HIV+ and med school

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md1day31

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Would a person with HIV have a hard time getting a residency position and furthermore a medical license?

What specialties would a person with HIV consider pursuing?

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Are you going to go around telling everyone that you're HIV+? If not, how do you expect residencies will find out?
 
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Are you going to go around telling everyone that you're HIV+? If not, how do you expect residencies will find out?

Isn't there some kind of responsibility to disclose such a thing? At least I would hope there is, from a public health/safety perspective.
 
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Isn't there some kind of responsibility to disclose such a thing? At least I would hope there is, from a public health/safety perspective.
Why would there be a responsibility to disclose. OP is not having unprotected sex with his/her patients. Bbe usually goes the other way. Where does this stop? Plus you do know that physicans have a 25% greater chance compared to the general public of becoming hiv positive, most likely due to workplace exposure.

OP you don't have to disclose.


I am clearly wrong.
 
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There was a case of a neurosurgery resident who was terminated because of HIV status. He sued and lost:

U.S. Appeals Court Upholds Firing of HIV-Infected Doctor"

Baltimore Sun (04/04/95) P. 2B

On Monday, a federal appeals court ruled that a Maryland hospital
acted correctly when it fired an HIV-infected doctor who refused
to end his surgical practice. A panel of the court unanimously
agreed with U.S. District Judge John R. Hargrove's decision to
throw out the doctor's lawsuit against the University of Maryland
Medical System Corp. The appeals court said that "Dr. Doe" posed
a significant risk because of the possibility that he could be
cut during surgery and bleed into a patient's wound. The doctor
was halfway through a six-year neurosurgery residency program in
January 1992 when he was stuck with a needle while treating a
patient who may have been HIV-positive. After the doctor tested
positive for the virus, the hospital suspended him from surgical
practice and offered him alternative residencies. The doctor was
dismissed after he refused the positions and demanded to be
reinstated with surgical privileges.

-----

I'd be very discrete who and where I share that info with, especially when it can and has been used as a reason to fire residents.
 
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There was a case of a neurosurgery resident who was terminated because of HIV status. He sued and lost:

U.S. Appeals Court Upholds Firing of HIV-Infected Doctor"
The doctor was halfway through a six-year neurosurgery residency program in January 1992 when he was stuck with a needle while treating a patient who may have been HIV-positive.

After the doctor tested
positive for the virus, the hospital suspended him from surgical
practice and offered him alternative residencies. The doctor was
dismissed after he refused the positions and demanded to be
reinstated with surgical privileges.

-----

Getting fired from residency as a result of HIV contracted while treating patients is brutal, much more so than if you had contracted then HIV from gratuitously risky activities. That's an unfortunate story.
 
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Getting fired from residency as a result of HIV contracted while treating patients is brutal, much more so than if you had contracted then HIV from gratuitously risky activities. That's an unfortunate story.

Talk about adding salt to an already fatal wound.

Only in Medical Education.
 
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I wonder if that would still be the case today. 95 was still in hiv hysteria era.

One would hope. I wouldn't want to be the test dummy though, especially not with that legal precedent.

Wasn't there also a suit brought by a resident last year who was fired because of having cancer? It was all over the news: Dismissed George Washington resident with cancer sues school, alleging discrimination

Med Ed gets away with stuff that wouldn't fly anywhere else in society.

Oh I'm sorry, did you just sustain a work related injury? Oh too bad, we are now going to use that same injury as the basis for terminating you and effectively ending your career. Thanks for playing "I wanna be a doctor."

Wtf
 
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One would hope. I wouldn't want to be the test dummy though, especially not with that legal precedent.

Wasn't there also a suit brought by a resident last year who was fired because of having cancer? It was all over the news: Dismissed George Washington resident with cancer sues school, alleging discrimination

Med Ed gets away with stuff that wouldn't fly anywhere else in society.

Oh I'm sorry, did you just sustain a work related injury? Oh too bad, we are now going to use that same injury as the basis for terminating you and effectively ending your career. Thanks for playing "I wanna be a doctor."

Wtf
I do wonder if the resident got a hefty settlement for workplace related injury in the first case. I don't see why the FMLA protections would not apply.
 
One would hope. I wouldn't want to be the test dummy though, especially not with that legal precedent.

