Hep B and Being a Pathologist

[MiDam]

Hi, this is my first post. I'm currently a med student and am contemplating about going into pathology for residency. The issue with me was I was exposed to Hep B through vertical transmission when I was an infant, and had been a chronic carrier since then. My Hep B Viral DNA level has always been undetectable, with Hep B sAg positive and sAb negative; Hep B eAg is negative. My liver enzymes are mildly elevated (<100 for AST and ALT) and the last Liver U/S showed only fatty liver.

While I am in med school, my school knows about this and I didn't have any trouble with the administration preventing me doing any clinical rotation/work. However, I'm concerned that being Hep B positive will prevent me from starting a residency position, especially since all pre-employment physicals will ask for Hep B Antibody titers and vaccination history. Anyone can shed some light on how institutions look at this?

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[lipomas]

I am unsure as to why this would prevent you from getting a spot. I think part of the reason for all of these pre-employment physicals and testing is to in part establish a baseline (thus if you convert your status, it is probably because you were recently infected). Or to encourage you to be vaccinated if you have no antibodies at all. There are physicians with HCV, HBV, even HIV who practice.

Why would being HBV positive prevent you from starting residency? Am I missing something?

 

[zao275]

Besides, you typically have these tests performed right when you begin residency, but not before the Match. So even if they had some issue with this, you would already have been accepted for the position by time this information became known to the program. But like lipomas said, the rule seems to be for your protection not to disqualify you from practicing.

 

[MiDam]

That's reassuring to know. I have heard an anecdote of a person who wanted to go into OB/GYN but couldn't or didn't do so because of her Hep B carrier status. I guess my concern was hospitals would be worried about the liabilities of physicians accidentally infecting patients through blood contacts. It's certainly different for specialties like OB/GYN and Surgery compared to Pathology.

Thanks for the reply.

 

[pathstudent]

That's reassuring to know. I have heard an anecdote of a person who wanted to go into OB/GYN but couldn't or didn't do so because of her Hep B carrier status. I guess my concern was hospitals would be worried about the liabilities of physicians accidentally infecting patients through blood contacts. It's certainly different for specialties like OB/GYN and Surgery compared to Pathology.

Thanks for the reply.

I hardly believe that anecdote, and if a medical center kept you from starting your residency because of hep B, they would seriously be on the wrong side of the law and at risk for lawsuit.

 

[yaah]

I admit I am not up to date on the issues of practicing physicians with known transmissible infectious diseases. I don't know whether people are allowed to be surgeons if they have HIV. But I doubt having HBV would preclude you from being a physician, especially because a fairly large percentage of the world is an HBV carrier.

 

[KCShaw]

In pathology I think you're in pretty good shape. As a surgeon I really don't know -- one would think there are statutes that would protect you in terms of training and getting a job, but in the unlikely event of a transmission (or worse, an unproven but alleged transmission) there are also probably statutes that could blur or break that protection.

In short, I wouldn't be concerned about it in terms of getting a training position. But, it -would- be something I'd want to get real informed advice about before it comes time to getting an attending position...just so you really know your rights, and obligations.