H. Health Exams & Immunizations

• Physical Exam
  California law requires that a medical evaluation be performed by a physician as a condition for employment in a hospital, and that the resident or clinical fellow be free of symptoms of any infectious disease.



• Immunizations
  Additionally, the US Public Health Service and the California Department of Health Services require that health care personnel be screened for rubella and measles antibodies. Rubella and/or measles vaccines are to be administered to those found to be susceptible. This must be accomplished before the date of employment.
  
  Vaccination with the recombinant DNA vaccine for hepatitis B is recommended for all health care workers. Full immunization requires 3 doses (the second dose 2 months after the first, then another dose 5 months later). The two initial doses should be received prior to employment. Arrangements for the 3rd dose may be made through the Employee Health Services at the Parnassus campus. The Medical Center will pay for this vaccine, if the health care worker is required to handle blood. Post vaccination antibody titers are recommended.
  
  All trainees who are uncertain of chicken pox susceptibility should be screened for the varicella antibody and/or provide proof of vaccination. Exposure of a non-immune trainee to varicella/chicken pox during clinical duties requires an immediate report to the UCSF Infection Control Department (476-5793).
  
  Finally, an annual tuberculin skin test is required (state law). This evaluation is provided (free of charge) year round at locations convenient to service assignments. Reappointment and continued employment will be held in abeyance pending proof of TB testing. The following are designated to verify a negative PPD reaction: Administrative Nurses, Clinical Nurse Specialists, Nursing Supervisors, Respiratory Therapy Supervisors, and Attending Physicians.
  
  New residents and fellows with a history of negative PPDs are required to provide documentation of 2 PPDs within the last year. For individuals with positive PPD history, a copy of the written interpretation of a chest x-ray taken within the preceding 12 months is required.
  
  In the event of injury at the VA, treatment on site is available and generally provided in the E&A. If there is a needlestick injury, the hotline number should be called at 469-4411. The resident will be referred immediately to the emergency department (E&A) for immediate assessment and treatment. All subsequent assessments, counseling and treatments will be coordinated with the resident’s schedule.