Would a TB in childhood automatically disqualify me as a potential med student?

[dbrokut]

Ok so before I immigrated to states from India, when I was maybe 8 or 9, I had severe case of tuberculosis for at least a year or two before doctors figured it might be TB and then I was on pills for about 9 months, which supposedly cured it because I no longer had any coughing. But last year when I went to have a step 2 test for TB, the test turned out to be positive but the lung x-ray didn't reveal anything so I am sure I do not have active TB at this point. I was given six-month dose of pills to take care of any infection I might have, which I did not finish after four months.

So whichever school accepts me and then.. when they request my immunization record and results of step 2 TB test, they'll see all that. Do you think that it would prompt them to disqualify me as their med student?

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[TexasFight]

.

 

[Siggy]

The standard TB test, which the 2 step TB test is a derivative of, does not test for an active infection. It tests to see if you have a cell mediated immune response (essentially, does your body recognize TB due to a prior infection or vaccination). The test is important for two reasons. First off, it tells us who needs and who doesn't need a chest x-ray. Second, since TB can remain in a person in a latent (non-active and more importantly, non-infective) stage, surveillance by chest x-ray is important to insure that it doesn't transform back to an active state.

Personally, (and, for the record, I am NOT a physician [yet], but I did stay at a Holiday Inn Express last night) I don't see why it would disqualify you for medical school. You would have to make sure that you stay up on your chest x-rays. If it makes you feel better, you might want to open up a free e-mail account (or use your own if you want) and send a handful of schools that you are considering an e-mail explaining your situation and your concerns.



Texas, how long ago was that? I could see discrimination based on HIV status even a short while ago, but I would surprise to learn of any examples in, say, the past decade.

 

[behealthy]

Isn't it illegal to refuse students because of HIV? I'm also curious how the schools learned of the applicants HIV status, since I'm 99.999999% sure you cannot ask.

 

[TexasFight]

Texas, how long ago was that? I could see discrimination based on HIV status even a short while ago, but I would surprise to learn of any examples in, say, the past decade.

I'm searching for it on the internet right now. I do remember reading that on a practice safe sex or bad things will happen to you website or something like that. I can't really find anything right now. It was a while ago though, so you are probably right in that it doesn't happen anymore.

 

[TexasFight]

Yeah I really can't find anything. I'll just delete my post so I don't scare anyone. Sorry to put something I read a while ago from a non-citable source up as fact.

 

[KnuxNole]

I dont get it, why would having TB(or HIV for that matter) disqualify someone from going to med school. It's not like having a past or present disease means anything.

Same with "psychological" disorders as well. I remember someone saying a student with Asperger's should not be in med school...but turns out that student is honoring class left and right.

 

[Arzt67]

When I had to do my pre-matriculation immunizations, I had a positive skin test and negative chest x-ray and nobody asked any me questions. I don't think you even have to mention having had TB in the past at all.

 

[adeline]

If your chest x ray is clear at pre-matric physicals, you should be okay.

If it's not, could be an issue.

You seriously needed to have finished those drugs, though. That might be an issue.

 

[the freest man]

I had TB and took the 9-month drug for it, but I included it in my application. Just figured it was a good idea, can't hurt you.

 

[Bacchus]

When you get the PPD/Mantoux test done if you display a positive result you will have a chest x-ray done. Most matriculation physicals will ask the status of your PPD and then require an x-ray if you have a positive PPD. TB won't keep you out of medical school.

 

[Tin Man]

A TB test might not mean anything to the medical schools, but there is a reason that even the lowly gift-shop volunteers at hospitals have to provide evidence of a negative TB test in order to work in that building. Med school might not be a problem, but finding a rotation might.

Seriously, this isn't a question you should be asking the wholly unqualified SDN. I would contact a couple of medical schools (anonymously, if you wish) and just ask them straight out if they think it's going to end up being a problem.

 

[iheartsnow]

Many people from countries where TB is prevalent get vaccinated against it, and therefore the Mantoux test shows up positive. So, I'm pretty sure there is no way for them to tell the difference between someone who has had the disease or has simply been vaccinnated against it. Anyway, I heard of a grad student who was in this situation and he simply had to get chest x-rays.

Also, I had to sign a million forms to start med school and one of them was something that said that you were physically capable of being a med student/doctor. It had a bunch of things about vision and motor function but nothing about TB. In addition, in the health forms that needed to be filled out, there was a spot for the Mantoux test, and a spot for the chest x-ray, which only needed to be done if Mantoux was positive.

 

[Bacchus]

When you get the PPD/Mantoux test done if you display a positive result you will have a chest x-ray done. Most matriculation physicals will ask the status of your PPD and then require an x-ray if you have a positive PPD. TB won't keep you out of medical school.

