Body
Unit Policy
Title
Offices of Medical Student Education: Policy on Preventing Student Exposure
Introduction
Purpose
This Policy establishes the University of North Carolina at Chapel Hill (“University”) School of Medicine’s (SOM) multi-step approach to preventing and addressing Medical Doctorate degree (MD) program student (“Student”) Exposure to Infectious and Environmental Hazards, and appropriate protocols.
Scope
This Policy applies to:
- all Students in all courses across all SOM campuses and sites, and
- Office of Student Affairs staff who are responsible for its implementation.
Policy
Policy Statement
In furtherance of its commitment to protecting Student health and maintaining a safe learning environment, the SOM will employ the multi-step approach in this Policy to prevent Student Exposure to Infectious and Environmental Hazards.
Prevention Methods
Preventing Student Exposure to Infectious and Environmental Hazards requires varied approaches, including the use of all of the following:
- Immunizations
To reduce the risk of Student Exposure to Infectious Diseases, Students must maintain immunizations in accordance with the requirements of the Centers for Disease Control and Prevention, the North Carolina Department of Health and Human Services, North Carolina law, and SOM and UNC Health policies and procedures.
- N95 Mask Fit Testing
All Students are required to complete N95 mask respirator Fit Testing during their first semester of the MD degree program. Students who do not comply with this requirement will be pulled from courses and/or activities that would place them at risk for Exposure in clinical settings.
- Training
The University’s Department of Environment, Health and Safety (EHS) and the SOM require all Students to complete annual training in infection prevention, bloodborne pathogens, and tuberculosis awareness by the deadline(s) established by the SOM.
- Annual Reminders and Publication of Policies and Procedures
Students will receive annual email reminders about each campus’ needlestick policies and procedures and bloodborne pathogen Exposure policies and procedures. All such policies and procedures are posted in Canvas. Students in Individualization Phase are required to complete an orientation module reviewing these policies and procedures in each of their selective courses.
- Phase specific Approaches
- First-year student Orientation
First-year students receive a card with a QR code that links to information on Exposure Protocol for central and all regional campuses.
- Transition to Application Phase Course
Students entering the clinical portion of the curriculum are required to attend a lecture in the first week of their third year about infection control issues, including the prevention of Exposure to Infectious and Environmental Hazards. Students who are assigned to the Central, Asheville, Charlotte, and Wilmington Campuses will be given instructions on handling Exposure to Infectious and Environmental Hazards during Application Phase Course orientations.
Financial Responsibility for Care and Treatment
Central Campus
Students are responsible for their medical care costs associated with evaluation and management of bloodborne or airborne Exposure, including medications associated with post-Exposure prophylaxis. Students must provide annual proof of valid health insurance through the SOM’s compliance platform, Exxat.
Regional Campuses
Students who are completing rotations at a site that is more than one (1) hour away from the Chapel Hill must follow the occupational health system guidelines in place at that institution. The costs of the initial evaluation and management of a bloodborne pathogen Exposure at the Asheville, Charlotte, and Wilmington campuses are covered by their respective occupational health offices for the source patient. In some circumstances, the source patient’s insurance may pay for source patient testing. Students are generally responsible for the cost of their medical care. All costs associated with medications for post-Exposure prophylaxis are typically filed by a Student using the pharmacy benefit of the Student’s health insurance plan, but Students may be reimbursed by their insurance for the cost of medications with documentation.
Care and Treatment Post-Exposure
Site-based Care and Treatment Requirements after Exposure
Students are given information regarding the management of bloodborne pathogen Exposure during their site orientations. All exposures to bloodborne pathogens must be handled according to the steps indicated by Campus Health. Campus Health at the University of North Carolina at Chapel Hill functions as the occupational health care provider for Students at Central Campus. The occupational health care providers at Wake Med (Raleigh) and Cone Health (Greensboro) serve other Central-Cross Regional Students. The occupational health care providers at Mission Hospital (Asheville campus), Novant Health Presbyterian Medical Center (Charlotte), and Novant Health New Hanover Regional Medical Center (Wilmington) serve Students at those campuses.
Bloodborne Exposures
Students are required to have completed a full Hepatitis B vaccination series and furnish a titer to prove immunity by the end of their first semester. Students who have potentially been exposed to Hepatitis B, Hepatitis C, Human Immunodeficiency Virus (HIV), or other bloodborne pathogens should follow the Exposure control plan for bloodborne pathogens for their site.
Tuberculosis (TB) Exposure
Upon matriculation, Students are required to have completed either a two-step tuberculin skin test (TST) or interferon-gamma release assay (IGRA) blood test and must complete an annual self-screening attestation. Students who have tested positive for TB are evaluated at either Campus Health, if they are rotating in a Central Campus site (Chapel Hill, Greensboro, or Raleigh), UNC Asheville’s Health and Counseling Center, UNC Charlotte’s Student Health Center, or UNC Wilmington’s Student Health Services, depending on the Student’s location, to determine whether the Student has latent TB or active TB.
Exposure Impact on Clinical or Educational Activities
Infectious Diseases
Bloodborne pathogens
Students with HIV, Hepatitis B, or other bloodborne Exposure will be evaluated according to the Healthcare Personnel Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus Policy.
TB
Students with latent TB may participate in patient care and educational activities without restriction but may wish to consult with a health care professional regarding treatment as studies have shown that treatment can reduce the incidence of disease progression. Students with active TB should be treated and placed in isolation and will not be allowed to participate in clinical activities until they are determined to no longer be infectious by a healthcare provider. The Student may be referred to an infectious disease specialist.
Covid-19 and Other Viral Respiratory Infections
Regarding in-person instruction and patient care, Students with Covid-19 and other respiratory infections will follow the guidelines of UNC Health if at Central campus or the hospital or clinic to which they are assigned if at another campus or site.
Religion & Preexisting Conditions/Disability
Students with religious beliefs or with preexisting conditions or disabilities requiring accommodations should contact the University Compliance Office as needed. The SOM Office of Student Affairs will work with the Student and UCO to determine the impact, if any, on the Student’s learning activities in either the classroom or clinical environment.
Definitions
Infectious and Environmental Hazards: Conditions which cause legally compensable illnesses, Exposure to Infectious Diseases, or any conditions in the work environment that impair the health of employees to the extent that they lose work and/or efficiency.
Infectious Diseases: Illnesses caused by germs (i.e., bacteria, viruses, and fungi) that enter the body, multiply, and can cause an infection. Infectious Diseases can spread:
- Between people;
- Between people and animals;
- Through vectors (e.g., biting insects); or
- Through food, water, and the environment.
Exposure: Contact with a pathogen or a situation in which transmission of an infection or sustainment of a physical injury could occur.
N95 Fit Testing: Process of verifying that an N95 mask respirator forms a proper seal on the wearer’s face to ensure effective protection.
Financial Responsibility: The monetary cost of coverage for prophylactic and other post-Exposure measures.
Related Requirements
External Regulations
Unit Policies, Standards, and Procedures
Contact Information
Primary Contact
Name: Valerie Glassman, Senior Director for Student Affairs
Email: Valerie_Glassman@med.unc.edu
Publication Details
- Issuing Officer: Alice Chuang, Associate Dean for Student Affairs
- Email: alice_chuang@med.unc.edu
- Effective Date: December 1, 2025
- Review Cycle: The Office of Student Affairs will review this Policy as needed, and the Education Committee will review and approve it.
- Next Review Date: November 30, 2027