Instructions for Completing Health Form

CLINICAL May-June 2019 and UK January and February 2019

Before students review the below requirements, they should go to the

SGU main webpage:

 Carenage (My SGU) and log in with your SGU password

 Look for the Student Services Heading ( Navy Blue)
 My Student Medical Record Portal is listed 3rd Area below
 Review the current health documents that have been received

 The listed requirements are documented by REQUIRED and

RECOMMENDED. Only the REQUIRED areas need to be completed
for a US rotation.

 Generally, if a requirement is complete, a date will be listed and I

will have signed off as complete.

 If incomplete and actions needed, in the date area will be “Hash

Tags” (#####). The item will be listed as “Required”.

 There will be comments related to a missing requirement.

Comments will be indicated under “Further Action Needed” or
“additional comments for students”

I am happy to answer questions from students; however, it is

expected that this memo and the on- line student record has been
reviewed prior to emailing me any questions.

MANDATORY REQUIREMENTS

1. HISTORY AND PHYSICAL EXAM

 All students planning on starting US rotations in May/June 2019

must complete a Personal History and Physical exam between:
January 1, 2019 and due date for all requirements (March 1,
2019.) If you are planning on staying in Grenada after term end,
the UHS clinic can complete the timed parts of the requirements
(H&P/ TB screening) during this period.

If you are a student who feels that they will be delaying taking
the Step exam and starting rotations later, you may wait to

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 complete the above timed requirements. Plan on completing
them so they fall within 4-5 months prior to starting clinicals. I
suggest that you make sure all the mandatory requirements are
completed prior to leaving Grenada, except for the above, if you
will be delaying taking your exam.

 Any student planning on starting clinical rotations in the UK

January 3, 2019 (Including 18-week option) must have all
mandatory requirements (US-UK) submitted by November 1,
2018

February 11,2019 UK rotations (including 18-week option)

all mandatory (US -UK requirements submitted by December1,
2018

 Any student planning on a UK rotation should remember that

getting
A Polio IPV vaccine and Tdap vaccines may be difficult after
leaving Grenada. The UHS clinic does supply these vaccines, but
supply may be low. If you need either of these requirements, I
suggest you get them early.

Please remember that the UK has additional specific requirements.

All must be completed, submitted, and finalized by the due date
indicated. The UK staff needs
6-7 weeks for scheduling any student and processing Visa
documents.
Some UK hospitals may require a HIV test. If required, the UK
hospital will draw blood and process test at the Hospitals expense.

2.TUBERCULOSIS SCREENING

Screening to be completed for US/ UK rotations:

Choose ONE of the following screenings based upon your past

and present screening history. Must be completed during the
January1 to March 1, 2019 time period.

Option #1:

****No prior history of positive PPD:

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 A. Complete a 2 step PPD. This is 2 PPD’s placed 1-3 weeks
apart.
OR
B. Complete ONE Interferon Gamma Release Assay test (Ex:
QuantiFERON or “T” Spot blood test). Lab copy of result to be
submitted. This test is NOT available in Grenada.

If IGRA test is positive, a chest x-ray and TB free statement

must be submitted. Anyone with a positive IGRA test must be
evaluated for Anti-TB medication prior to hospital placement.
A MD statement of that evaluation and decision regarding
anti-TB medication must be indicated on health form.

Option #2

****Student has a history of documented positive PPD by history or a new

positive PPD.
Students must have on file a MD Statement that they have a positive PPD
history.

A statement that a student has had BCG is not a valid assumption of positive
PPD

A. A chest X-ray completed after January 1, 2019 (UK students may complete
< 6 mths prior to date of UK start date). An official X-ray report must be
submitted.
A physician statement that you are currently free of communicable TB is
also required.

B. If positive PPD history is due to BCG past administration, a single IGRA

test is a good option. The IGRA test is not affected by BCG and is an
excellent TB screening choice. This test may be completed staring
January 1, 2019. It is not available at UHS clinic on campus.

3. Tdap VACCINATION
All students must submit proof of Tdap vaccination received within the past 5
years. The reason we require this test to be < 5 years old for clinical rotations
is because we are concerned that our students have adequate coverage for
the acellular Pertussis aspect of this vaccine. Infant children who are sick
have not received any vaccines and adults without proper pertussis coverage
can infect these sick children with pertussis.