I'm looking at my physical form as this post is filled out. Its usually a chest x-ray after a positive PPD. You'll be fine.

 

[dbrokut]

Wow. Thanks everyone for fast and valid responses/advice. I'll keep in mind all your advice.

Thank you!

 

[Mattabet]

👍 Right, I second Bacchus. I was actually just at the doctor for my physical, so I've got a bunch of the forms right here.

Every year, as someone in a healthcare setting, you're going to have a skin test for TB, from doctors, nurses, or med. techs. all the way down to volunteers. Because TB spreads so readily, hospitals need to stay on top of it - it's not like discriminating because of a disease, it's just testing everyone to try not to kill patients. If the test comes back negative, you're fine. In the case of the OP, it'll come back positive (after one or two, they'll probably just skip it). He'll probably need a chest x-ray to confirm that he doesn't have active, spreadable TB. Even if he did, they'd just put him on meds to get it under control.

TB is never going to cost you your medical school admission*. It's just something that needs to be taken care of before they set you loose in the hospital.

*Unless it kills you, I suppose. Dead people tend not to meet technical standards for admission.

 

[Chemdude]

If you had TB as a child(active or latent), you're not supposed to get a PPD test done. If you test positive once, your PPD test will always be positive, even after you get cured.

All you have to do is mention that you had TB, and they will give you the chest x-ray without a PPD test.

 

[Rendar5]

A TB test might not mean anything to the medical schools, but there is a reason that even the lowly gift-shop volunteers at hospitals have to provide evidence of a negative TB test in order to work in that building. Med school might not be a problem, but finding a rotation might.

No it won't. They get tested regularly because they work in a healthcare setting and come into contact with sick people much more often. They're tested to see if they develop latent TB, so they need to be treated before they develop active TB and spread the bug around. That is all.

 

[mokamadness]

Ok so before I immigrated to states from India, when I was maybe 8 or 9, I had severe case of tuberculosis for at least a year or two before doctors figured it might be TB and then I was on pills for about 9 months, which supposedly cured it because I no longer had any coughing. But last year when I went to have a step 2 test for TB, the test turned out to be positive but the lung x-ray didn't reveal anything so I am sure I do not have active TB at this point. I was given six-month dose of pills to take care of any infection I might have, which I did not finish after four months.

So whichever school accepts me and then.. when they request my immunization record and results of step 2 TB test, they'll see all that. Do you think that it would prompt them to disqualify me as their med student?

Just out of curiosity, why didn't you finish the six month regiment?

 

[dbrokut]

Just out of curiosity, why didn't you finish the six month regiment?

Because I felt it wasn't necessary. Stupid me I know. But I just got sick of taking medicine everyday and also as long as I was on the TB meds, I was not allowed to drink.. the doctor said I could drink socially once every two weeks or so but even then, no more than three beers or one or two shots. And my 21st was coming up and I didn't wanna have to spend that without some drinking... so I stopped it. It seemed at right at the time but right now as I reflect on it, makes me feel like *******.

 

[DRIN]

I remember someone saying a student with Asperger's should not be in med school...but turns out that student is honoring class left and right.

Well there is a lot more to becoming a doctor than being able to satisfactorily complete medical school...that's probably what they meant. I have a friend whose brother has Asberger's and while he is very intelligent, his social skills are not appropriate for becoming a doctor.

 

[CyclistOK]

Many people from countries where TB is prevalent get vaccinated against it, and therefore the Mantoux test shows up positive. So, I'm pretty sure there is no way for them to tell the difference between someone who has had the disease or has simply been vaccinnated against it. Anyway, I heard of a grad student who was in this situation and he simply had to get chest x-rays.

The most common test for TB is a Purified Protein Derivative (PPD) Test, because TB and BCG express similar proteins to the PPD test, exposure to either of these will produce a positive response. If this reacts positively, you will need chest x-rays to check for granuloma formation, indicative of active TB.

IF you had TB in the past or the vaccine and the Chest x-ray comes back negative you're fine. If not, get ready for 9-12-18 months of Antibiotics...

 

[adeline]

Because I felt it wasn't necessary. Stupid me I know. But I just got sick of taking medicine everyday and also as long as I was on the TB meds, I was not allowed to drink.. the doctor said I could drink socially once every two weeks or so but even then, no more than three beers or one or two shots. And my 21st was coming up and I didn't wanna have to spend that without some drinking... so I stopped it. It seemed at right at the time but right now as I reflect on it, makes me feel like *******.

Go ask your doctor if doing something now would be useful.

