Hepatitis C

[JJ1]

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Hello all,

I have been lurking for a while, but this is my first post. Please do take it seriously - I am not a troll, not a spammer and my question is genuine.

I am originally from South Africa, where I trained in Gen Surgery for a few years before coming to the UK a few years ago. When I arrived in the UK, all was well: I passed UK licensing tests, got a decent job in surgery and thought I was all set. Never was I farther from the truth... On the first day of the job, I was screened for Hep C - and this was when my nightmare started...I was positive. I never used drugs in my life, and to be honest practising as a surgeon in South Africa, I had plenty of opportunities to get the infection. Plus, I had IVIG transfusion as a kid for Kawasaki - and I am nearly 30 now, so obviously hep C virus was not even known to medicine at the time...

I got a different job, was treated and now have been confirmed as having had sustained virological response (ie, virus free). I have been virus-free for more than 18 months now.

This year, I applied to and interviewed at several FP and Psych programs in the US (all community-based, but with good reputations). I am awaiting the results of the Match.

My questions are:

1) Will I pass the health clearance for the residency, if I match? Would they be concerned about my PMHx of Hep C? Would they want to retest me, or would they take my UK results (i have to admit, that there is a tiny creature inside me that is nagging me every day, "what if it comes back?")?

2) Will I get the state medical licence?

3) Will I be able to get health insurance for myself? How about my wife and my kid (they both have been tested - thank heavens, they are negative)?

Thank you so much for your insights.

Please, please - anyone, any ideas, thoughts on my situation?

 

[Blade28]

Good questions.

(1) I honestly don't know what would happen if your residency program found out you used to be hep C positive. I mean, it shouldn't matter - just like if you had hep B or HIV - but I just don't know.

(2) You mean later, after you pass Step 3 and finish internship? Yes.

(3) Since all health insurance companies require an extensive past medical history - though not as thorough as diability insurance companies - you may find your options are slightly limited and/or your premiums more expensive. But if you're talking about the health insurance that you obtain for free through your residency program, well, again, perhaps see (1).

I honestly don't know the answers to some of your questions, but you raise a good point.

Best of luck!

 

[dkpwalker]

Hello all,

I have been lurking for a while, but this is my first post. Please do take it seriously - I am not a troll, not a spammer and my question is genuine.

I am originally from South Africa, where I trained in Gen Surgery for a few years before coming to the UK a few years ago. When I arrived in the UK, all was well: I passed UK licensing tests, got a decent job in surgery and thought I was all set. Never was I farther from the truth... On the first day of the job, I was screened for Hep C - and this was when my nightmare started...I was positive. I never used drugs in my life, and to be honest practising as a surgeon in South Africa, I had plenty of opportunities to get the infection. Plus, I had IVIG transfusion as a kid for Kawasaki - and I am nearly 30 now, so obviously hep C virus was not even known to medicine at the time...

I got a different job, was treated and now have been confirmed as having had sustained virological response (ie, virus free). I have been virus-free for more than 18 months now.

This year, I applied to and interviewed at several FP and Psych programs in the US (all community-based, but with good reputations). I am awaiting the results of the Match.

My questions are:

1) Will I pass the health clearance for the residency, if I match? Would they be concerned about my PMHx of Hep C? Would they want to retest me, or would they take my UK results (i have to admit, that there is a tiny creature inside me that is nagging me every day, "what if it comes back?")?

2) Will I get the state medical licence?

3) Will I be able to get health insurance for myself? How about my wife and my kid (they both have been tested - thank heavens, they are negative)?

Thank you so much for your insights.

Please, please - anyone, any ideas, thoughts on my situation?

As far as i know you aren't tested for any kind of blood bourne diseases in residency. you just have to pass a physical and a toxicology screen for drugs. i suppose they may give you a health form to fill out which mat require for you to divulge your hep c status otherwise "don't ask, don't tell". It shouldn't have any effect on you getting your licence and i think your wife and kid will be covered under you insurance once you start residency. I could be wrong in that regard...but don't sweat it, you'll be fine.

 

[yaah]

Personally, I find it astoundingly hard to believe that of all the med students and practicing physicians around the country that none of them have tested positive for HCV (or HIV). I suspect if you ever transmit it to a patient you would be in big trouble, but I don't really speak with any real expertise on that aspect.

 

[core0]

Personally, I find it astoundingly hard to believe that of all the med students and practicing physicians around the country that none of them have tested positive for HCV (or HIV). I suspect if you ever transmit it to a patient you would be in big trouble, but I don't really speak with any real expertise on that aspect.

From here:
http://www.cdc.gov/NCIDOD/DISEASES/HEPATITIS/c/faq.htm#3h
"Should HCV-infected healthcare workers be restricted in their work?
No, there are no recommendations to restrict a healthcare worker who is infected with HCV. The risk of transmission from an infected healthcare worker to a patient appears to be very low. As recommended for all healthcare workers, those who are HCV positive should follow strict aseptic technique and standard precautions, including appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments."

To the OP the only time I've ever been tested was when I had a needle stick. The issue is that you probably will not be able to get disability insurance. When I did GI we had one patient that was able to get it with a letter from the hepatologist that he was cured. As far as coming back if you are more than six months out the treatment is 99% durable. More than 2 years out and its 99.9%. You may have trouble getting healthcare coverage for HCV but most hospital insurance plans cover pre-existing conditions (my small n here). Won't affect your wife and kids. I'm assuming they have been tested since there is a very small chance of environmental infection.

David Carpenter, PA-C

 

[dpmd]

I was tested for hepatitis, HIV, TB, and drug use before I started residency. What they would have done with positive results, I do not know. It seemed like they just wanted to avoid being responsible if we test positive after a needlestick or something.

 

[IndyXRT]

I don't think that residencies can discriminate against you based on HepC positive status as long as you show you are in good health (there is always a question about any health problems that would prevent you from performing your duties). I wouldn't look for opportunities to bring it up, but neither would I lie if asked.

Hep C positive should have absolutely no bearing on getting a state licence (at least not in Indiana; I can't speak for other states).

Buying insurance as an individual will be difficult; if you are covered as part of a large group (as you are in most residency programs), it would be less problematic. As long as they have tested negative, I don't think there would be a big problem getting insurance for your family, although I could be wrong.

 

[JJ1]

I really appreciate time and thought that everybody put into their responses. You all sound very reassuring, and I am much more positive now about the whole thing. Thank you very much!

God bless,

JJ

 

[ajlmd]

You will be able to get into a residency as well as obtain a medical license being HepC +. Many (if not most) programs do not require blood testing prior to entry.

I know of practicing physicians with Hep C and one that does primary care with HIV. At this point, Hep C is not prohibitive to practicing surgery (though HIV is.) And being that you want to match in FP or psych, your status should not be a problem.

I can't comment about insurance but think that you probably will be fine.