We advise that all prospective medical students have a least two doses prior to commencement of course. You will have a busy timetable once you start and it can be difficult to attend appointments for further vaccination. There is also the opportunity to learn phlebotomy skills during the first term and if you are not vaccinated, this may result in you not being able to participate. If you are unable to obtain or complete this immunisation prior to entry, this will be done by the Occupational Health Service on commencement of the course.

The preferred course for full protection is 3 vaccinations of Hepatitis B vaccine over a period of six months, with a final blood test after the third dose to check that the vaccination has been successful.

On entry, full Hepatitis B immunisation history will be confirmed and a blood test taken for Hepatitis B surface antigen and Hepatitis B antibodies.

Note: We are aware that there is currently a shortage of Hepatitis B vaccine and you may find it difficult to obtain.  Please do not worry, Occupational Health will vaccinate you when supplies resume.

All students should have a documented history of two doses of MMR vaccine, which is usually given in early childhood to prevent the spread of infectious diseases or provide serological evidence of immunity to measles, mumps and rubella from an authenticated laboratory. If you are unsure of your vaccination history, please consult your General Practitioner (GP) who should be able to provide you with a booster MMR vaccination if necessary.

BCG vaccination is recommended for all medical students where there is a risk that they may come into contact with patients infected with TB.

All students need to provide documented proof of BCG vaccination or evidence of a visible BCG scar.  If you have not had this vaccination in childhood you may be able to obtain this from your GP.  If you are not able to source this yourself, you will be seen by the Occupational Health Service on commencement and this vaccination will be given, unless medically contraindicated.

All new entrants to the NHS who have been living or working overseas  for more than 3 months in a country where there is a high prevalence of TB may be required to have additional screening tests.

If you cannot confirm history of this disease, you will be required to have blood test and will be offered vaccination if necessary.  Students who have had the disease diagnosed in a tropical country will also require a blood test to ensure immunity.

All students should have a documented history of five doses of DTP vaccine. This is part of the childhood immunisation programme to prevent the spread of infectious diseases.

Clinical work exposes you to the risk of infection and injury.  Infection with HIV or blood-borne viruses can restrict you from working in some areas of surgery, patients are also at risk.  Careless hygiene practice by nurses and doctors are a major cause of wound infection and contribute to thousands of patient deaths each year. 

Blood-borne viruses are carried in human blood, tissue and secretions.  Accidental exposure can result in you becoming infected and in some individuals cause severe disease.  Although occupational transmission of these viruses is rare, all unscreened blood samples should be treated as potentially infectious. Infection is not only damaging for your health—it could destroy your career.

The three main blood-borne viruses in the UK are:

• Hepatitis B
• Hepatitis C
• Human Immuno-deficiency Virus (HIV)

Blood-borne virus risk may arise from: human blood, amniotic fluid, cerebrospinal fluid, breast milk, pericardial, peritoneal  and pleural fluids, saliva, synovial fluid, semen, vaginal secretions, unfixed human tissue, exudate from burns or skin lesions and any visibly blood-stained fluid.  And of course blood borne viruses can be introduced via any break in the skin or via a splash to mucosa eg eyes and mouth.

Avoiding the risks

Vaccination

• Hepatitis B can be effectively avoided by vaccination, ensure that you complete the vaccination programme.

Follow safe sharps practice

• The most common exposure risk comes from careless handling of hypodermic needles and IV cannulas, cover broken skin on hands with a waterproof dressing. Wear gloves when dealing with blood or body fluids, they do not always stop a penetrating injury, but they do reduce the volume of blood inoculated.
• Never re-sheath needles.
• Dispose of used sharps into a proper sharps bin immediately after use.
• Do not carry used sharps in your hand.  Use a kidney dish or take the sharps bin to the bedside.
• Ensure that you are supervised when carrying out new procedures until you are competent and confident.

Reporting an incident

• If you ever injure yourself with a needle or other contaminated sharp during clinical training or get a blood splash on to broken skin or into your eye nose or mouth get help from the hospital Occupational Health department or outside core hours from A&E.
• You should report any exposures via the College online accident reporting system.
• You also need to report it to the Trust and inform the School and to the College Occupational Health department.

Clinical students must not carry out venesection/invasive procedures on patients known to be Hepatitis B, HIV or Hepatitis C positive until all DOPS are signed off and Year 3 exams including the OCSE are passed.

Undergraduate medical students arranging summer placements which do not form part of their formal course may be required to complete a health screening questionnaire from the institution prior to acceptance.  This will usually include details of their vaccination history. However, students may also be asked to supply details of tests which are not usually required for studying medicine in the United Kingdom. Occupational Health (OH) at the College may be able to assist students in preparing for such placements but please note that students will be responsible for the fees for blood tests and/or a chest x-ray.

If your Host Institution requires a Pertussis containing vaccine, we can provide this at a cost if you are not up to date. Please supply your GP/Doctor vaccine history when submitting your forms if available as this may save you having this vaccine. OH do not have access to GP records.

We will not be providing the Influenza vaccine if it is needed by the Host as this should be given by the NHS OH Team or can be obtained from a Pharmacy.

We also will not provide travel vaccines (Hepatitis A, Revaxis, Typhoid, Japanese Encephalitis, Rabies, Meningitis). Students who are arranging summer placements in destinations where travel vaccines are recommended, will need to make arrangements to have these through their GP or a commercial travel clinic such as MASTA or Nomad.

Students travelling to countries with a high risk of HIV are strongly advised to take HIV prophylaxis with them. 

Students are not covered by the College travel insurance scheme and will need to get their own insurance.

All information from the institution requesting tests must be brought to the appointment in paper format – not on your phone or laptop!