Guidance 07.05.2014

Health clearance for Hep B, C, HIV and TB

This guidance can be used as a basis for decision making about vaccinations for medical programmes, which necessarily contain lots of exposure prone procedures for medical students. Local occupational health will be able to advise on risks if any vaccines are unavailable.

Summary

This guidance document, jointly issued by the Medical Schools Council, Dental Schools Council, Public Health England, and other health bodies, outlines the health clearance requirements for medical and dental students in relation to blood borne viruses (BBVs) and tuberculosis (TB). It provides protocols for screening, eligibility to perform exposure prone procedures (EPPs), and responsibilities of students, schools, and occupational health services.

Key findings
  • BBV testing is required for all dental students before admission and for medical students before performing EPPs.
  • Students infected with BBVs may still train and qualify, but restrictions apply unless they meet specific criteria for viral suppression and monitoring.
  • EPPs are defined as procedures where injury to the healthcare worker could expose patients to their blood.
  • TB screening is mandatory for new healthcare workers and includes risk assessment, skin testing, and vaccination where appropriate.
  • Confidentiality is paramount; only clearance status (not clinical details) is shared with training providers.

Recommendations and protocols

For medical students
  • Admission is not conditional on BBV status.
  • BBV testing should occur early in training, before EPPs.
  • Students who decline testing or test positive may continue training but cannot perform EPPs unless they meet clearance criteria.
  • Medical schools must manage training pathways for EPP-ineligible students and ensure confidentiality.
For dental students
  • Admission is conditional on BBV clearance due to the nature of dental training.
  • All applicants must undergo BBV testing before acceptance.
  • Successfully treated and monitored students may be eligible for EPPs and admission.
For occupational health services
  • Coordinate screening and monitoring.
  • Provide pre- and post-test counselling.
  • Liaise with NHS services in case of exposure incidents.
  • Maintain confidentiality and ensure proper documentation.
For medical and dental school deans
  • Ensure students understand EPPs and BBV protocols.
  • Manage training adjustments for EPP-ineligible students.
  • Liaise with health providers and occupational health services.
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Health clearance for Hep B, C, HIV and TB (PDF)
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