 

[Disinence2]

Don't worry about it.

As long as you don't have active TB you'll be fine.

 

[Rendar5]

Go ask your doctor if doing something now would be useful.

it wouldn't be. He has to get a chest x-ray. If he has something active, he gets treated, if he has nothing going on, he doesn't.

 

[sustentacular]

If you had TB as a child(active or latent), you're not supposed to get a PPD test done. If you test positive once, your PPD test will always be positive, even after you get cured.

All you have to do is mention that you had TB, and they will give you the chest x-ray without a PPD test.

Yes, this is what I was told. You may also want to have on hand a letter from your PCP saying you completed the drug treatment, if that's the case. If you have the PPD test again it could lead to an "over-reaction" which, if you wanted to talk about it really dramatically, could become infected/develop flesh eating bacteria etc.

 

[adeline]

it wouldn't be. He has to get a chest x-ray. If he has something active, he gets treated, if he has nothing going on, he doesn't.

That sounds useful to me. 😉

 

[Omni]

All right, here's the answer. The skin test that they use to check for TB isn't that effective, that's why there are a few steps to determining whether someone has it or not. Basically, people who come from Asia (more specifically people who've lived in India for a bit), usually show a greater chance of having a positive skin test. The reason to this is that the water or anything else that you may consume is not exactly "clean" and thus you may have something in your body that may react with the test and give it a positive.
That's why you need to do an X-ray, so that a doctor can definitively say whether or not you have TB. If the X-ray comes out as negative, then you don't have TB at all. You are then put on medication in order to clean out whatever it was that was making a + result.

 

[Mashizhao]

All right, here's the answer. The skin test that they use to check for TB isn't that effective, that's why there are a few steps to determining whether someone has it or not. Basically, people who come from Asia (more specifically people who've lived in India for a bit), usually show a greater chance of having a positive skin test. The reason to this is that the water or anything else that you may consume is not exactly "clean" and thus you may have something in your body that may react with the test and give it a positive.
That's why you need to do an X-ray, so that a doctor can definitively say whether or not you have TB. If the X-ray comes out as negative, then you don't have TB at all. You are then put on medication in order to clean out whatever it was that was making a + result.

Can anyone else confirm this? I thought my positive skin test meant that I had latent stage TB - meaning I got infected with TB before but my immune system has suppressed it.

I heard that if you have a + skin test you cannot work in peds?

 

[adeline]

Can anyone else confirm this? I thought my positive skin test meant that I had latent stage TB - meaning I got infected with TB before but my immune system has suppressed it.

I heard that if you have a + skin test you cannot work in peds?

You got exposed and picked up the bug but you lack an active infection.

As long as your chest x ray is clear you should be fine. Pertussis is what I'd worry about in peds. And chkn pox.

 

[sustentacular]

All right, here's the answer. The skin test that they use to check for TB isn't that effective, that's why there are a few steps to determining whether someone has it or not. Basically, people who come from Asia (more specifically people who've lived in India for a bit), usually show a greater chance of having a positive skin test. The reason to this is that the water or anything else that you may consume is not exactly "clean" and thus you may have something in your body that may react with the test and give it a positive.
That's why you need to do an X-ray, so that a doctor can definitively say whether or not you have TB. If the X-ray comes out as negative, then you don't have TB at all. You are then put on medication in order to clean out whatever it was that was making a + result.

I've not heard of this unclean water yielding a false positive theory... maybe drinking water contaminated with TB could lead to an actual positive.

The PPD is a test for exposure to TB. A positive skin test just means you've been exposed to someone who has active TB. The chest X-ray is to determine if you have active TB. If your chest x-ray is negative you may still have latent TB which could become active if you are ever immunocompromised, but you cannot spread TB to others. The drugs (usually INH) are administered to kill the latent TB so it does not have a chance to become active.

 

[Rendar5]

Can anyone else confirm this? I thought my positive skin test meant that I had latent stage TB - meaning I got infected with TB before but my immune system has suppressed it.

I heard that if you have a + skin test you cannot work in peds?

A + skin test indicates TB exposure. It may indicate latent, active, reactived, or prior TB (different from latent in that it was treated and any mycobacteria lying dormant were killed). It is not clear that the BCG vaccine necessarily makes it +. If you have a new + and a prior -, then we assume that you have contracted latent TB, and are treated for it so that you are not at risk for reactivation TB.

Now if you have a prior +, any further testing will be useless, and it will be impossible to differentiate latent TB (which is not really transmissable, but can reactivate) from no TB. The benefits of treating for possible latent TB in this scenario are not great enough to outweight the small risks associated with the anti-TB regimen, so nothing is done. However, we can still perform X-rays to look for active and reactivated TB in these patients so that we can treat early and prevent spread. If there's a finding on CXR, we treat. If not, we don't.

