Hep B carrier + pgy 1 residency start questions

[Cubioh]

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Not sure if this is the right forum, (seems to be), and I didn't come across this specific question, so here goes,

Do U.S. hospitals deny residency positions if it turns out that a candidate is a hep b carrier? husband just found out via pre-entry blood tests, a nurse called and said he should come in tomorrow to speak with a doc, but now he's worried that they may kick him out before it even starts. 2 yrs of working for a position and now this comes up.

I've been reading things online, and it seems that there isn't any legal basis for termination, but there isn't anything specific he can use in his defense either (if he needed to). Do any of you guys know for sure, considering you are already working in clinical rotations? This is in NJ by the way (yes I've been searching about online, but as I said, nothing definite has come up yet).

Thank you in advance for your time & any assistance (even though we could just wait until tomorrow and 'see what happens' I thought I should ask anyway).

 

[StIGMA]

The risk is dependent on the field that your husband is entering. Fields with invasive procedures (blood contamination risk) will require more precaution. HepB is not transmitted casually, and there are doctors & surgeons practicing with HepB. I doubt that he will be denied residency based on his health status. Anyways, best of luck. Let us know how it turns out.

 

[tco]

I only know of one physician that had hepatitis, but I believe that it was Hep C. He ended up choosing to go into pathology to avoid potentially spreading it to his patients. I think it was his choice, however, so I'm not sure if this is any help to you at all.

Just know that if he can't go into direct patient care there are always other options.

 

[Gastrapathy]

Unless your husband plans on sleeping with or bleeding on patients, I don't know what problems there would be. Hep B is not transmitted casually.

Ah, advice from a medical student who didn't even bother to google before answering. HBV transmission from doctor to patient has clearly occurred in the setting of invasive procedures.

OP, your husband should google SHEA guidelines for blood-borne pathogens. The hospital's credentialing committee will decide how to handle this. Good news is that there are great drugs for HBV now.

 

[StIGMA]

Ah, advice from a medical student who didn't even bother to google before answering. HBV transmission from doctor to patient has clearly occurred in the setting of invasive procedures.

OP, your husband should google SHEA guidelines for blood-borne pathogens. The hospital's credentialing committee will decide how to handle this.

The reference to bleeding on patients was to indicate potential risks for invasive procedures. I don't believe I said that there was no risk or that is has never happened.

We do not know what field the OP's husband is entering. Clearly specialties dependent on invasive procedures would be treated differently than others. Do you know any cases where residency has been denied for HepB, HIV, or other status?

 

[smq123]

Moving to the general residency forum.

 

[NotAProgDirector]

The risk of transmitting Hep B (or Hep C) from physician to patient is very, very small. You would need to cut yourself and bleed into the patient. I could imagine that happening in the OR rarely. Otherwise, it seems too unlikely to be a problem. So, in all fields except surgery, I think this is a non-issue. Even in surgery, the risk seems very low.

It would be illegal for a program to terminate someone over this unless they could prove a significant, unmitigatable risk.

The vast majority of healthcare worker to patient transition of Hep B or C is caused by needle or drug diversion by the worker (i.e. shooting themselves up with needles, which they then use on patients and discard as a way to hide their addiction)

 

[Law2Doc]

The risk of transmitting Hep B (or Hep C) from physician to patient is very, very small. You would need to cut yourself and bleed into the patient. I could imagine that happening in the OR rarely. Otherwise, it seems too unlikely to be a problem. So, in all fields except surgery, I think this is a non-issue. Even in surgery, the risk seems very low.

It would be illegal for a program to terminate someone over this unless they could prove a significant, unmitigatable risk.

The vast majority of healthcare worker to patient transition of Hep B or C is caused by needle or drug diversion by the worker (i.e. shooting themselves up with needles, which they then use on patients and discard as a way to hide their addiction)

If you do google searches if sharps injuries, particularly in procedural settings, the rate of annual reported injury in certain fields (bearing in mind that not all injuries are reported) is actually pretty high. Surgeons on average stick themselves about once annually. The rates in some studies are actually even less among doctors themselves and more among techs and nurses they stick. The rate of contracting something is very very low however. There is an existent but minute risk here, and liability on the part of the hospital if they know of an employees disease. You can't terminate someone for an ilness, but you could certainly keep them out of certain work environments.

 

[Gastrapathy]

The reference to bleeding on patients was to indicate potential risks for invasive procedures. I don't believe I said that there was no risk or that is has never happened.

We do not know what field the OP's husband is entering. Clearly specialties dependent on invasive procedures would be treated differently than others. Do you know any cases where residency has been denied for HepB, HIV, or other status?

Gotta love the edited post trick. Did you even read the reference?

 

[Oxer45]

I'm sure there are surgeons who got HepB/ HepC/ HIV after becoming an attending (either through sex/needle sticks etc). What happens to them? Do they leave clinical side and get involved in research or become a drug rep?