Abstract

The Medical Student Health Care Policy covers topics related to medical student health.  It establishes that all students must have access to appropriate and timely health care services on all campuses.  It stipulates that all medical students comply with health insurance, disability insurance, and vaccination requirements.  It details expectations for student confidentiality and avoidance of conflicts of interest related to faculty members who may treat students and who also teach/supervise students.

Reason for Policy

This policy ensures faculty oversight of the undergraduate medical curriculum and that the medical school meets the requirements set forth by the Liaison Committee for Medical Education (LCME) accreditation requirements as follows:

Standard 12: Medical Student Health Services, Personal Counseling, and Financial Services
“A medical school provides effective student services to all medical students to assist them in achieving the program’s goals for its students. All medical students have the same rights and receive comparable services.”

Element 12.4: Student Access to Health Care Services
“A medical school provides its medical students with timely access to needed diagnostic, preventative, and therapeutic health services at sites in reasonable proximity to the locations of their required education experience and has policies and procedures in place that permit students to be excused from these experiences to seek needed care.”

Element 12.5: Non-Involvement of Providers of Student Health Services in Student Assessment/Location of Student Health Records
“The health professional who provides health services, including psychiatric/psychological counseling, to a medical student has no involvement in the academic assessment or promotion of the medical student receiving those services, excluding exceptional circumstances.”

Element 12.6 Student Health and Disability Insurance.
“A medical school ensures that health insurance and disability insurance are available to each medical student and that health insurance is also available to each medical student’s dependents.”

Element 12.7 Immunization Requirements and Monitoring.
"A medical school follows accepted guidelines in determining immunization requirements for its medical students and monitors students’ compliance with those requirements."

Policy

The Heersink School of Medicine is committed to ensuring that all medical students have access to appropriate health care services at all campus sites. UAB Student Health Services is available to all medical students, and arrangements are made so that students at campuses without a student health clinic will have timely access to primary care services in their local community.

Student health insurance (also available to spouses and dependents) or equivalent private coverage is required for all medical students. Insurance must provide coverage at any educational site, including visiting electives. The school provides disability insurance for all medical students.

Students may be excused from classes or clinical duties to access needed health care services on a reasonable basis by working through Medical Student Services or the equivalent office on regional campuses, and, if applicable, UAB Disability Support Services.

Health professionals who provide any health services to a medical student should have no involvement in the academic assessment or promotion of the medical student receiving those services, excluding exceptional circumstances.  Medical student health records are maintained in accordance with legal requirements for security, privacy, confidentiality, and accessibility.  The School of Medicine and health providers involved in the academic assessment or promotion of medical students do not have access to medical student health records.

Medical students must comply with all immunization and health requirements as determined by UAB Student Health Services and the university.  Immunization compliance is monitored by the school and required to participate in coursework.

General Procedure

1. Access to health care services

UAB Student Health Services (SHS) is available to all students (See the SHS website for further description of available services). Tuscaloosa-based students may utilize the Student Health Center at the University of Alabama or UAB SHS, depending on individual arrangements. Huntsville- and Montgomery-based clinical students may be seen at UAB SHS, or they may use their health insurance to see a local primary care provider or specialist.  In the latter case, the School of Medicine and Huntsville or Montgomery Medical Student Affairs are available to help students find providers in the area. Huntsville, Montgomery, and Tuscaloosa Medical Student Affairs offices cover any applicable co-pay.

Psychiatric and psychological services are available to all students. Services may be accessed through the Heersink School of Medicine Professional Development Office (PDO) or through UAB SHS. Local services for regional students are also available. The PDO, Medical Student Services, and regional campus Medical Student Affairs offices can help students find local providers.

2. Health Insurance

The Heersink School of Medicine complies with UAB’s requirement that all students have major medical health insurance. Medical students may choose to enroll in the Student Health Insurance Plan (SHIP) or provide proof of private coverage by submitting a waiver to Student Health Services at the beginning of every semester. The SHIP offers plans for students’ dependents.

