History and Physical Examination Requirement
Each student must have a comprehensive history and physical examination performed by a licensed physician, nurse practitioner, or physician assistant under physician supervision and must be signed by a licensed physician. This exam must be completed after the date of acceptance and before matriculation into VCOM. This examination must establish, and the examining physician must verify, that the student’s health status is adequate to meet the demands of the curriculum as defined by the Technical Standards detailed in this Catalog and Handbook. Students must return the Personal Medical History Form and the Physical Examination Form to the Department of Clinical Affairs by the dates specified in order to maintain acceptance status.
Required Laboratory Tests and Immunizations
VCOM requires that students meet all immunization requirements prior to matriculation and must maintain compliance with these requirements throughout their tenure here at VCOM. Students must return the VCOM Immunization Form and Tuberculosis Screening/Testing Form to the Department of Clinical Affairs by the dates specified in VCOM admission policies in order to maintain acceptance status.
As a part of these requirements, all osteopathic medical students, just as physicians in practice, are required to be current with required immunizations and must do everything possible to prevent the spread of communicable disease. Students, as healthcare providers, must abide by the policies of the affiliated hospitals and clinical practices where VCOM students receive their clinical education and training. The clinical site retains full responsibility for its patients, which encompasses the supervision of students in the direct and indirect care of patients. Clinical sites require medical clearance of students, which includes immunization status and that students are free from infectious disease. Students should be aware that the information shared with clinical sites includes immunization status, any disease status that might affect patient care, and background checks. Therefore, accepted students must report any restrictions prohibiting participation in immunizations or inability to meet the Technical Standards for Admission and Continued Enrollment in advance of enrollment to ensure that students can meet the Technical Standards.
VCOM does attempt to provide accommodations, where possible, for medical, religious, or other protected purposes. If such accommodations are not possible, the student may be delayed in their education or unable to complete all educational requirements required for graduation. Students who are requesting accommodations should apply well in advance of enrollment to assure they can complete the educational program.
Students should also be aware the international outreach experiences are electives and not required for graduation and as such, students who are not immunized or otherwise at risk, do not participate in such experiences.
Required laboratory tests and immunizations may change annually based on recommendations from the Centers for Disease Control (CDC), the United States Prevention Task Force (USPTF), and healthcare facilities. Students will be notified of any changes and will be required to comply with any mandated changes upon receipt of notice from VCOM. Health and immunization requirements are updated annually according to national guidelines and the clinical teaching hospital requirements.
VCOM requires the following laboratory tests, immunizations, and approved boosters:
- Diphtheria, Pertussis and Tetanus
- Annual Tuberculosis (TB) test
- Hepatitis B Virus (HBV) immunization and titers
- Hepatitis C Virus (HCV) test
- Measles (Rubeola), Mumps, and Rubella (MMR)
To read more about the required laboratory tests and immunizations please review Policy S013: VCOM Minimal Health Requirements for Admission and Continued Enrollment Policy
Chronic Infectious Diseases and/or Conditions with Increased Risk for Infection
Students who have chronic infectious diseases or weakened immune systems may participate in patient care in certain settings as long as they follow the CDC guidelines. Students who have certain communicable diseases may require treatment prior to clinical participation according to the guidelines provided by the CDC (i.e. such as chronic hepatitis). Students who have viral illnesses or chronic infectious diseases may be assigned an altered clinical educational experience. Students who have certain immunodeficiencies or medical conditions that prevent them from patient care participation, will be reviewed to assure they meet Technical Standards for Admission and Continued Enrollment.
Hepatitis B is a serious infection that is spread by infected blood and body fluids and can lead to serious health risks including liver failure, cancer and death. Protection from the disease can often be obtained from a series of vaccinations and is recommended for all health care professionals. A small number of people can fail to develop immunity despite adequate vaccination and thus remain at increased risk of infection during the course of their education and occupation in the health care field. For vaccine non-responders (those without immunity after vaccination), it is critical they understand potential sources of hepatitis B infection, methods of transmission and the importance of seeking immediate medical attention if accidental exposure occurs. Meticulous adherence to blood and body fluid precautions is critical to preventing the spread of the disease and non-responders must use these and all other available methods of prevention to protect themselves. In addition, if a potential infectious exposure does occur, non-responders must seek immediate medical attention as protection may still be provided with the administration of hepatitis B immunoglobulin immediately following exposure. The availability of post-exposure prophylaxis with immunoglobulin does not in any way alleviate the need to practice universal precautions and hand hygiene.
Medical students who are not immune to hepatitis B after appropriate vaccination are at increased risk for infection if exposed to infectious blood or body fluids. As a non-immune medical student, it is important for those students to understand that they may be exposed to potential infected patients and material, that the transmission rate of hepatitis B with an accidental percutaneous exposure is high and that the consequences of infection may be severe. These students are required to have a counseling session with the Associate Dean for Clinical Affairs regarding Hepatitis B transmission, post-exposure prophylaxis, management of exposures to HBV, and steps to take to reduce risks of infection. Following this counseling session, students will complete and sign an Acknowledgement of Hepatitis B Non-Immunity and Risk of Infection Form.
Students with Chronic Hepatitis B, should speak with the Associate Dean for Clinical Affairs for the most recent CDC ruling on clinical training and experiences for medical students, as VCOM follows the most recent CDC ruling and guidelines.
Expert Panel for Infectious Disease Considerations
VCOM will appoint an expert panel to review each case of a student who is experiencing difficulty with immunizations, acute or chronic infectious disease, and/or chronic illness that may impact patient care. If the expert panel recommends an altered clinical education plan, the plan must ensure that all academic requirements are met, including completing all required clinical rotations. The student will be subject to placement in clinical sites that can accommodate an altered clinical educational plan in lieu of participation in the rotation match system.
A student may also request an evaluation by an expert panel prior to matriculation. Students should read the health requirements in the Technical Standards to assure they will be able to complete all curricular requirements, including those in the clinical setting.
Pregnancy, Allergies, and Student Participation in Special Environments
Education at VCOM takes place in special environments, such as the anatomy lab and clinical facilities that may contain hazardous physical and chemical environments. Working and studying in these special environments may require the student to make an informed decision concerning continued participation because failure to participate in required classes could result in dismissal. Examples may include, but are not limited to: students who believe they are allergic or sensitive to certain chemicals, students who are pregnant and are concerned about potential hazards to a developing fetus, or students who believe they are immuno-compromised or have increased susceptibility to disease. The student must decide upon their ability to participate in all educational environments prior to matriculation. For a student who develops problems or becomes pregnant after matriculation, their program may be delayed until the student has taken appropriate precautions to successfully complete the program, or the pregnancy is completed. If the student is unable to resume the academic program, he/she should seek a medical withdrawal from VCOM. Students who choose to participate in these special environments with such medical conditions, assume the risk of any medical complications that may arise as a result of their participation.