I also agree with all that has been expressed!! As I stated in my earlier
reply we would advise on redeployment if appropriate. We don't asess medical
students either but do assess student nurses and all are screened at
entrance. We would advise positive individuals to avoid careers with EPP but
not just barr them from training! However this appears to be an easier
option with in the nurse training areana.
Also we still have issues about Drs not providing current Hep B status
levels so we have taken the step of catching them at induction! It may sound
old fashioned but it seems to work very well and we use the opportunity to
introduce ourselves informally and discuss sharps injury protocol amongst
other things.
I would also like to know about the stability of the viral load!
Sue Manthorpe
-----Original Message-----
From: Occ-health is a list open to everyone with an interest in
teaching, learning [mailto:[log in to unmask]]On Behalf Of Jeremy
Smith
Sent: 19 July 2001 14:29
To: [log in to unmask]
Subject: Re: HepB entry requirements for medicine
I wholeheartedly agree with everything expressed but the biggest problem I
had when in the NHS was getting some of the blighters to attend for their
initial screening in the first place! Some of the Consultants were helpful
but many others just ignored letters sent to them as the manager. The
max/fax bods were the worst. Medical staffing was often powerless to act so
how do you police it, if that's the right phrase to use.
Jeremy R F Smith
RGN AIIRSM BSc Hons (OHN)
Occupational Health Advisor - Dover Harbour Board
-----Original Message-----
From: Swann, Alan B [mailto:[log in to unmask]]
Sent: 19 July 2001 13:25
To: [log in to unmask]
Subject: Re: HepB entry requirements for medicine
Geoff,
Thanks for this. It is how the DoH guidelines should be applied to medical
students that I am looking for other's views.
My concern is that a blanket exclusion on entering training for a medical
career if a 'high-risk' carrier is, I think, unfair and old style thinking
about disability. The majority of medical careers do not involve carrying
out exposure-prone procedures. UG medical training focuses on learning about
health, disease, diagnosis and treatment. Craft learning- surgical skills-
occurs post-qualification. There is no requirement in the training
prescribed by the GMC which requires a student to undertake exposure-prone
procedures. Provided a surgical house job can be arranged so that the House
Officer doesn't have to hang about in theatre holding retractors for the
boss, then s/he can get through to a career where no patient can ever be put
at risk. & working in theatre if you are not planning on being a surgoen is
a waste of time. Far better being out on the wards building up skills on
presentation of surgical conditions & the care of patients post-surgery
The GMC say they cannot register anyone who would be restricted from
practising in some fields of medicine. Why the hell not? Left & right are a
complete mystery to me. A hidden disability that could endanger patients (I
actually did put someone down to have their wrong leg chopped off on my very
first day as a doctor. Thankfully realised & corrected before theatre.) I'd
be an awful surgeon. Can hardly cope with shoe laces. Should I have been
prevented from qualifying?
The GMC worry that the student, once qualified, may conceal their status &
get a job as a surgeon. Surely this risk can be and is now adequately
controlled by pre-employment screening. I'm confident I can identify (&
counsel) students early on . All applicants are warned of the HepB issue at
offer of a place &, if in a risk group, encouraged to get tested before
confirming their place. Once at School, we establish status by the end of
the first term, so if students have to change course, they can.
J'accuse the GMC of concentrating on the disability rather the abilities &
closing their minds to the concept of 'reasonable adjustments'. Who'll be
the first to challenge it under the DDA?
Right, rant over. I'll get on with some work now.
Regards
Dr. Alan Swann, BM, AFOM
Director of Occupational Health
Occupational Health Service
Imperial College Health Centre
Watts Way
London
SW7 1 LU
Tel: +44 (20) 7594 9385
Fax: +44 (20) 7594 9407
http://www.ad.ic.ac.uk/occ_health/ <http://www.ad.ic.ac.uk/occ_health/>
-----Original Message-----
From: Geoff Helliwell [SMTP:[log in to unmask]]
Sent: Thursday, July 19, 2001 7:00 AM
To: [log in to unmask]
Subject: Re: HepB entry requirements for medicine
Alan,
I am sure the DofH's answer would be in HSC 2000/020, and require
viral load
tests if HBsAg positive and e-antigen negative.
Guidelines on Hep B affected HCW
http://www.doh.gov.uk/nhsexec/hepatitisb.htm
PDF file of Policy on testing re Hep B
http://www.doh.gov.uk/pdfs/hepatitisb.pdf
I have recently dealt with several persons e-antigen negative, but
significant viral loads, it wrecks careers (especially of surgeons).
As
part of the counselling process I have asked them about their views
of
having entered the medical profession, they have all said they would
still
wish to have entered provided the risks to their patients were
controlled.
I do not assess Medical Students, and look forward to seeing the
revised GMC
guidance. As all of the above DofH guidance applies to nurses
entering the
profession, why should it not also apply to Medical Students ?
(groans about
the cost of viral load titres are unacceptable against the overall
cost of
training a doctor).Appropriate OH advice should be prior to taking
up a
career, but if not possible should be early in the training (not
waiting
until the week before going into clinical work).
Geoff Helliwell
-----Original Message-----
From: Occ-health is a list open to everyone with an interest in
teaching, learning [mailto:[log in to unmask]]On Behalf Of
Swann,
Alan B
Sent: 17 July 2001 15:32
To: [log in to unmask]
Subject: HepB entry requirements for medicine
Anyone out there assessing medical students?
How are you dealing with effects of the revised DOH guidance on
assessing
e-antigen negative surgeons?
Our policy till now has been to exclude applicants who are HBsAg
positive,
HBeAg positive, but accept those HBsAg positive, HBeAg negative.
This fits
with current, though now out-dated GMC guidance ("Fitness & conduct
of
medical students.") The GMC are reviewing in the light of the DoH
guidance,
but not yet decided.
What are you doing?
* Accepting only HBsAg negatives?
* Still deciding on basis of e-antigen status?
* Arranging viral load tests?
* Pondering?
Dr. Alan Swann, BM, AFOM
Director of Occupational Health
Occupational Health Service
Imperial College Health Centre
Watts Way
London
SW7 1 LU
Tel: +44 (20) 7594 9385
Fax: +44 (20) 7594 9407
http://www.ad.ic.ac.uk/occ_health/
<http://www.ad.ic.ac.uk/occ_health/>
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