Health Policy for Medical Students

Stony Brook University H1N1 Influenza Planning and Preparedness
Stony Brook Medical Center H1N1 Influenza Planning and Preparedness
Novel H1N1 Influenza: Resources for Clinicians from the CDC
Novel H1N1 Influenza Preparations for Medical Schools and Students. From the AAMC.

Annual Physical Examination

Exposure to Infectious and Environmental Hazards
Blood-Borne Pathogens Exposure
For Students at the Winthrop University Hospital Clinical Campus
HIV Testing
Health Insurance Policy
Monitoring and Documentation of Requirements
Disease Surveillance and Immunization Requirements
Immunizations
Clinical Site Health Requirements
Student Health Center

 

Annual Physical Examination

All SOM students are required to submit a completed Health History Form prior to their first day of enrollment. This form includes a physical exam, health history, record of immunizations and titers. It must be completed by the student and a health care practitioner and must be signed and dated by both. Copies of these forms are kept in the Student Affairs Office, official health records are maintained by the Student Health Service (SHS), located on West Campus. Information on the Student Health Service can be found at: http://studentaffairs.stonybrook.edu/shs/index.shtml

Each subsequent year of enrollment, all SOM students are required to have an annual physical assessment, which includes a physical exam and PPD update. Physical Assessment forms are available in the Student Affairs Office and should be submitted there upon completion. Physical assessments may be done at the SHS.

It is important to note that some clinical affiliates and elective sites have health policy requirements in addition to those required by the School of Medicine. Students will be informed of these policies, and where possible, the SOM will expedite the process for student compliance. It is, however, the student’s responsibility to maintain compliance with additional health requirements.

Compliance with the SOM health policy is monitored on C-Base. The date of a student’s most recent physical assessment will be entered on C-Base upon submission of a completed physical assessment form to the Student Affairs Office. Students will be notified by e-mail one month prior to the expiration date of the most recent assessment. The Office of Undergraduate Medical Education and all clinical affiliates will have access to this C-Base information and can monitor compliance prior to the beginning of each clinical rotation or sub-internship.

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Exposure to Infectious and Environmental Hazards Policy

Contact with patients is an integral part of the medical education at SUNY Stony Brook. Contact with patients may entail exposure to hazards, including exposure to patients with contagious diseases that can be transmitted to students and other health-care providers by way of airborne droplets or needle-puncture wounds involving infected body fluids. Examples of these diseases include tuberculosis, hepatitis B, hepatitis C and AIDS.

Although the risk of contracting serious illness from these hazards is very small, Stony Brook Medical School seeks to reduce incidents of students' exposure to infectious diseases and environmental hazards. For example, students are required to obtain the hepatitis B vaccine prior to enrollment into medical school and receive a skin test for tuberculosis intermittently throughout medical school. Mandatory educational sessions on universal precautions for blood-borne pathogens are provided within the first week of the first year for entering students, in the second year as part of our Medicine in Contemporary Society Course and for students as they enter the core clinical clerkship year of studies. Information about safety and response to exposure to infectious agents or hazardous substances is presented during the orientation programming for entering students, in the second year as part of the curriculum inn MCS 2 and at entry into the third year of the curriculum. Information is also provided during course orientations for those specific courses in which students may be exposed to infectious agents and/or toxic substances. An orientation PowerPoint presentation is available on online and may be accessed by any student via their student number. Students receive training in proper blood-drawing techniques and patient-isolation policies prior to the intense clinical exposure in the third and fourth years of medical school. In addition, physicians are available to advise students and answer any questions through Student Health Services. The school reserves the right to restrict student contact by a patient believed to pose a risk to the health of the student.

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Blood Borne Pathogen Exposure (Refer to the special policy on Exposure to Blood Borne Pathogens)

Students who have been exposed to a blood borne pathogen must complete an incident report and follow the instructions at the associated web site. If exposed while training at University Medical Center during the week, go to Occupational Medicine for evaluation and counseling. If the incident occurs on weekends or after hours report to the Emergency Department. If the exposure occurs anytime at our major affiliates, students should report to the Emergency Department of that hospital. There may be some differences in the procedures after exposures to blood borne pathogens at clinical training site out of the Stony Brook system and students rotating at away sites should find out the proper procedures when beginning a rotation. All affiliates are required to provide emergency care.

