Occupational Risk Training, Prevention, and Protocols

Occupational Risk Training

Participation in direct patient care activities can pose risks to health care professionals, particularly in terms of exposure to infectious diseases. 

The School of Medicine requires that all medical students participate in annual safety training that facilitates students’ anticipation, recognition, and avoidance of potential occupational risks. The School of Medicine also provides practical training in safe practices so that students minimize risk in potentially hazardous situations, such as in the anatomy laboratory and the operating room, with a particular emphasis placed on strict adherence to universal precautions.

Specific training requirements include:

  • Medical students are required to complete two courses on Worksafe prior to matriculation, and refresher trainings annually:
    • Bloodborne Pathogens
    • Laboratory Safety Fundamentals
  • Prior to working in the Gross Anatomy Laboratory, all students must review two sets of standard operating procedures:
    • What to do in the event of an incident or injury in the laboratory
    • What to do in the event of a spill of cadaver hydrating fluid in the laboratory
  • Before transitioning to clerkships, students must participate in training on an introduction to sterile procedures and personal safety during the clinical years.

Prevention

Students are Required to Show Proof of Immunity

In addition to the above training, students are required to show proof of immunity to a series of vaccine-preventable diseases as outlined in the UCLA Immunization Requirements.

UCLA Immunization Requirements

Student seeking medical or religious vaccine exemptions should submit the appropriate exemption request form with supporting documentation.

Exception requests are reviewed by the Medical Director at the UCLA Arthur Ashe Student Health Center, and updated manually by Ashe Center Staff in the Medical Clearances section.

Exception FAQs - UCLA Immunization Requirement

Respiratory fit testing is also required annually for all students.

Protocols

Bloodborne Pathogens Exposure Protocol for Medical Students at DGSOM and UCLA-Affiliated Sites

  • Medical students (including visiting students) are covered for emergency and follow-up care after body-fluid exposures that occur in the classroom, clinical, or research settings.
  • When an exposure (e.g., needle-stick injury) occurs, students are to immediately alert their supervisor.
  • Source patient testing should be initiated, if feasible. For exposures that occur at UCLA (including UCLA/Santa Monica), the order requisition and instructions for source testing can be found on the Mednet Forms Portal (Form #10935, Occupational Exposure- Source Patient Requisition).
  • Immediate Care
    • Students rotating at UCLA:
      • The student should go immediately to UCLA Occupational Health during operating hours (Monday-Friday from 7 AM to 4 PM, excluding holidays). Occupational Health is located in room 17-240 CHS, on the first floor and in the main lobby of CHS. No appointment is necessary.
      • If the incident occurs after hours, the student should proceed to the nearest UCLA Emergency Department (Ronald Reagan Medical Center or UCLA Santa Monica Hospital).
    • Students rotating at a remote site:
      • If the site has an Occupational Health or Employee Health office that is open, the student should have their initial evaluation there. Otherwise, the student should go to the nearest Emergency Department.
      • After this initial evaluation, follow-up evaluation and care should occur at UCLA Occupational Health (location details above).
      • The student should obtain results of their baseline lab testing, and if possible, source patient testing (if performed), so that this information is available for follow-up at UCLA Occupational Health.
  • Following exposure, the student should contact their Society Dean, or Dr. Calmes, who in turn will communicate with leadership at Occupational Health so that they are aware of the upcoming follow-up evaluation. If the student cannot reach one of the above deans, or is a visiting student, a call should be made to the medical student emergency line at 310-825-6281 to speak with a dean on call.
  • Medication Prescriptions
    • If HIV postexposure prophylaxis (PEP) is prescribed at any location other than UCLA’s Occupational Health, a starter prescription should be written to cover medications in sufficient quantity until follow-up at UCLA Occupational Health can occur.
    • Prescriptions written at UCLA Occupational Health must be filled at UCLA’s outpatient pharmacy, or at a pharmacy that is able to dispense medications covered under UCLA’s workers’ compensation program.  Prescriptions filled under regular health insurance cannot be reimbursed.
  • Follow-up Care
    • All follow-up care must occur at UCLA Occupational Health, regardless of the location of the incident or the results of the initial evaluation. 
    • Students initially evaluated elsewhere should call UCLA Occupational Health at 310-825-6771 for an appointment to be seen the following business day between 7 AM and 4 PM. Occupational Health is located in room 17-240 CHS, on the first floor and in the main lobby of CHS.
    • Students should notify their Student Affairs dean to be excused from class or clinical duties, if necessary.
  • Billing Issues
    • The cost of the initial evaluation and care is the financial responsibility of the institution at which the exposure occurred. In the event that a student receives a bill for the initial consultation, the student should send bills to UCLA Insurance and Risk Management at wcreports@IRM.ucla.edu.    
    • A claim will be filed with Segdwick Claims Management Services, and they will be asking for your personal information to process the claim (including the student’s social security number)
    • Questions and concerns should be directed to the Workers’ Compensation Program Manager at wcreports@irm.ucla.edu or 310-794-6954.
  • Resources
    Detailed management protocols for exposure to blood-borne infections can be found on the following websites:

Exposure to a Patient with Confirmed Active Pulmonary Tuberculosis, Other Infectious Agents, or Environmental Pathogens Protocol for Medical Students at DGSOM and UCLA-Affiliated Sites 

  • This protocol applies to students who are notified that they have come in contact with a patient with active pulmonary tuberculosis and who meet the definition of exposure (e.g., >30 minutes of close contact without a mask).  It does not apply to “TB conversions” after routine annual screening.
  • Notification that you have been exposed may come from the Department of Public Health or from infection control personnel at UCLA or an affiliated training site.
  • If a true exposure is confirmed, call the UCLA Arthur Ashe Student Health and Wellness Center at (310) 825-4073 to make an appointment for baseline and follow-up testing.
  • Please notify your Assistant and/or Associate Dean for Student Affairs, who in turn will communicate with leadership at the UCLA Arthur Ashe Student Health and Wellness Center, so that they are aware of the upcoming evaluation.
  • Outside medical evaluations are not reimbursable.

Implications of Infections and/or Environmental Disease or Disability on Medical Student Educational Activities

If a medical student develops an infectious and/or environmental disease or related disability after matriculation, whether or not it is a direct result of their training, the medical school will assist the student in completing their MD requirements, as long as the student is able to still meet DGSOM Technical Standards, with or without accommodations.

Students with an infectious or environmental disease requiring medical attention are excused from training duties to seek health care (see relevant sections of Attendance Policies).

Students with infectious and/or environmental disease or related disabilities are encouraged to seek counseling with the UCLA Arthur Ashe Student Health Center or their own medical provider. While California law does not require disclosure of chronic bloodborne viral infections (such as Hepatitis B, Hepatitis C, and HIV), students with these diseases are highly advised to seek educational and career counseling through the Ashe Center. The Ashe Center will provide counseling to students, including consideration of career options that may be best suited for the student’s disease and/or disability, regardless of insurance through UC SHIP or private insurer.

Students with disabilities may also seek additional information and advice on reasonable accommodations from the Center for Accessible Education (CAE) and from DGSOM’s Disability Services Director, Grace Clifford:

Email: GClifford@mednet.ucla.edu

Work Cell: 424.402.9864 (call or text)

Book an appointment

Depending on the student’s individual needs, a student may be referred to an occupational health, infectious disease, or disability specialist for further consultation.

Students with disabilities should contact the UCLA Center for Accessible Education (CAE) regarding accommodations, if applicable. CAE and the School of Medicine will engage in the interactive process to discuss the provision of reasonable accommodations.

For some conditions, students may need to consult with the Ashe Center or their own medical provider prior to returning to duty. For some conditions, if a reasonable accommodation cannot be identified by CAE, the student may be restricted from participation in some or all educational activities. This restriction may be necessary to protect the health and safety of both patients and other members of the DGSOM community. Because student and patient well-being are of the utmost importance, failure to adhere to these work restrictions is considered a violation of the DGSOM Honor Code (See Professionalism, Honor Code, and Student Conduct).

Contact Information for DGSOM Student Affairs Deans (Box Link)