Pre-start physical/labs?

[Itsame]

Can anyone tell me specifics on medical clearance/documentation needed to start residency? I'm sure there is some variability by program specialty, but anything would help. I'm hoping to match med/peds if that matters.

Within how many months must your last physical be before starting residency?
Will I need to recheck titers for immunizations, or will the results from my medical school tests be okay?
PPD within last year, or six months?

...I'm aging out of my parents' excellent health insurance within the next couple of months and somehow managed to schedule a physical with my PCP at the end of this month. I'm hoping to do as much as I can now before I pick up my own more expensive and less awesome insurance (some of those labs can cost an arm and a leg!)

Thanks for your help!

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[NotAProgDirector]

Anything that you need for work will be covered by Occ Med when you're hired.

 

[Law2Doc]

Anything that you need for work will be covered by Occ Med when you're hired.

Agreed. I recall I made an appointment the week before I started intern year and got a full set of titers and boosters, a PPD placed and a urine drug test -- all free of charge 🙂 , so your folks health insurance isn't really an issue.

 

[mcl]

Anything that you need for work will be covered by Occ Med when you're hired.

Unfortunately, that's not universal. My institution makes a point in post-match communications that insurance coverage starts on the first day of work, but no one will be cleared to start work until the health screen is complete. We'd accept the medical school report on the titers, but require 2 ppd tests within the calendar year prior to your start date.

 

[styphon]

When I started residency we were put thru a physical + labs by the hospital we were based at, but I would guess it would be institution dependent.

 

[Raryn]

The Occ Med office at my medical school covered everything for all 200 of us graduating and going wherever. They even did a CXR for those of us who had a hx of a prior positive ppd.

 

[Crayola227]

do yourself a favor:

gather all your titer/vacc records that have already been done, when you start work have the records transferred
it can avoid having to repeat certain tests later down the road, and we all want to steward resources right?
ones you are missing you can wait for occ med, but again, if you can get the records/get them drawn now with other bloodwork your PCP is doing you might avoid another blood draw later, and like people said it can be hard to know what is covered vs not (usually it is covered)

as far as the PPD thing, that varies so much by institution just be good with your med school and wait to see what the program wants, some are strict it has to be read by them

occ med usually has you see a nurse for a pre-employment physical closer to your start date, so seeing your PCP especially this far in advance isn't likely to do anything for you from a work standpoint, but kudos to you get that in before you lose good coverage

get an HIV test done now, and then repeat in 6 mos right before starting residency, or, have it done when you get your residency health coverage and again repeat
this can help exclude any claim of seroconversion having taken place in any timeframe before residency or at least in the first 6 mos if you have to go with the latter scenario
too many horror stories abound of needlesticks and worker's comp being dicks
(needlesticks are surprisingly common, at least 1/3 of residents by graduation report having had one according to some EM conference I went to, the rate of anything bad happening as a result is thankfully quite low)

 

[dozitgetchahi]

Unfortunately, that's not universal. My institution makes a point in post-match communications that insurance coverage starts on the first day of work, but no one will be cleared to start work until the health screen is complete. We'd accept the medical school report on the titers, but require 2 ppd tests within the calendar year prior to your start date.

That absolutely sucks and your institution is doing a real disservice to its incoming housestaff.

 

[Raryn]

That absolutely sucks and your institution is doing a real disservice to its incoming housestaff.

That's standard. Everywhere I've ever heard of requires you to submit health screening before you start and you don't have health insurance until after you start. That said, there should be an occupational health office associated with the institution willing to do it for free...

 

[Law2Doc]

That's standard. Everywhere I've ever heard of requires you to submit health screening before you start and you don't have health insurance until after you start. That said, there should be an occupational health office associated with the institution willing to do it for free...

Meh, I've worked a couple of places now and in each case occupational health was more than happy to give vaccines, check titers, place a PPD and screen my urine before my health insurance kicked in. If a place wants to ensure this happens before you start, they pretty much have to make this available. And there are record keeping advantages for them at having these things done at their own facility. And they want you to come in and give them urine anyhow in some cases.