As a part of contractual agreements with externship agencies, students may be required to fulfill the following requirements. Failure to submit all requirements may result in dismissal from the program. All requirements must remain current throughout the program or prior to starting the externship based on specific program requirements. It is important to note that the contracted externship agency agreements are not negotiable in their requirements. Subject to externship site requirements, students who do not have documentation that evidences acceptable criminal background history, negative drug screen, immunization, and health clearance may not be accepted at the externship site.
Students are responsible for all costs of program immunizations and medical clearance required for admission and continuation within the program. In addition, students are responsible for all costs that may be associated with injury or illness while on campus, in the learning laboratories, at an externship experience, or while performing other campus/program related activities during enrollment in the program.
Current BLS CPR Card
Basic Life Support (BLS) for Healthcare Providers certification by the American Heart Association must remain current while the student is enrolled in the program. The College must maintain a current signed copy of the student’s CPR card within the student file. Students will be provided BLS for Healthcare Providers training prior to the completion of the initial 18 weeks of the program, prior to any externship or clinical activities. Upon successful completion of BLS for Healthcare Providers training, students are required to always have their physical CPR card on them during class, laboratory, and externship activities. If the CPR card expires during the program, the student may not participate in any externship activities until the CPR certification is renewed, and the student may be dropped from the program until it is renewed.
Student Health Requirements
It is essential that students be able to perform a number of physical and cognitive activities in the classroom, externship and learning laboratory portions of the program. Students are not to enter any externship facility with contagious conditions or injuries. A student must consult with the externship instructor if an illness, medical condition, or injury is present prior to entering the externship facility. The College or externship agency reserves the right to request a medical release from a health care provider if an identified condition, illness, and/or injury may cause a potential safety risk to the student, patient, or others. Additional health care clearance documentation may be required. Any additional requirements will be at the student’s expense. Examples of medical issues include, but are not limited to: limitations required after surgery or accident, immuno-suppression, pregnancy, back injury, behavioral health, etc.
Students may not enter or practice within an externship area under the influence of a controlled substance or any medication which may impair judgment, alertness, or physical agility regardless of if prescribed by a healthcare provider. The externship instructor and program director will be the final deciding authority as to their perception if the student may practice safely within the externship environment. The externship agency may be consulted as well.
NOTE: Any changes in physical or mental health must be reported immediately to the program director within 24 hours or before entering an externship area (whichever comes first).
Students must submit the approved physical and health clearance forms to the College prior to the designated deadline.
NOTE: Students with medical and/or mental health conditions which may place the student or patient’s safety at risk may not be eligible for admission or continuation in the program. Risk assessment is at the discretion of the Dean/Director of Education in consultation with the Regional Dean of Education.
Immunizations
| Vaccination/ Screening | Requirements in Brief |
|---|---|
| COVID-19 Vaccination | A COVID-19 vaccination may be required for students to permit them to go into a hospital-based externship medical practice |
| Hepatitis B | Serologic proof of immunity is required. Three dose series (dose #1 now, #2 in 1 month, #3 approximately 5 months after #2). Obtain serologic testing 2 months after dose #3. |
| MMR | Serologic evidence of immunity or laboratory confirmation of disease is required. If no evidence of immunity or equivocal serology results are reported, two doses of MMR at least 28 days apart are required. |
| Varicella | Serologic proof of immunity or laboratory confirmation of disease required. If no evidence of immunity or equivocal serology results are reported, two doses of Varicella vaccine at least 28 days apart required. |
| Tetanus, Diphtheria, Pertussis | One-time dose of Tdap is required. Td boosters every 10 years thereafter. |
| Influenza | Required annually. |
| Tuberculin Skin Test (TST) | For students with no history of previous annual tuberculin skin testing, an initial two-step is required. For those students with previous annual and current testing who provide evidence by documentation, only a one-step is required. Testing must be within the past 90 days. For students with a positive tuberculin skin test, a current chest x-ray (within the past two years) or serological evidence of no active disease must be provided. |
Proof of immunizations may be required and will be verified as complete prior to the student being permitted to enter any externship site (whether for the assigned course activities or for orientation at the externship site prior to the course start).