Medical students should use their UAB SHIP or their private health insurance to receive medical treatment from providers permitted under their plan. Students may access providers both within UAB Medicine and in the community according to the terms of their particular insurance policy.

3.  Disability Insurance

All students are required to have disability insurance and are enrolled in long-term disability insurance paid through medical school student fees.

4. Dissemination of Information to Students regarding Available Health Care Services

The School of Medicine disseminates information to medical students about the availability of health services, including psychiatric/psychological services, prior to matriculation, during orientation sessions and class meetings, through frequent e-mail communication, and on various UAB and SOM websites.

Students also receive education about methods to prevent infectious and environmental exposures (See Infectious and Environmental Hazards: Guidelines to Prevent and Respond to Exposures).

5. School of Medicine-Initiated Healthcare Referrals

Medical students who present a need for medical, psychiatric or psychological evaluation or treatment to Medical Student Services or the Student Affairs Office on a regional campus are referred to UAB SHS (or the Student Health Center at the University of Alabama, if appropriate) or equivalent services at other clinical sites, or the Professional Development Office. Students who present an urgent or emergent need for medical, psychiatric, or psychological evaluation/treatment are referred to these same services or the closest Emergency Department depending on the nature of the student’s need.

6. Professional Development Office (PDO)

Because the school recognizes that confidentiality is particularly important to students receiving and providers delivering sensitive medical care and psychiatric/psychological counseling, the PDO providers serve as liaisons for such services. Students in need of neuropsychological and educational testing are referred to UAB or community psychologists who maintain a close working relationship with the PDO and UAB Disability Support Services. Private health information is protected to the greatest extent possible. When the School of Medicine requires a student to undergo assessment or monitoring through the PDO, the PDO provider documents compliance with the recommended evaluation and treatment plan and provides limited information about sensitive health concerns on a need-to-know basis. Students may choose to sign a release allowing the PDO provider to communicate more information with SOM administrators.  See https://www.uab.edu/medicine/home/offices-services/professional-development.

7. Psychiatric Services

For non-emergent psychiatric services, the PDO works closely with the school's clinical liaison in UAB Psychiatry to facilitate appropriate referrals. Students in need of routine psychiatric treatment are often referred to community psychiatrists who are not School of Medicine faculty. On occasion, when deemed appropriate by the PDO provider and the clinical liaison to Psychiatry, students are referred to UAB faculty psychiatrists for specialized services. In these cases, a referral is made to faculty members who do not supervise medical students. The clinical liaison psychiatrist communicates closely with UAB Psychiatry faculty to be apprised of any students who are self-referred to UAB psychiatrists or referred by outside providers to UAB faculty members. The clinical liaison psychiatrist communicates with the Clerkship Coordinator for Psychiatry and Clerkship Director for the Birmingham-based psychiatry clerkship to ensure that students are not assigned to a psychiatrist who has provided medical care to them. Similar processes are used at the regional campuses so that students are referred to community-based providers or university clinicians who do not supervise, evaluate, or participate in advancement/promotion decisions regarding medical students.

8. Impairment

When a medical student demonstrates evidence of possible impairment, a rapid assessment is made to determine whether the student should be referred to the UAB or another Emergency Department. This decision is typically made by the Associate or Assistant Dean for Students or an MSS Director in consultation with the UAB Assistant Vice President for Student Life, PDO providers, or equivalent individuals on a regional campus.

9.  Protection of Private Health Information

Private health information is protected to the greatest extent possible.

When a student requests medical care or psychiatric/psychological counseling, or members of Medical Student Services feel that a student could benefit from such services, the student is referred to the PDO, UAB SHS, UAB Student Counseling, or local services for regional students.  These offices function independently from the Heersink School of Medicine. The School of Medicine does not have access to records kept by the PDO, UAB SHS, or UAB Student Counseling.

