Student Health Services
Psychiatric Counseling for Students
The Psychiatric Counseling Service for Students, directed by Heather Goodman, M.D., Ph.D., of the Department of Psychiatry and Behavioral Sciences, provides confidential, free counseling for students or couples (students and their spouses or significant others) but not for postdoctoral research fellows. Students interested in obtaining counseling may call Dr. Goodman's office at (713) 798-4881. An appointment will be made to see her or another BCM faculty psychiatrist, or other professional, usually within two or three days. The telephone line has a 24-hour answering service. Through the service, consultation, counseling (including marital counseling), or psychotherapy up to 12 sessions are provided free of charge, but students are responsible for prescription purchases through their insurance.
Information given to the counselor will be treated as confidential. It will not be available to the administration, faculty, or any committee of the College. With the permission of or at the request of the student, limited information may be given. No claim will be made against medical insurance.
The counselor will not participate in any academic decision concerning students. If a psychiatric evaluation is requested by the school administration to aid in decisions concerning admission, leave of absence, disciplinary issues, etc., such matters will be referred to psychiatrists who do not serve as counselors.
In the event of a psychiatric emergency or when a faculty psychiatrist cannot be reached immediately, a student may go directly to The Methodist Hospital or Ben Taub Hospital emergency rooms.
For extended treatment of psychiatric problems requiring hospitalization, a student may be referred to other specialists in the Department of Psychiatry and Behavioral Sciences or to one in the community. For psychiatric treatment in these instances, there will be fees which will come under the provisions of the student's health insurance policy and the student's own resources. One option among these is the Baylor Psychiatry Clinic, where a student or spouse can be seen for ongoing psychotherapy by a Psychiatrist resident at the clinic's minimum fee. In addition, if a student needs ongoing psychotherapy in order to remain enrolled and cannot afford to pay for it, Baylor will pay for the treatment-which will be provided by a voluntary faculty psychiatrist as often as once a week for up to one year. This will be available only to a few students at a time and will be determined on the basis of financial need.
Health Requirements and Services
Before registration, all students must complete the Student Health Assessment, and show proof of immunizations/serologic confirmation required by the Texas Education Code and Baylor College of Medicine:
- Measles (Rubeola)
- Hepatitis B
- Tuberculosis* (PPD/Mantoux)
- Varicella (Chicken Pox)
*If positive, a chest x-ray is required.
Health care services are offered by primary care providers chosen by the student. The Occupational Health Program Office consults with students in regard to safety and health related issues pertinent to all health care professionals and conducts TB testing annually.
The Office of Environmental Safety requires that all students view the annually updated OSHA Bloodborne Pathogens Training Film and be trained to prevent transmission of tuberculosis. Students may consult with a dean in the Office of Student Affairs in regard to all available health care service options in the Texas Medical Center.
The Office of Corporate Compliance Programs requires that all BCM students, visiting students and observers complete the on-line training in regard to The Health Insurance Portability and Accountability Act of 1996.
See the Insurance hand book page for information on health, long term disability and malpractice insurance.
Learning and practicing medicine has always involved exposure to infectious agents. Personal risks can be minimized by intelligent attention to immunizations, standard precautions and other preventable measures. Each student must take personal responsibility for being aware of his/her status and taking proper precautions.
Baylor College of Medicine subscribes to the American Association of Medical Colleges statement of responsibility in treating patients with HIV: medical students, residents, and faculty have a fundamental responsibility to provide care to all patients assigned to them regardless of diagnosis. Failure to accept responsibility violates a basic tenant of the medical profession to place the patients interest and welfare first.
Students who have not fulfilled all immunization requirements will not be allowed to register for/attend classes.
Students exposed to or with infectious or communicable illnesses including chicken pox, diarrheal illness, measles, tuberculosis, group A strep infection or draining lesions on the hands must see their primary care physician or consult a physician in the Family Medicine department.
In addition, students with such circumstances should consult with the infection control office in the institution where the infection occurred or where the student is doing a clerkship about the advisability of working with patients to be sure that he or she is following the local regulations. When caring for patients with TB, students should adhere to local regulations. Precautions may include wearing appropriate masks, or custom fitted masks.
Blood Borne Pathogens
Protocol for Needle Stick Injuries and Exposure to Blood or Bodily Fluids
Baylor College of Medicine students (“Students”) are expected to provide the appropriate level of care to all patients while following standard precautions to prevent the spread of infectious diseases due to exposure to human blood or bodily fluid.
All Students must follow standard precautions at all times which are based on the assumption that all blood, body fluids or other potentially infectious materials, secretions, excretions other than sweat, non-intact skin, and mucous membranes may be infectious. The Occupational Safety and Health Administration (OSHA) defines occupational exposure as reasonably anticipated skin, eye, mucous membrane, or parenteral contact with human blood or other potentially infectious materials (OPIM) that may result from the performance of an individual’s work duties. Standard precautions for preventing occupational exposure incidents are set forth in OSHA’s Bloodborne Pathogen (BBP) Standard.
