Remember - testing is not compulsory!
Why you would need to have the tests
You will need to have these tests if you want to carry out what are known as Exposure Prone Procedures (EPP) during your course. These are procedures where there is a risk of exposure of a patients open tissues to your blood, for example, assisting in a caesarean.
You do not have to carry out EPPs to qualify as a doctor but some medical courses include some experience or offer EPPs as part of the basic training. The Medical Students Committee believes that you should not be prevented from assisting in EPPs if you want to do this but if you do want to carry out EPPs you will need to be tested.
If you don't want to have the test then you will not be able to carry out EPPs. This is perfectly acceptable. It should not affect your entry to medical school, or continuing or completing your course.
If you are offered the test
You should be given information beforehand about the tests and time to discuss these with an occupational health practitioner before making a decision. You should be told:
- that the test is not compulsory
- about the implications of either refusing to test or of a positive result, on your studies and future career options i.e. that you may be restricted in the type of work you wish to undertake
- that any refusal to have the test will not affect your access to medical school or the continuation or completion of your course
- that the discussion will be confidential
If you are tested
The results of any test should remain completely confidential and there should be full support for you including pre- and post- test counselling as well as occupational health support if you need it.
If you test positive
You should be given:
- Occupational health support
- Careers guidance so that you can make informed decisions about your future career
Medical students should not bear the cost of testing for BBVs at any stage.
Advantages of being tested
You may not wish to be tested but there are advantages in being tested:
- Early treatment and support if you are tested positive
- The ability to make informed decisions about your career
- Patient safety
It is possible that you will be offered to participate in carrying out EPPs whilst on elective. It is sensible to apply the same standards of practise as you would in the UK. Therefore if you choose not to be tested or test positive whilst at medical school, it is recommended that you do not carry out EPPs whilst on elective.
Whether or not you are 'cleared' for EPPs in the UK, in some countries or areas you should consider carefully whether you should participate in EPPs as some areas carry more risk than others.
What you can do
Do not feel pressured into being tested
If you hear of any compulsory testing taking place at your medical school, please inform your MSC representative who will take the matter up on behalf of the students at your school. Feel free to use the information in this guidance to raise any concerns with your medical school.
Get in touch with a BMA adviser on 0870 60 60 828 or email us using our feedback form.
What is MSC doing
The Medical Students Committee is representing medical student views on the working group which has been set up by the Medical Schools Council to develop a protocol for medical schools on testing. We have made our views clear and have created this guidance for reference. We will keep medical students updated of any developments.
Further information and support
'Doctors for Doctors' - BMA Counselling Service
24 hours a day, seven days a week
T: 08459 200 169 (calls charged at local rates)
The Terrence Higgins Trust
The National AIDS and Sexual Health line
T: 0800 567 123
The Hepatitis C Trust
The Hepatitis B Foundation UK
In March 2007 the Department of Health (DH) published 'Health clearance for tuberculosis, hepatitis B hepatitis C and HIV: New healthcare workers'. The DH guidance recommends that all new healthcare workers have checks for tuberculosis disease, immunity and are offered hepatitis B immunisation, with post-immunisation testing of response and the offer of tests for hepatitis C and HIV.
For new healthcare workers who will perform exposure-prone procedures (EPPs)1 it recommends that additional health clearance should also be undertaken including HIV, hepatitis B and hepatitis C.
Medical students are, for the purposes of the guidance, classed as healthcare workers.
Exposure Prone Procedures
The GMC no longer requires students to undertake Exposure Prone Procedures during medical training and the Department of Health guidance acknowledges this. The guidance recommends additional health clearance for those students who will be involved in EPPs. Many students have the opportunity to undertake EPPs during their training and in order for this to continue, will require BVV clearance.
Medical Schools Council
The Medical Schools Council, the Dental Schools Council, the Association of UK University Hospitals and the Higher Education Occupational Physicians Group has published guidance on Blood Borne Viruses. The guidance is intended for use by medical and dental schools, medical and dental students, occupational health services and health provider organisations.
Medical Students Committee position is as follows:
- The MSC remains against compulsory testing for BBV
- The setting of a consistent and achievable policy on the screening of medical students before entry is vital to avoid inappropriate testing, inappropriate exclusion of potential students, and inconsistencies between medical schools
- The MSC therefore recommends a national standard of best practice to include – standard information, protocols, treatments codes of practice
- Students who have opportunity to carry out EPPs whether through medical school or on elective, should continue to have this opportunity. It is accepted that in order to do this they will be tested for BBV
- Students who refuse a test or who test positive should not be restricted from either entering medical school or from completing their studies leading to full registration with the GMC, in keeping with the treatment of other healthcare workers in the DH guidance.
- There should be full information for students prior to being offered testing. This information should include:
- the implications of either refusing to test or of a positive result, on their studies and their future career options i.e. that they may be restricted in the type of work they wish to undertake.
- explicit reference to the fact that the test is not compulsory nor will any refusal to have the test affect their access to medical school or the continuation or completion of their course.
- The results of any test should remain completely confidential and there should be full support for medical students including pre- and post- test counselling as well as occupational health support for those who need it.
- Careers guidance for those who test positive should be provided in order to enable individuals to make informed decisions about their future.
- Medical students should not bear the cost of testing for BBVs at any stage.
1 The DH defines EPPs as - those invasive procedures where there is a risk that injury to the worker may result in the exposure of the patient's open tissues to the blood of the worker. These include procedures where the worker's gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (e.g. spicules of bone or teeth) inside a patient's open body cavity, wound or confined anatomical space where the hands or fingertips may not be completely visible at all times.
Testing medical students for Blood Borne Viruses - PDF