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For Students at the Winthrop University Hospital Clinical Campus

In the event of a needle stick incident or blood borne exposure, report the incident to the supervising physician and nursing staff. Immediately clean the skin and wound sites with soap and water, then report to the Emergency Department.

The clinician in the Emergency Department will evaluate the type and severity of exposure and counsel the student on the risk of transmission to HIV, HBV, and HCV. Post exposure prophylaxis (PEP) to HIV and HBV will be recommended in accordance with CDC guidelines (see below).

If you are treated in the Emergency Department, you may only be given one or two day supply of post exposure medication.

The student is then referred to Stony Brook Occupational Health at 631-444-6250, or their personal physician, for follow-up counseling and testing, and to obtain the rest of the medications if needed.

After you have reported the blood borne exposure and received initial management from the Emergency Department, you should inform the Office of Medical Education.

In the event of non-blood borne exposure, you should see your primary care practitioner on an acute visit basis.

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HIV Testing

HIV testing is not required. The HIV Testing Policy for health care workers, including students is provided in a manner that protects patient rights and is consistent with other relevant medical center policies No student will be tested without his/her consent.  Some highlights follow:

HIV Testing of Health Care Workers Who Are Medical Students:

Health care providers who are students of the University who need to be tested will be referred to Occupational Medicine or the Student Health Service. Testing is anonymous and confidential.

Test Results

To provide confidentiality, written test results will be mailed (in an envelope marked "confidential") or given in person to the ordering health care provider.  Results will not be given verbally, by phone or by fax.

The physician who ordered the test or his/her representative will inform the tested individual of the test result face-to-face, whether positive or negative, and provide post-test counseling. If the tested individual is to be discharged from the medical center before test results are available, this individual must be given a follow-up appointment with his/her primary physician or designee in the appropriate out patient setting for receipt of this information.

HIV Testing of a Source Patient
Written, informed consent must be obtained before a licensed physician, nurse practitioner, nurse midwife, or physician's assistant may order an HIV-related test

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Health Insurance Policy

All Stony Brook University students are required to have health insurance coverage. Students who do not have private insurance coverage through a parent, employer, spouse, domestic partner or through their own individual plan are required to be enrolled in the university’s Student Health Insurance Plan (SHIP). All students will be automatically enrolled in and charged for the SHIP. However, students may waive out of SHIP through SOLAR AND by providing documentation of private insurance to the Student Affairs Office.

Stony Brook’s SHIP is offered through Aetna Student Health. SOM students are enrolled in a clinical plan, which provides additional coverage for treatment resulting from clinical incidents. Information on Aetna can be found at: www.aetnastudenthealth.com. Management of the Student Insurance Plan is through the Student Insurance Office, located in the Student Health Service. They can be reached at: 631.632.6331; email: sho-rship@notes.cc.sunysb.edu. Student Health Insurance information can be found at: http://studentaffairs.stonybrook.edu/shs/insurance.shtml

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Monitoring and Documentation of Health Policy Requirements:

The Division of Occupational and Environmental Medicine (DOEM) can perform immunizations needed to meet the schools requirements. The offices of The Division of Occupational and Environmental Medicine (DOEM) are located on Nesconset Highway (Rt. 347) one light west of Nicholls Road, in Stony Brook Medical Park, Building 9 (use entrance on right side of building).

For inquiries or appointments call (631) 444-2167 or fax (631) 689-6211
Their Mailing Address:
Center for Occupational and Environmental Medicine
2500 Rt. 347 Suite 9
Stony Brook  NY  11790

Students needing immunizations or Tuberculin tests may make an appointment to do so. Tuberculin tests must be read in 48-72 hours.  Because of the restricted time needed to read the test results, students should consider holidays falling on Mondays and Fridays when making appointments.

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Disease Surveillance and Immunization Requirements

Tuberculin Testing

The school of medicine requires annual tuberculin (intradermal) testing for actively enrolled students.  All students, including those who have received BCG vaccine, must have a documented intradermal tuberculin test unless a previously positive reaction can be documented, or unless completion of adequate preventive therapy or adequate therapy for active disease can be documented.  Student Health Services or DOEM can place, read and document test results.  Plans for the evaluation and management of medical students with positive tests or of those whose tests become positive during medical school can be made in conjunction with Division of Occupational and Environmental Medicine.  Students who are not in compliance will be barred from participation in clinical activities regardless of the clinical site. Should a student develop symptoms suggestive of tuberculosis, a chest radiograph will be required before the student is allowed to resume clinical activities.

