108.12.5 Guidelines with Respect to Applicants to or Students in Health Care Programs

For applicants to or students in health care programs as defined by the Provost and Vice-President (Academic), including Dentistry, Dental Hygiene, Medicine, Medical Laboratory Science, Nursing, Pharmacy, Rehabilitation Medicine and some specific fields in Physical Education and Recreation, the following additional provisions are applicable.   These provisions have been instituted in light of current medical evidence which shows that the risk of transmission of hepatitis B for individuals who are surface 'e' antigen positive (HBeAg) when contact is made with their blood is in the order of 30%.   Similarly, the current transmission rate for Hepatitis C is in the order of 3 to 10%.  Students in health care programs are normally required to perform some invasive procedures as part of their training which, if they are hepatitis carriers, could put patients at risk.  In order to minimize that risk, it may be necessary to deny admission, modify a student's training program or exclude the student from some clinical experiences, which could preclude that student from satisfying the requirements for that degree.  The risk of transfer of HIV under similar circumstances is currently estimated at 0.3%. (GFC 15 OCT 1997) (BG 07 NOV 1997)

1. For applicants to or students in a health care program where there is a greater potential for transmission of blood-borne pathogens to patients/clients as a result of clinical activities in practice settings, the following procedures shall apply:

a. Hepatitis B surface antigen testing will be performed either prior to or after acceptance into a health care program. For individuals who test positive for Hepatitis B surface antigen, their "e" antigen status will also be determined. Applicants to some health care programs may be denied admission if their "e" antigen status is positive. Any decision of an Admissions Committee is final. There is no formal appeal to any other body within the Faculty or the University. (GFC 15 OCT 1997) (BG 07 NOV 1997)

For those applicants or students who test negative for Hepatitis B surface antigen, Hepatitis B vaccination will be required. An exception may be made for those for whom vaccination is medically contraindicated. Post-vaccination testing will be required to check for vaccine failure. (GFC 15 OCT 1997) (BG 07 NOV 1997)

b. Testing for Hepatitis C antibody will also be performed on all individuals either prior to entry or once accepted into the health care programs specified above. (GFC 15 OCT 1997) (BG 07 NOV 1997)

c. All students accepted into health care programs are encouraged to undergo HIV testing upon admission and at any time during their program when concerns about infection have arisen.  Given that the risk of transmission of of HIV in a health care setting is minimal, testing for HIV is not mandatory at this time. (GFC 15 OCT 1997) (BG 07 NOV 1997)

For information on the timing of testing for particular Faculties, either the admission or program requirements in the University of Alberta Calendar should be consulted. (GFC 15 OCT 1997) (BG 07 NOV 1997)

All testing will be done through the University Health Centre. (GFC 15 OCT 1997) (BG 07 NOV 1997)

2. Counselling/Education Programs: All students in health care programs found to be Hepatitis B "e" antigen, Hepatitis C or HIV positive will be required to undergo both appropriate counselling as well as education related to infection control.   In addition, as appropriate, students who test positive for Hepatitis B "e" antigen, Hepatitis C, or HIV will be provided with a modified training program in order to minimize the risk of transmission.  Such modifications will be determined by the student's Faculty in accord with the University policy on reasonable accommodation. Where no reasonable accommodation is possible, a student may be withdrawn from a program.  Withdrawal will only be considered as a last resort. (GFC 15 OCT 1997) (BG 07 NOV 1997)

3. Appeals concerning modifications to or exclusions from a student's training program should be directed to the policy on Practicum Placements, Professional Practice and Public Safety (See Section 87, GFC Policy Manual). (GFC 15 OCT 1997) (BG 07 NOV 1997)