurance is available though the College of Medicine Student Affairs Office.
Potential Exposures to Bloodborne Pathogens and Communicable Diseases
Policies and procedures concerning bloodborne pathogen exposures and exposures to communicable diseases are addressed during the orientation sessions for first and third year students. In addition, these policies are reinforced during the Surgery and Internal Medicine clerkships.
It is the responsibility of the student to report sharps injuries, needle sticks, or other potential exposure to bloodborne pathogens via blood or body fluids immediately to the supervisor at the facility where the accident occurs.
In the event that the student contracts a communicable disease which potentially poses a risk to patients or co-workers (e.g. tuberculosis, varicella), steps will be taken to prevent dissemination in accordance with Student Health, Public Health and/or CDC protocols. Certain communicable diseases may also be reported to county or state health authorities, as required by law.
Potential Bloodborne Pathogen Exposures
It is the goal of the UF Student Health Care Center to offer timely, state-of -the-art care for students who have experienced potential bloodborne pathogen exposures in the UF/Shands Health System. Time is frequently of the essence in managing bloodborne pathogen exposures. For example, some treatment regimens must be started within two hours of exposure to be maximally effective.
In the event of a potential bloodborne pathogen exposure, students should immediately contact a medical provider at 1-(866) 477-6824 (toll free). A member of the medical staff is available for phone consultation 24-hours a day. The SHCC medical provider will make recommendations for immediate evaluation and care as follows:
- If the student is within a one-hour radius of Gainesville (including Shands at UF Hospital and Clinics, the Gainesville VA Hospital, or other nearby clinical sites), the student should receive their care at one of the following Student Health Care Center facilities:
- The Student Health @ Shands satellite clinic, (352) 392-0627, Room D2-49, located in the 2nd floor Dental Tower, open Monday through Friday 8:00 a.m. to 4:30 p.m, Fall & Spring semester; closed University break weeks.
- The Student Health Care Center (SHCC) at the main Infirmary Building on Fletcher Drive, located next to the Florida Gym, (352) 392-1161. During Fall and Spring semesters, the SHCC is open Monday through Friday 8:00 am to 4:30 pm. They are closed on weekends and university holidays. During Summer semester and semester breaks, please call the SHCC for hours.
- If the student is at an off-site rotation more than one-hour from Gainesville (including University Medical Center in Jacksonville and rotations in Orlando), the student should notify their rotation supervisor and the medical provider at 1-(866) 477-6824 (toll free), and then seek care at the Emergency Department or Employee Health clinic at their hospital, or at a nearby hospital emergency center. Subsequently, the student should call to make an appointment at the SHCC @ Shands or the main SHCC @ the Infirmary Building for appropriate follow-up care.
- After hours, the student should first call the provider at 1-(866) 477-6824 (toll free) for instructions regarding immediate care for potential bloodborne pathogen exposures. Care may be given at the Shands at UF Emergency Department, (352) 395-0050, or at the local Emergency Department for distant off-site rotations. Once again, the student should call to make an appointment at the SHCC @ Shands or the main SHCC @ the Infirmary Building for appropriate follow-up care.
In the event of any potential bloodborne pathogen exposure, the student should obtain the name of the source patient, medical record #, room number and diagnosis. This information is necessary to assist the medical provider in determining the potential severity of the exposure. If initial care is provided outside the SHCC/Shands system, the student should inform the provider that UF physicians follow current CDC guidelines in determining the need for post-exposure HIV prophylaxis. If the physician has questions, he/she could call the provider at 1-(866) 477-6824 (toll free) or the Shands at UF Emergency Department at (352) 395-0050. Appropriate first aid should also be given for the injury in question and a tetanus booster should be administered when indicated.
If a student’s health insurance carrier has finally determined that it will not cover a medically appropriate course of prophylactic treatment for the student’s potential exposure to HIV (which exposure occurred in the course of the student’s college studies and activities), the College will assist the student and pay for the treatment. A student may request the College’s assistance by discussing their situation with the Associate Dean for Student Affairs.
Students with Communicable Diseases
In certain situations, students with communicable diseases or conditions may not be allowed to have patient contact. This restriction may be necessary to protect the health and safety of both patients and coworkers.
Persons with the following medical conditions will not be allowed to have patient contact without a medical clearance:
- Active chickenpox, measles, rubella, herpes zoster (shingles), hepatitis A, hepatitis B, hepatitis C, tuberculosis
- Oral herpes with draining lesions
- Group A streptococcal disease (i.e., strep throat) until 24 hours of treatment received
- Diarrhea lasting over three days or accompanied by fever or bloody stools.
- Draining or infected skin lesions
- Viral influenza
If an ill student is unsure whether he/she should participate in patient care, the student should contact the SHCC clinical staff at (352) 392-1161, or the Student Health @ Shands Satellite Clinic at (352) 392-0627.
Standard Universal Precautions
When providing patient care, regardless of the real or perceived communicable disease status of the patient, all students and staff should follow Standard Universal Precautions:
- Wash hands before and after patient contact, according to hospital policy, even if gloves are used.
- Wear gloves when exposure to blood, body fluids, excretions or secretions is likely.
- Use gloves appropriately according to aseptic and/or sterile techniques, and change gloves between patients.
- Wear gowns/aprons when soiling of clothing with blood or body fluids is likely.
- Wear masks, face shields and eye protection when aerosolization of blood or body fluids may occur.
- Dispose of sharps in designated rigid sharps containers.
- Never recap needles or scalpel blades by hand.
- Dispose of waste saturated with blood or body fluids in designated red-bag trash containers.
College of Medicine Policies Regarding HIV/AIDS and Other Communicable Diseases
It is the policy of the University of Florida to assess the needs of students or employees with HIV infection or other communicable diseases on a case-by-case basis. If any such infection occurs in a medical student, any recommendations made or actions taken by the College of Medicine will respect the confidentiality and welfare of the student, while also recognizing and responding to issues regarding the welfare of patients, the College of Medicine and the hospital and outpatient clinics. Each student’s situation will be evaluated by the College on a case-by-case basis. With the permission of the affected student, the Director of the Student Health Care Center (a physician) will assist in the coordination of resources and services.
Currently, the UF College of Medicine does not require routine HIV testing of patients, students or healthcare workers. However, it is certainly prudent for individual healthcare workers, including students, to be aware of their own individual HIV status so that they can take appropriate precautions and measures. With current advances in treatment of HIV infection, early intervention can be crucial in maintaining well-being and delaying complications of the illness. If future state or federal legislation were to change guidelines or requirements for HIV testing of healthcare workers or healthcare students, the College of Medicine will comply as required.
In the event of a potential bloodborne pathogen exposure in a student, the medical provider will recommend HIV testing as a baseline and also follow-up intervals of 6 weeks, 3 months and 6 months. When testing is medically advisable, it is subject to informed consent, and results are treated confidentially.