Micro-Particulate Respirators

Because of the increasing prevalence of tuberculosis and the appearance of multiple drug resistant strains, some of the hospitals and sites where students train require that the student be fitted for a micro particulate respirator (HEPA). At this time, these masks are not required at all clinical sites. 

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Immunizations

Hepatitis B

All medical students are required to have been immunized against Hepatitis B and provide serologic proof of immunity (titer). Hepatitis B immunization consists of a series of three vaccines that should be completed prior to or as soon as possible after matriculation to ensure safety at the time of patient contact. Students who are not in compliance with this requirement will be barred from participation in clinical activities.

Rubella

Rubella immunity via history of disease or documented vaccine; AND serologic titer is required of all students.

Rubeola

Rubeola immunization is required for all students born after 1957. Students must provide physician documentation of a history of the disease or receipt of two doses of the vaccine; AND serologic titer.

Mumps

Students must provide physician documentation of a history of the disease or a receipt of the vaccine; AND serologic titer.

Polio, Tetanus, Diphtheria

Documented proof of immunization against polio, diphtheria and tetanus is required of all students. Tetanus immunization must be within ten years.

Varicella

Students with a history of varicella should provide documentation. Students without a history of the disease must have a titer for varicella antibody determined. Students with a negative titer are required to have varicella immunization.

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Clinical Site Health Requirements

Some of our clinical affiliates may have additional health requirements, exceeding the University and School of Medicine requirements. The clinical affiliate requirements must be met before you can begin any clinical rotations or electives at that site.

Currently, sites with additional health requirements are Nassau University Medical Center (NUMC) and Flushing Hospital Medical Center (FHMC):

NUMC requirements:

  • Annual physical examination.
  • Titer results for Hep B, Measles, Mumps, Rubella and Varicella.
  • Tetanus immunization within ten years.
  • A record of annual PPD readings. If no record of annual PPD readings, the student must have 2 PPD readings within the last 12 months. If a second PPD is required, the student can have it placed and read at NUMC Employee Health Clinic at no cost. “Annual” is defined as never having a gap or expiration between PPD readings. All PPD readings must have been done within 12 months of each other.
  • Students with a positive PPD history must submit proof of the positive reading AND a chest x-ray report dated within one year of the start date of the rotation.

This information is to be submitted to NUMC 4 weeks prior to the start date of the rotation. For more information, please call Yanick Joseph at 516-572-5881 or email yjoseph@numc.edu. NUMC’s info can be found at: http://www.nuhealth.net/education/ume.

FHMC requirements:

  • 7 Panel drug screen to be completed no earlier than 2 weeks prior to the start of the rotation.
  • Annual physical examination within 9 months of the start date of the rotation.
  • Titers and immunization history for Hep B, Measles, Mumps, Rubella and Varicella.
  • Tetanus immunization within 10 years.
  • PPD reading within 9 months of the start date of the rotation.

All testing can be done at the Student Health Service or with your private practitioner. All testing results should be submitted to the Student Affairs Office. Student Affairs will update your CBase record. You can view the status of your health information dates on CBase. In addition, you will receive e-mails from CBase beginning 30 days prior to the expiration date. For additional information, please contact FHMC Occupational Health at 718-670-5630.

Fourth Year Electives

When applying for away electives, please be aware that, typically, a site’s health requirements must be met as part of the application process. However, if your health status is up to date at the time of application the site may accept your current status (with documentation) for the application. Keep in mind that you will be required to provide updated information prior to the elective start date.

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Student Health Center

The Student Health Center at Stony Brook University is the on-campus source for meeting all students’ primary health care needs. The staff of physicians, physician assistants, nurse practitioners, nurses, social workers, health educators, laboratory technologists, and technical and administrative staff are dedicated to the mission of providing students with quality medical care, and the services necessary to optimize preventive health and wellness. For fee services, insurance is billed first and students are responsible to cover the cost of any co-pay or uninsured services. Complete information on the Student Health Center can be found at: http://studentaffairs.stonybrook.edu/shs/index.shtml

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Last updated by Webmaster on September 14, 2011

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