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 Many MD’s only look at the standard length of tetanus/diphtheria coverage
and do not want to administer a Tdap vaccine if already received < 10 years.
Students can receive this vaccine at the clinic on campus or have a Pertussis
IgG titer completed as an option, if necessary.

The Tdap vaccine is NOT the same vaccine that you received as a child. The
DTP vaccine that is administered to children is a live vaccine. Many children
had reactions to it. The Tdap is NOT a live vaccine, and safe for adults.

4. SERUM IgG TITERS

If you completed serum IgG titers on admission to 1st term and they are listed
in your SGU health record and signed off by me, you do NOT have to repeat
these titers for clinical rotations.

If you did not complete all the titers, the clinic on campus can run any titers
missing. It is NOT necessary to repeat titers done and verified already.

SERUM IgG TITERS CONT.

****The only exception to the above is if you are planning on UK rotations

and the present titer results do NOT have a numerical value listed and an
index value shown. The UK wants to see numerical values. They generally will
not accept results listed as “Immune”.

Lab copies of serum IgG titers for MMR and Varicella must be documented in
your health record.
If one component of the MMR is equivocal or non-immune, proof of a MMR
vaccination received after the titer date is required.

If TWO of the components of MMR are non-immune, proof of a total of two

MMR vaccinations must be documented. One vaccination must be received
after the titer date, however ONE may be documented as having received
prior, usually from childhood records.

If a Varicella IgG titer report indicates equivocal or non-immune results,

proof of two varicella vaccines obtained at least 30 days apart must be
completed. Every vaccination counts with Varicella, if you have one
vaccination documented prior to serum IgG titer, it counts as one of the two
required if the titer is non-immune.
If you have documentation of TWO varicella vaccinations received in the
Past, and now have a non-immune Varicella IgG titer, you do NOT need any
additional Varicella vaccinations.

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 A Varicella IgG titer must be documented, however. Vaccine history alone is
not proof of immunity

****If ANY non-immune MMR, Varicella titer is present and the additional
vaccination (s) have been received, it is NOT necessary to have a repeat titer
done after receiving the “booster” vaccinations.
(Exception is regarding Hepatitis b immunity)

Students should submit copies of past vaccination records. They must be

clear and legible with your name on each page.

5. HEPATITIS B SERIES

For most students, documentation of having completed a full series of

vaccinations and a Hepatitis b surface antibody test indicating immunity is
mandatory.
This requirement must be completed PRIOR to receiving a health clearance
for clinical rotations.

If a student has not completed this series, it can be administered in an

accelerated method of 3 vaccinations received over 3 weeks (each 1 week
apart). The Hepatitis b antibody test is then done 3-4 weeks after completion
of the three vaccinations.
The UHS clinic on campus is aware of this accelerated method and will
administer this series and then do the Hepatitis b surface antibody titer.

As of November 2017 there is a new Hepatitis b vaccine available. It is two

vaccines received one month apart. The name is Heplisav-B. At present, it is
only available in the US. For students who failed to receive this vaccine prior
it is an option your MD may want to choose.

Many MD’s are unaware of the accelerated administration schedule for the
original Hepatitis b vaccine administration or unwilling to administer it
unless it is in the standard 6-month schedule. The new vaccine could be
helpful if this situation.
Please remember, you will not be eligible to start clinical rotations unless this
requirement is completed.

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Some people have a positive hepatitis B Core antibody test. This test is
positive in people who have been prior exposed, usually through their
mother, at birth or blood handling (ex: lab personnel).
This is not a test that would be done to determine your Hepatitis b immunity
regarding past vaccinations.

Some students have been told that they are hepatitis B “carriers”. These
students need to contact Susan Conway RN Sconway@sgu.edu) for further
information and tests needed to confirm this status.

***Some countries only administer two hepatitis B vaccinations (original

vaccine)to children, or perhaps two vaccinations are all that was received. A
hepatitis B surface antibody test was completed prior to 1st term showing
immunity. I accepted this for admission, however as you enter clinical
rotations, you will be exposed to people who have active hepatitis B.
For this reason, we must be assured that you have immunity to Hepatitis b.
To satisfy this requirement:

If you are a student who has only received 2 of the 3 vaccinations and has an
immune titer present the following are your options:

A. Have a third hepatitis B vaccination administered now and you are

complete.