Wasn't there also a suit brought by a resident last year who was fired because of having cancer? It was all over the news: Dismissed George Washington resident with cancer sues school, alleging discrimination

Med Ed gets away with stuff that wouldn't fly anywhere else in society.

Oh I'm sorry, did you just sustain a work related injury? Oh too bad, we are now going to use that same injury as the basis for terminating you and effectively ending your career. Thanks for playing "I wanna be a doctor."

Wtf

Hep C and HIV can still end a surgical career. Doesn't have to end your career in medicine, though.
 
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Yep, if you have the money, or are almost dead enough for your insurance to cover the drugs that actually cure.

Yeah doctors probably couldn't afford it.
 
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Hep C and HIV can still end a surgical career. Doesn't have to end your career in medicine, though.

What fields in medicine would you think are still open for these residents/physicians. Derm, EM, path, PM&R, rads, anesthesiology, IM/FM?
 
Hep C is curable bro

I guess I'm not sure how that would play out. Especially if you're a resident
What fields in medicine would you think are still open for these residents/physicians. Derm, EM, path, PM&R, rads, anesthesiology, IM/FM?

I would guess anything that doesn't involve doing surgery.
 
Why would there be a responsibility to disclose. OP is not having unprotected sex with his/her patients. Bbe usually goes the other way. Where does this stop? Plus you do know that physicans have a 25% greater chance compared to the general public of becoming hiv positive, most likely due to workplace exposure.

OP you don't have to disclose.
I would hope not!
 
I guess I'm not sure how that would play out. Especially if you're a resident


I would guess anything that doesn't involve doing surgery.

Dude, you're not allowed to discriminate based on medical disability assuming the person can actually perform the tasks or job.

HAART controls your HIV viral load and you can be cured of hep c in 9 months. That with universal precautions means you post effectively zero risk to patients.
 
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Holy crap, so I just read the rationale for the decision and it is
HIV status does not qualify as a protected disability for this instance because you become "not qualified" to practice.
Yup, this would still hold today. Although it seems that the risk of transimission in this manner is very small. Sucks.

I think the worst aspect of this would be if you are exposed to HIV at work, become infected, and then you get fired for not being able to work absolutely terrible situation for the surgeon.
 
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I understand that there are regulations regarding surgeons, but I'm interested in knowing what fields of medicine can an HIV/HBV/HCV positive medical student/resident/physician look towards.
 
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If you require mandatory reporting, restrict a doc from performing "invasive procedures" (either categorically or without formal panel review), and require mandatory disclosure to patients, you've killed a surgeons career. That's the point you responded to.
Out of curiosity, could a resident and/or an attending refuse to operate on an HIV + patient?
 
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Out of curiosity, could a resident and/or an attending refuse to operate on an HIV + patient?
https://www.capphysicians.com/court-explains
A CA court found that this violated the state's Unruh Civil Rights Act and categorized HIV as a disability. It probably would vary based on state legislation, and I'm guessing different state supreme courts would come to different conclusions about whether HIV counts as a disability in this context.
 
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I understand that there are regulations regarding surgeons, but I'm interested in knowing what fields of medicine can an HIV/HBV/HCV positive medical student/resident/physician look towards.
Looking at the Different criteria from different states it seems any physician that does not perform invasive procedures should be ok. IM, FP, DR, Neuro, heme onc, some borderline things might be Optho and derm.
 
Not the USA, but relevant: Ban on doctors with HIV lifted

Under the new rules, healthcare workers with HIV will be allowed to undertake all procedures if they are on effective anti-retroviral drug therapy.

They must also have an undetectable viral load of HIV in their system, and must be regularly monitored.

The Government predicts that patients will have more chance of being struck by lightning than being infected with HIV by a health worker.

There have been four cases worldwide of health workers infecting patients, with no cases in the UK.
 
Holy crap, so I just read the rationale for the decision and it is
HIV status does not qualify as a protected disability for this instance because you become "not qualified" to practice.
Yup, this would still hold today. Although it seems that the risk of transimission in this manner is very small. Sucks.

I think the worst aspect of this would be if you are exposed to HIV at work, become infected, and then you get fired for not being able to work absolutely terrible situation for the surgeon.