At this point, unless the person is coughing, there's no reason to quarantine them or prevent them from working in the hospital. If they are coughing and therefore contagious, they are quarantined while treatment is initiated, and after the start getting better, they can still work with patients while finishing off the 9-month drug course.

As for chickenpox, if you have not been vaccinated or had a case of this while younger, you will run into issues with your pediatric rotation that can be discussed with your school health office and the hospital you will work at. This will at most mean you cannot be in the same room as kids with undifferentiated rashes.

As for pertussis, yeah, the immunity on this tends to wane as you get older. I haven't seen a case of this, but I do know there were a few patients with this the past year at my med school's hospital. wash your hands and your'e fine.

 

[ensuii]

The standard TB test, which the 2 step TB test is a derivative of, does not test for an active infection. It tests to see if you have a cell mediated immune response (essentially, does your body recognize TB due to a prior infection or vaccination). The test is important for two reasons. First off, it tells us who needs and who doesn't need a chest x-ray. Second, since TB can remain in a person in a latent (non-active and more importantly, non-infective) stage, surveillance by chest x-ray is important to insure that it doesn't transform back to an active state.

Personally, (and, for the record, I am NOT a physician [yet], but I did stay at a Holiday Inn Express last night) I don't see why it would disqualify you for medical school. You would have to make sure that you stay up on your chest x-rays. If it makes you feel better, you might want to open up a free e-mail account (or use your own if you want) and send a handful of schools that you are considering an e-mail explaining your situation and your concerns.

It's my dream to one day stay at a Holiday Inn...is it as nice as they say it is?

 

[vickpick]

u would get the same results if u were given these shots which are often given in asia and europe to prevent TB, I was given the shot, and thus my skin test always come to be positive too... so u'll be fine, this aint rare at all..

 

[dbrokut]

I've not heard of this unclean water yielding a false positive theory... maybe drinking water contaminated with TB could lead to an actual positive.

The PPD is a test for exposure to TB. A positive skin test just means you've been exposed to someone who has active TB. The chest X-ray is to determine if you have active TB. If your chest x-ray is negative you may still have latent TB which could become active if you are ever immunocompromised, but you cannot spread TB to others. The drugs (usually INH) are administered to kill the latent TB so it does not have a chance to become active.

My doc had told me exactly the same things before putting me on the 6-month dose of INH. I stopped the dose four months into it and I just read on a reputable website that, I quote, "patients are highly advised not to disturb or stop the dose" and then goes on to say that it might result in latent TB having a higher chance of becoming active than it normally would have been. The reason for that, the website says, is because the INH has to make the latent TB supposedly "Active" before it can be completely destroyed. 😱

There goes a ring to my doctor..........

 

[vickpick]

It's my dream to one day stay at a Holiday Inn...is it as nice as they say it is?

lol, if u are serious, it isnt very different then say another 3 star hotel, which i often consider motels..

 

[redlight]

edit: FAIL. i forgot to quote.

 

[redlight]

If you had TB as a child(active or latent), you're not supposed to get a PPD test done. If you test positive once, your PPD test will always be positive, even after you get cured.

All you have to do is mention that you had TB, and they will give you the chest x-ray without a PPD test.

this. also, you'll have to get those x-rays every few (i think it's 3ish) years to make sure all is clear. non-active tb wont keep you out of medicine.

 

[premedbeachgirl]

I agree with everyone who's said that tb won't affect med school admissions. In fact, I've heard that it's fairly common for doctors to be exposed and test positive, so it's not a big deal. I haven't found a good source though. Has anyone seen something about the prevalence of tb in healthcare workers?

 

[Siggy]

lol, if u are serious, it isnt very different then say another 3 star hotel, which i often consider motels..

....someone hasn't seen the commercials apparently.

 

[TMP-SMX]

My doc had told me exactly the same things before putting me on the 6-month dose of INH. I stopped the dose four months into it and I just read on a reputable website that, I quote, "patients are highly advised not to disturb or stop the dose" and then goes on to say that it might result in latent TB having a higher chance of becoming active than it normally would have been. The reason for that, the website says, is because the INH has to make the latent TB supposedly "Active" before it can be completely destroyed. 😱

There goes a ring to my doctor..........

Antibiotics only kill TB during an active infection (AKA dividing mycobacteria). The problem is that they have an extremely slow rate of division, thick waxy cell walls, build resistance to antibiotics very quickly, and if the drug isn't in the system while the bacteria are dividing it won't do anything.