The BBP Standard requires employers to develop and implement a written Exposure Control Plan which prescribes the use of engineering controls, safe work practices, PPE, training and medical surveillance to eliminate or reduce occupational exposure to blood and OPIM. A current version of Baylor’s Exposure Control Plan is available through the Office of Environmental Safety. See Biological Safety (Baylor login required).
Additional information can be found at the Baylor Office of Occupational Health or within the CDC’s 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.
An exposure is a percutaneous injury (puncture by needle or sharp object), contact with mucus membrane or skin contact (especially when the exposed skin is chapped, abraded or afflicted with dermatitis or the contact is prolonged) involving blood, tissues, or other potentially infectious bodily fluids.
Immediate Response to Exposure
The immediate response to any exposures should be to clean the wound or area of exposure based on the type of exposure. For a percutaneous injury or non-intact skin exposure, remove any foreign objects embedded in the wound and wash wound with soap and running water. For a mucous membrane exposure, irrigate with sterile saline or sterile water for 15 minutes. For an intact skin exposure, thoroughly clean and wash exposed intact skin.
Notification and Reporting
In the event of an exposure, the Student is excused from their current activity for treatment, but may have to make up time lost to meet curricular requirements. Students should immediately inform their supervisor and should notify the BCM Occupational Health Program (“OHP”) at 713-798-7880. Students will be provided with all OHP and associated hospital’s and clinic’s contact information during orientation. For treatment and source patient blood testing based on the location at the time of exposure:
Students at BCM should contact the OHP. Students at Ben Taub General Hospital should contact the OHP or the Ben Taub Nursing Office if after hours. Students at Saint Luke’s Episcopal Hospital should contact the Saint Luke’s Occupational Health Clinic or the Saint Luke’s Emergency room if after hours. Students at Texas Children’s Hospital should contact the Texas Children’s Employee Health Clinic or Texas Children’s Employee Health on Call if after hours. Students at the Veteran’s Affairs Medical Center should contact the Veteran’s Affairs Emergency Room.
The OHP will provide instructions in the event of an exposure should a student not know the procedure. Students should request assistance from hospital or clinical staff as needed for treatment and identification of source patient information and history. Students are required to complete hospital/clinic specific incident reports, located at any nursing station at the facility, in addition to a BCM incident report for all exposures.
Depending on where the exposure occurred, Students should arrange with the office as detailed above to obtain patient blood draw results for HPB, HPC, HIV and any other tests. All Student blood draws are done through the OHP except when the incident occurs at the Veteran’s Affairs Medical Center where the test should be done at the Veteran’s Affairs Emergency Room. Students should evaluate possible treatment options including immunoglobulin therapy for Hepatitis and anti-HIV therapy from HIV exposure. The potential benefit of prophylactic intervention for all of these types of infections is time dependent and should be initiated in the initial hours after exposure, particularly with HIV.
Counseling and Follow-Up
Students are required to discuss their exposure with the infection control officer in the institution where the incident occurred. Additionally, post-exposure counseling and a follow up should be arranged with the OHP.
Disclosure of History of Infection and Infection
Students with a history of infection with a blood borne pathogen which include, but are not limited to, hepatitis B virus (HBV), hepatitis C (HCV) and human immunodeficiency virus (HIV) or who develop an infection with a blood borne pathogen are required to report the infection to the OHP. Failure to report an infection will be considered a breach of professional behavior and may result in sanctions or even dismissal from BCM.
In consultation with the OHP, the student will know that there may be limitations that his/her disease may put on medical career options. Medical students may be referred to the Associate Dean of Student Affairs for additional counseling. The OHP will advise the student on their career options and limitations and issues related to appropriate practice. Depending on the nature and severity of the student’s infection, the OHP may determine that specific clinical duties or rotations may not be feasible. OHP will provide career counseling to assist students in choosing specialties most appropriate to their specific situation. Students should also be aware that some specialties with high-risk procedures will not be deemed an appropriate choice for residency training. BCM will attempt to provide reasonable alternative experiences to insure the student meets curricular requirements. However, patient safety is paramount and, therefore, in certain situations students infected with blood borne pathogens may not be able to meet the curricular requirements to advance and/or graduate from their BCM program.
Costs associated with testing are covered by the hospital or clinic where the incident occurred as long as the student follows the reporting procedures of that facility and Baylor. Costs associated with services recommended and provided by OHP (i.e. counseling, testing, and medication) as they relate to an exposure are covered by OHP. OHP will provide counseling regarding their responsibility for expenses in some circumstances in the course of evaluation or follow up, and also with respect to informing them that they are not eligible for worker’s compensation benefits because they are not an employee of the hospital, clinic or Baylor.
Medical Licensure requirements are published in the Directory of Residency Training Programs. Specific requirements for licensure in a particular state may be obtained by visiting the state's board of medical examiners web site.
Visit the National Board of Medical Examiners web site for Medical Licensure requirements information.