How you get HIV is irrelevant. Making sure you don't pose a risk to patients is. It's important to be careful and report any exposures. Also important to have disability insurance
 
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Seems that a few people missed this critical part of this story

U.S. Appeals Court Upholds Firing of HIV-Infected Doctor"

Baltimore Sun (04/04/95) P. 2B

On Monday, a federal appeals court ruled that a Maryland hospital
acted correctly when it fired an HIV-infected doctor who refused
to end his surgical practice. A panel of the court unanimously
agreed with U.S. District Judge John R. Hargrove's decision to
throw out the doctor's lawsuit against the University of Maryland
Medical System Corp. The appeals court said that "Dr. Doe" posed
a significant risk because of the possibility that he could be
cut during surgery and bleed into a patient's wound. The doctor
was halfway through a six-year neurosurgery residency program in
January 1992 when he was stuck with a needle while treating a
patient who may have been HIV-positive. After the doctor tested
positive for the virus, the hospital suspended him from surgical
practice and offered him alternative residencies. The doctor was
dismissed after he refused the positions and demanded to be
reinstated with surgical privileges.

.
 
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Seriously? It used to be that if you were HIV+ you were ineligible to receive a green card. Thankfully that particular ban was lifted during the Obama administration. It's unfortunate if that kind of retrograde policy could still exist in medicine.
 
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Why don't doctors just take PrEP?
Half of everyone on the Grindr (gay tindr) does, and I think for doctors, the stakes are even higher.
 
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Why don't doctors just take PrEP?
Half of everyone on the Grindr (gay tindr) does, and I think for doctors, the stakes are even higher.
They do if they get a needle stick, but it can have
Also, men who have sex with men are way more likely than health care professionals as a whole to have HIV, probably especially for those active on Grindr. PrEP can have both short term and long term side effects.
 
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Seriously? It used to be that if you were HIV+ you were ineligible to receive a green card. Thankfully that particular ban was lifted during the Obama administration. It's unfortunate if that kind of retrograde policy could still exist in medicine.

Thankfully? Err..no, quite the opposite. Most countries in the world won't even grant you a long term visa if you have any of a number of communicable diseases, and they don't even have to be incurable. It's a sound policy, which is why it was implemented in the first place. It's unfortunate enough when citizens acquire communicable, incurable diseases which put a strain on the healthcare system and place others at risk, but once they do, there is not much to be done about it aside from trying to contain the risk.

But inviting over foreigners with HIV, Hep C, etc? Why on god's green earth...:smack: It's all problems and no reward, and doing something that hurts you while providing you with no benefit is one definition of insanity. Coming to America is like trying to get that Derm residency...way more people want it than can get it, which is why Derm doesn't take people who failed their Step the first time, and why America should not take people with huge black marks like serious diseases. Not that picking people who won't spread AIDS among our population is that high a bar to have to clear when selecting immigrants...
 
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Thankfully? Err..no, quite the opposite. Most countries in the world won't even grant you a long term visa if you have any of a number of communicable diseases, and they don't even have to be incurable. It's a sound policy, which is why it was implemented in the first place. It's unfortunate enough when citizens acquire communicable, incurable diseases which put a strain on the healthcare system and place others at risk, but once they do, there is not much to be done about it aside from trying to contain the risk.

But inviting over foreigners with HIV, Hep C, etc? Why on god's green earth...:smack: It's all problems and no reward, and doing something that hurts you while providing you with no benefit is one definition of insanity. Coming to America is like trying to get that Derm residency...way more people want it than can get it, which is why Derm doesn't take people who failed their Step the first time, and why America should not take people with huge black marks like serious diseases. Not that picking people who won't spread AIDS among our population is that high a bar to have to clear when selecting immigrants...
lol you just opened pandoras box
 
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So doctors cannot have hiv. But have to treat hiv patients?

Sounds hypocritical
 
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So what, people with HIV or hep C can't possibly contribute to society in a positive way?

They can contribute as much or as little as anyone else, but unlike anyone else, they also spread HIV and hep c, which is a bad thing. Since we can choose which foreigners to admit and there are plenty more foreigners out there than there are spots for them, it makes no sense to choose the ones who contribute positively but carry and spread serious diseases. I'll take my positive contributions without a side of HIV, thank you very much.
 
Except they don't necessarily spread HIV and hep C. That's a couple pretty big assumptions. With good treatment adherence chances of passing it on are about as close to zero as can be, even if they are having unprotected sex with new partners or are IDUs who share needles.