B. Repeat the hepatitis B surface antibody test NOW. If the test result
remains immune, it will be accepted as immunity and valid for clinical
rotations.
If the new HbsAb titer is done and it comes out NON_IMMUNE, you will
need to have the 3rd hepatitis B vaccination and then repeat the HbsAb
titer three to four weeks later.

C. If you are a student who received THREE Hep. B vaccines in the past, but
never had an antibody titer completed, I suggest that you first have ONE
additional Hep. B vaccine done at the clinic. Receiving one additional
vaccine now will “boost” the antibody level. Then have a Hepatitis b
surface antibody test done 3-4 weeks later.

If it has been several years since you completed the Hepatitis series, the
antibody titer level goes dormant in a person’s system.
Hopefully one additional vaccine will initiate the level and it will show
immune when the antibody level is checked after 3-4 weeks.

If the antibody level still comes out non- immune, you will need to
complete the remaining 2 vaccines to complete a full second series of

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 vaccines (total of six). A repeat antibody test will also have to be
completed again.

Please make sure that you have completed this requirement fully. It can
delay the start of rotations if you have not satisfied the requirement.

6. MENINGOCOCCAL MENINGITIS SCREENING:

All students must complete the screening, which is part of the clinical health
form.
There are three options. Each student must read and choose an option, sign
and date
A student may decline receiving the Meningococcal vaccine, if they choose.
Completion of this screening section of the form is a mandatory requirement.

ADDITIONAL REQUIREMENTS FOR UK STUDENTS ONLY

Any student who is planning on a UK rotation must submit all requirements

listed above plus the UK requirements by the dates listed in this form.
If you are planning on a 2019 UK rotation, these requirements should be
worked on NOW!

If you are a student who thinks there is a possibility that you may go to the
UK for rotations, please complete the ALL requirements prior to leaving
Grenada. These requirements can be difficult to obtain in many countries.

1. Lab copy of Hepatitis B surface ANTIGEN test (Negative result

expected)
2. Lab copy of-hepatitis C antibody test (Negative result expected)
3. Proof of Polio IPV vaccination received < 10 year.

Many students plan on going to the UK in the 4th year for elective rotations.
The UK has a rule that the two blood tests listed above must have been
completed < 1 year prior to UK rotation start date. Please keep this in mind.
Getting the above completed now will probably be too soon for a 4th year
rotation in the UK.
You should get the Polio IPV vaccine now for any planned UK rotation. It is
valid for 10 years.

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 SUBMITTING DOCUMENTS

All documents must be scanned and emailed in a single

submission. PDF attachments are appreciated.
All forms and supporting documents are to be emailed to:
ClinicalHealthForms@sgu.edu

Do NOT send to Susan Conway or any other SGU staff member.

These are protected medical documents and sending anywhere
except the above address violates Federal HIPPA Laws. Do not send
to CLINED, clinical advisor or any other SGU faculty member.

Please add in the Subject Area: May/June US Clinical 2019 OR

“Date” UK Clinical Rotations

Attach all documents and send using your official SGU email
account.
Do NOT have any other person submit your documents.

###There are several free APPS available (Ex: Camscanner, Guinus

Scan). It is strongly suggested that students learn how to use these
APPS prior to attempting to scan multiple pages and sending to
this office. Prior students have told me that UTube helped them
understand the process. Check a few on-line to find
the one that will give you step by step instructions you understand.

There are also students who are very familiar with using this
process. Please try and connect with someone who can help you
learn the proper manner to submit documents.

1. It is very important that you use the Clinical Health Form that
will be sent to you. It identifies who you are and when you are
starting.
2. All documents should be completed and then submitted.
Receiving partial data slows the process down.

3. Faxed documents will not be accepted.

4. Students expecting to start US rotations May/June. 2019

should have all health documents submitted as instructed by
March 1, 2019

5. For US clinical rotations all completed documents may be

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Submitted as soon as you have completed requirements
(After January 1, 2019).

#### We process forms in the order of those starting rotations

first. Clined will send us lists of the students they expect to
start first. We will pull those forms first.

Submitted documents will be reviewed and students will

receive a status email.
When you receive a completion email, your clinical coordinator
and CLINED will be notified you have a satisfied health
requirement status.

We cannot respond to any emails from family members. If you

have questions not covered in the memo, you can email Susan
Conway RN at Sconway@sgu.edu

Students that email should have already reviewed this memo

for answers.