When the Heersink School of Medicine requires a student to undergo assessment or monitoring, the PDO or UAB Student Counseling provides documentation of compliance with the recommended evaluation and treatment plan, providing limited information about sensitive health concerns on a need-to-know basis to the school. A student may choose to sign a release allowing the PDO provider to communicate more information with SOM administrators but only when such information is deemed relevant to the student’s medical education by PDO.

When a student is admitted to a medical service in the medical school, every effort is made to provide them care on a non-teaching service so that students, residents, and physicians who frequently work with learners are not involved in the student’s care.  If no options are available for a student’s medical care except a teaching service, clinical students are not allowed to participate in their care.

Student health records are not a part of a student’s medical school record. They are maintained in accordance with legal requirements for security, privacy, confidentiality, and accessibility of the health organization keeping those records.  For example, the medical school may not access medical records at UAB SHS or at UAB Hospital.  All faculty and staff members must comply with the UAB Data Protection and Security Policy and the UAB Data Access Policy which prevents accessing personal health information without a direct need to know.  Non-compliance with these policies results in consequences commensurate with the offense, up to and including termination of employment, appointment, student status, or other relationships with UAB.

10. Faculty Provider Restrictions

Health professionals who provide health services to a medical student should have no involvement in the academic assessment or promotion of the medical student receiving those services, excluding exceptional circumstances (i.e., cases where students are at risk for damage to their health, injury, or other negative sequelae without immediate intervention).

When staff members in Medical Student Services are aware of students who receive health care services in any facility where students participate in clinical coursework, every effort is made to inform Course and Clerkship Directors and course coordinators of potential conflicts without disclosing the nature of the conflict. The purpose of this communication is to keep them from pairing medical students with preceptors who have served or serve as their healthcare providers.

Students are informed at MS1 and MS3 orientations and through the SOM website of the policy governing health care treatment by a faculty member. Students are encouraged to bring any concerns to the attention of Medical Student Services and Course or Clerkship Directors.

Faculty members who treat medical students and who serve on the Student Academic Standing Committee (SASC) may not participate in decisions regarding their advancement or promotion and must recuse themselves from a vote on any student for whom they have provided medical, psychological/psychiatric care, or with whom they have any other conflict of interest. SASC members are made aware of this stipulation when appointed to the SASC and reminded of this on the SASC website and at the beginning of each SASC meeting. Members also sign a confidentiality and conflict of interest attestation annually.

Students may request to work with a faculty member who has previously been their health care provider if it may provide a unique training opportunity. Such requests will be considered on a case-by-case basis by the Associate Dean for Students and the Associate Dean for Undergraduate Medical Education.

Faculty members are asked to self-identify conflicts of interest, including current or previous health care treatment when evaluating students so that the Associate Dean for Undergraduate Medical Education can determine the necessary steps to take within the realm of this policy and procedure.

11. Student Medical Immunization, Compliance, and Clearance

All medical students must participate in UAB's web-based medical clearance program and must comply with health requirements for physical examinations, laboratory studies, immunizations, and other health-related requirements as determined by UAB SHS and the university. Students are expected to maintain medical clearance at all times. Compliance is monitored by the school at least biannually and is determined by UAB's web-based medical clearance program. Students are informed via the school’s website and email of health requirements and deadlines. Current students who fail to comply with the health requirements may be fined, administratively withdrawn from school, and placed on school-initiated leave of absence until they come into compliance. Incoming students not achieving medical clearance by the announced deadline may be fined, prevented from having patient contact, prevented from attending class or participating in orientation, or may have their acceptance to medical school withdrawn.

History

Policy Created: Aug. 20, 2013
Approved: March 1, 2022 by UA Systems Office
Revised: March 1, 2022

University of Alabama at Birmingham Marnix E. Heersink School of Medicine policies shall be reviewed periodically to determine whether revisions are appropriate to address the needs of the medical school community.