If we offer you a place, this will be conditional on a satisfactory health check. We will ask you to complete a health questionnaire before the course starts, and some applicants may be asked to undergo an independent medical examination or a skills assessment before they can be registered on the course.
Immunisation
After you register at HYMS, you'll undergo a pre-course health assessment. This is to make sure that:
- you don't pose a potential risk to patients
- working in a clinical environment won't pose any risk to your health and wellbeing
- you meet the requirements of the GMC and the Department of Health.
Both you and your GP will be asked to complete an Occupational Health form which will be the basis of this assessment.
We will expect you to provide evidence of two MMR jabs. Vaccinations will be provided if required. You will be assessed for TB, and we may offer you TB screening or BCG vaccination. You will also need to take a blood test, which will include testing for hepatitis B, hepatitis C and HIV, and may assess immunity status for varicella, measles and rubella, and hepatitis B.
Blood-borne diseases
Hepatitis B and hepatitis C are blood-borne viruses which cause serious diseases of the liver. Symptoms may vary considerably, from flu-like symptoms to an acute illness with abdominal pain and jaundice. Its consequences vary from one individual to another, but they can include chronic liver disease, cancer of the liver, and remaining an infected carrier of the disease. Many people are unaware that they have been infected.
HIV is another blood-borne virus, causing a serious condition of the immune system that can lead to AIDS.
If you work in healthcare, your risk of contracting a blood-borne virus is much higher than otherwise (five to ten times higher, in the case of hepatitis B and C). There is also a risk that you might pass on a virus to patients, for instance through a needle injury, cuts and skin lesions, or blood splashes to mucous membrane. The spread of blood-borne diseases can be minimised through a system of good practice, regardless of whether any given situation is considered 'high risk' or not.
In addition, all HYMS students are offered a blood test for these viruses at the start of their medical course. There are three possible outcomes. None of these will normally prevent you from training as a doctor.
- If you are free of infection: You will be offered an immunisation programme to protect you from hepatitis B. The programme will consist of a course of three doses of vaccine: the first immediately, the second after four weeks, and the third after a further five months. (A small percentage of the population will not develop immunity after this. If this applies to you, we will give you suitable advice, but it won't prevent you from continuing with your training.)
- If you are infected: You will be informed and counselled about the meaning of the result by the Occupational health service. You will still be able to train, but you will be required not to undertake 'exposure-prone procedures'.
- If you decline to be tested: You still will be able to train, but you will be required not to undertake 'exposure-prone procedures'.
An 'exposure-prone procedure' is any procedure where there is a risk that injury to you might result in exposing the patient’s open tissue to your blood. For example, this includes procedures where your gloved hand or fingertips may not be completely visible and may come into contact with sharp instruments, needle tips or sharp tissue (e.g. spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space.
Our undergraduate curriculum may involve these procedures. If you are infected or you decline to be tested, you will have to avoid these, but they are not essential in order to qualify as a doctor. Once qualified, you will not be able to enter certain branches of postgraduate medicine that involve exposure prone procedures (for example, surgery).
Many common procedures where the hands can be seen are not classed as 'exposure-prone'. Examples include taking blood, setting up an IV line (drip), minor surface suturing and simple endoscopic procedures.
Mumps
Mumps is an acute viral illness characterised by parotid swelling, though some cases have no symptoms. Complications include pancreatitis, oophoritis, orchitis, meningitis and encephalitis. The incubation period is 14-21 days, but mumps is transmissible for several days either side of the appearance of swelling.
Incidence of mumps in teenagers and young adults has gradually increased from 372 confirmed cases in 1999 to 3756 confirmed cases in the first 9 months of 2004.
The group most affected are those young people born between 1982 and 1990, who were too young to be offered the initial MMR vaccine and to benefit from the two-dose system introduced in 1996, which is important in securing good levels of protection.
In line with guidance from the Health Protection Agency, we recommend that all HYMS students seek advice from their GP to make sure they are protected by two MMR vaccinations against mumps. The vaccination also gives protection against measles and rubella. If you are not properly protected, you may be excluded from clinical practice if there are known cases of mumps within the group.