Students will be provided information about the local resources for obtaining the immunizations if they have not had the required immunizations or do not have acceptableimmunization documentation.
Where the campus has an affiliation with a healthcare center for immunizations, the expectation is the student will use the center. Students may choose to obtain immunizations from another healthcare provider. However, immunization documentation must include specific information about the type of healthcare provider and the immunizations administered and/or verified.
Failure to provide the required documentation no later than 10 business days prior to the start of 1st externship session may result in suspension from the externship portion of the program. No student will be permitted to enter an externship site without having satisfied the requirement for immunization documentation. Students unable to participate in scheduled externship sessions will be recorded as absent and may potentially risk failure of the entire course.
Immunization requirements are generally based on the current recommendations of the Centers for Disease Control (CDC) for health-care workers and the Advisory Committee on Immunization Practices (ACIP). Externship agencies may have additional health clearance and immunization requirements beyond the current recommendations outlined by the CDC or College policy. The College has identified a standard immunization policy but reserves the right to require additional healthcare clearance assessment, documentation, immunization, and serology testing at any point throughout the enrollment of the program. In addition, immunizations and health requirements may change without notice and students may be required to provide verifiable documentation of their ability to meet new requirements. Failure to meet this requirement may result in failure to progress in the program. Students may be responsible for the cost of any additional requirements.
Students are not permitted to participate in any externship experience if their immunizations do not meet the standards outlined in this document or those required by specific externship agencies.
Serological Evidence of Immunity
COVID-19 Vaccination
A COVID-19 vaccination may be required for students to permit them to go into a hospital-based externship medical practice.
Hepatitis B Vaccine
Students must demonstrate serological evidence of immunity to hepatitis B. For previously vaccinated individuals, serological testing must indicate immunity against hepatitis B. For those who have not been previously vaccinated, a series of three vaccines must be completed. If the student does not have proof of titers, he/she must submit documented proof of receiving the first vaccination within the first week of admission. The second vaccination is to be given one month after receiving the first vaccination. The third vaccination is to be given approximately five months after the second. Proof of the first administration must be provided in order to participate in any agency-based externship rotations.
The student must submit documented proof of completing the hepatitis B series six months from receiving the first hepatitis B vaccination. Documented serological evidence of protection against hepatitis B (positive serology titer) must be provided two months following the third vaccination for those individuals undergoing initial vaccination.
For non-responders or those who have not completed the series of hepatitis B vaccination, the individual should be considered susceptible to HBV and should be counseled regarding precautions and prevention methods to reduce exposure. Individuals may need to obtain HBIG prophylaxis for any known or probable exposure to hepatitis B (HBsAg) surface antigen positive blood.
For all non-responders or individuals exempt from hepatitis B vaccination based on a valid healthcare provider recommendation, a vaccination waiver must be on file. Any individual who has not completed the hepatitis B vaccination series and final serologic testing indicating immunity must maintain a vaccination waiver on file. Students assume all risk and expenses associated with potential exposure during an externship experience. Expense may also include testing of the patient in the event of exposure.
Measles, Mumps, and Rubella (MMR)
Students should have received two doses of live measles and mumps vaccines given on or after the first birthday, separated by 28 days or more and at least one dose of live rubella vaccine in their lifetime.
Individuals must submit proof of immunity against measles, mumps, and rubella through serology testing or laboratory confirmation of the disease.
If serology results indicate that the individual is not immune or serological test results indicate “indeterminate” or “equivocal,” individuals should be considered non-immune, and additional MMR vaccination may be required in accordance with current CDC recommendations/guidelines. Students are required to provide documentation to the College and maintain compliance with the immunization and health clearance policy. Failure to complete required vaccinations, serology testing and/or provide documentation in a timely fashion, may result in program dismissal.
Varicella (Chicken Pox)
Students must submit proof of varicella immunity by providing documented serology evidence of immunity against varicella or laboratory confirmation of the disease. If serology results indicate the individual is not immune, varicella vaccination is required in accordance with current CDC recommendations/ guidelines (two doses of varicella vaccine, four weeks apart). Students are required to provide required documentation to the College and maintain compliance with the immunization and health clearance policy. Failure to complete required vaccinations, serology testing and/or provide documentation in a timely fashion, may result in program dismissal.
