SA-4414 Management of Medical Students with Communicable Infections

1.0      Purpose

The purpose of this policy is to promote a safe clinical learning environment while ensuring that medical students with known or suspected communicable infections, including blood‑borne infections (hepatitis B virus [HBV], hepatitis C virus [HCV], and human immunodeficiency virus [HIV]) are treated in a fair and nondiscriminatory manner. This policy aligns with LCME standards regarding student health, access to educational opportunities, and confidentiality, following Carilion Clinic’s Employee Health policy which incorporates evidence‑based recommendations from the Society for Healthcare Epidemiology of America (SHEA) and related guidance.

2.0      Policy

Medical students with a known or suspected bloodborne or communicable illness should follow the guidelines in Carilion Clinic’s Employee Health Policy to guide return to classroom and clinical activities.  Students with bloodborne infections are not categorically excluded from participation in clinical education. The institution supports full participation in educational activities to the extent that such participation does not pose a significant risk to patients or others. Decisions regarding clinical activities are based on individualized risk assessment rather than diagnosis alone. The institution will maintain strict confidentiality of student health information in accordance with applicable laws and institutional policies. All students are required to adhere to standard infection prevention and control practices at all times. This policy affirms the institution’s commitment to nondiscrimination, patient safety, and the academic progression of all learners.

3.0      Procedures

Students who are aware of a bloodborne infection are encouraged to seek care through Student Health (Carilion Clinic Community Care or VT Schiffert Health Center) where evaluation and counseling will occur confidentially.  Students may also choose to seek care with their primary care provider.  Students are required to report known bloodborne infections to the medical school by contacting VT Occupational Health (ehsmedserv@vt.edu).  When appropriate, cases will be referred to an expert review panel as outlined in Carilion Clinic’s Employee Health Policy.  The panel will conduct an individualized assessment that considers clinical status (including viral load and treatment adherence), the nature of clinical activities, and the potential for exposure‑prone procedures.

Based on this assessment, the panel may recommend full participation or specific, limited modifications to clinical activities. Any restrictions will be narrowly tailored, consistent with current SHEA guidance, and subject to periodic review. Students will not be required to disclose their status to patients, peers, or faculty outside of those directly involved in the review and oversight process.  Students who require clinical accommodations will be given a letter to share with their clerkship or elective directors outlining any accommodation details. 

Students must comply with all standard precautions, including appropriate use of personal protective equipment, safe handling of sharps, and immediate reporting of occupational exposures. Ongoing monitoring, including laboratory evaluation when indicated (e.g. viral load), will be guided by current clinical recommendations and results reviewed by the expert review panel. Failure to adhere to infection control practices or monitoring requirements may result in adjustment of clinical responsibilities.

4.0      References

• Carilion Clinic Employee Health policy (Table 1)
• Henderson DK, Dembry L, Fishman NO, et al. SHEA Guideline for Management of Healthcare Workers Who Are Infected with Hepatitis B Virus, Hepatitis C Virus, and/or Human Immunodeficiency Virus. Infection Control and Hospital Epidemiology. 2010;31(3).
• Society for Healthcare Epidemiology of America (SHEA). Updated guidance on management of healthcare personnel with bloodborne pathogens (2019–2020 updates).
• Centers for Disease Control and Prevention (CDC). Guidelines for infection control in healthcare personnel.
• Virginia Tech Schiffert Health Center
• HS&T Student Health Center – Carilion Clinic Community Care
• VT Occupational Health (ehsmedserv@vt.edu) 

5.0      Approval and Revisions

Approved by the Medical Curriculum Committee on July 16, 2026