Tetanus, Diphtheria, Pertussis (Td/Tdap)
Students must provide proof of vaccination for tetanus, diphtheria and pertussis within the past 10 years. If no documentation is presented, vaccination is required. Evidence of one time Pertussis vaccination is required. A one-time dose of Tdap is required for all students who have not received Tdap previously. A Td booster should be documented every 10 years thereafter. Students are required to provide documentation to the College and maintain compliance with the immunization and health clearance policy.
Seasonal Influenza
Students must provide documented evidence that one dose of influenza vaccine is received annually. Students are required to provide required documentation to the College and maintain compliance with the immunization and health clearance policy.
Tuberculosis/Tuberculin Skin Test (TST)
Students are not permitted to practice in any externship, laboratory, or classroom activities with active or suspected tuberculosis disease. All students are required to undergo initial and annual tuberculosis screening while enrolled in a program.
For students with no history of previous annual tuberculin skin testing (TST), an initial two-step is required. For those students with previous annual and/or current TST (within the past 364 days) who provide evidence by documentation, only a current one-step TST is required. A current one-step TST is valid and may be accepted by the College only if completed within the past 90 days and can be verified through an appropriately credentialed healthcare provider.
Initial Two-Step TB Skin Test:
- Step #1 TB skin test administered and read within 48-72 hours.
- Step #2 TB skin test is administered 7 to 14 days after the 1st test, and it is read within 48-72 hours.
- Annual TST.
One-Step TB Skin Test (for students with evidence of previous screening within the past 364 days):
- Step #1 TB skin test administered and read within 48-72 hours.
- Annual TST.
After the initial two-step TST, annual tuberculosis screening and TST is required each year the student is enrolled in a program. Students must provide documented evidence of compliance to the College. The annual tuberculosis screening will include a questionnaire and tuberculin skin test.
For students with a history of a positive TST, they must complete a questionnaire, have a post treatment or symptom negative chest x-ray free of active pulmonary disease, and be currently free of any symptoms. An annual tuberculin skin testing is not required for previous TB positive students. A repeat or annual chest x-ray is not required unless the questionnaire or symptoms suggest further evaluation. A negative chest x-ray result must be no older than 2 years for health clearance and must document “no evidence of active pulmonary disease” by an appropriately credentialed healthcare provider.
If an annual TST is read as a new positive, documentation of a negative chest x-ray report documenting “no evidence of active pulmonary disease” must be provided. The student will not be permitted to participate in externship experiences until this requirement is satisfied and health clearance has been provided by an appropriately credentialed healthcare provider in the management of pulmonary and/or tuberculosis disease.
Students with a history of vaccination of Bacilli Calmette-Guerin (BCG) must complete required initial and annual screening and TST testing. In the event of a positive TST for those who received BCG, students are required to provide documented evidence of a negative chest x-ray reporting “no evidence of active pulmonary disease.” Students with a history of BCG vaccination are not exempt from annual TB screening.
A negative QuantiFERON-TB Gold test (QFT-G) or other Food and Drug Administration (FDA) approved TB blood test may be accepted in the place of a TST or chest x-ray. Both results must be within the past 90 days prior to the first week of the Semester/Quarter in which the student initially enrolls in a program.
Students who demonstrate a positive TST, QuantiFERON-TB Gold test (QFT-G) or other Food and Drug Administration (FDA) approved TST, or positive pulmonary disease on a chest x-ray, will not be permitted to participate in externship experiences until cleared from an appropriately credentialed healthcare provider in the management of pulmonary and/or tuberculosis disease.
Students in the Dental Assisting and Medical Assisting programs must either present documentation of having had Hepatitis B injections 1 and 2 and a TB test within an acceptable timeframe or must complete the first two Hepatitis B injections and a TB test at least one quarter prior to the term in which they take any externship course. If the TB test result is positive, a chest X-ray test must be completed.
If there are any questions regarding these requirements, students should make an appointment to speak with the Program Director and/or Dean of Education.