ETA: Can show me data suggesting that there has been a significant uptick in cases of HIV, particularly transmission coming directly from legal immigrants, since HIV+ individuals were allowed to immigrate into the US?

Brahhh. Just think about what you are saying. There are millions of people with HIV and hepatitis in the country, how do you think that happened? People aren't "afflicted" with HIV due to a spontaneous act of god, they catch it from others, in every single case. Obviously the odds that someone carrying HIV and hep c will pass it on are not "close to zero" else we wouldn't have millions of people with those diseases generations after they were introduced. All of this is fact, not assumption.

I have no idea if the studies you are asking me to provide exist but I am sure I'm not going to bother finding out. You don't need studies, this is basic common sense. Can we agree that 100 people carrying HIV will lead to more subsequent infections than 10 people carrying HIV? I hope we can. The more people have a communicable disease, the more people will get infected as a result. Basic epidemiology. By bringing in HIV positive people from overseas, you are guaranteeing that more Americans will get infected by the disease than would otherwise be the case. And for what, SJW points?

If there was a way to ensure only lefties suffered the results of their own insane policy choices I would be more than happy to let them go to town. The problem is that they want to hoist the consequences of their lunacy on the rest of us!
 
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Why don't doctors just take PrEP?
Half of everyone on the Grindr (gay tindr) does, and I think for doctors, the stakes are even higher.
There hasn't been a single case of a healthcare provider catching HIV in the course of work since the mid-90s (>20 years). Between universal precautions and post-exposure prophylaxis, while the odds aren't zero, they're pretty damn close. Close enough that universal pre-exposure prohylaxis isn't indicated.
 
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So what, people with HIV or hep C can't possibly contribute to society in a positive way?


Sorry, but wouldn't it be illegal under the ADA to fire/refuse a patient because they have HIV or another disability? Not saying it doesn't happen, I'm sure people make their excuses, just wondering.
If I refuse a patient because they are HIV+ then that could be an issue. That's why we are encouraged to not give reasons why we are firing/not accepting patients
 
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Data please! "I'm not going to bother finding out. You don't need studies," seriously?

Yes, of course HIV was (unknowingly) imported into the country initially, but I am not aware of any evidence to suggest that allowing HIV+ immigrants to enter the country over the last few years has caused a statistically significant increase in the amount of HIV cases in the country. I have worked with many HIV+ patients; anecdotal, but I don't know of any who got the disease from an immigrant. The only population in which HIV incidence is growing is young black MSM, and people tend to have sex within their social and cultural groups. So again: data please.

Yes, if someone is adherent to their HIV treatment, the odds of passing it on are close to zero, and there is excellent access to treatment in the United States. That's cute how you twisted what I said on that one. Transmission occurs when people are not being treated.

Let's focus on the discussion at hand rather than ad hominem attacks...I'm not a "leftie" or a "SJW" and this isn't about political correctness. It's about factual correctness.

You're asking me to spend hours searching for data to prove that increasing the number of HIV carriers will lead to a greater number of HIV transmissions! If you need "studies" to accept this most basic of epidemiology/math/common sense then look for them yourself. Most people reading this will accept this fact as self evident even if you don't, and that's good enough for me.

Secondly, I don't care about a mythical world where everyone adheres to their treatment regimens and behaves responsibly. We are not in such a world, so why bring up a scenario that doesn't exist and try to base policy on it? In the real world, people infect others with their HIV and hep C all the time, which is why we don't need to bring in foreigners with those disease to do even more infecting. Not only that, but treating HIV costs around $20k per year, so remind me again why we want to import a foreigner who is not only a health risk, but costs our medical system $20k a year for retrovirals alone? Seems pretty stupid, doesn't it.

Finally, I brought up lefties because it was Obama who is responsible for the change in policy, not as a direct reference to you. At any rate, I've said all I have to say on this tangent so the last word is yours if you want it.
 
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There hasn't been a single case of a healthcare provider catching HIV in the course of work since the mid-90s (>20 years). Between universal precautions and post-exposure prophylaxis, while the odds aren't zero, they're pretty damn close. Close enough that universal pre-exposure prohylaxis isn't indicated.

That's really interesting
 
Can we please stick to the original question?
 
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You're asking me to spend hours searching for data to prove that increasing the number of HIV carriers will lead to a greater number of HIV transmissions! If you need "studies" to accept this most basic of epidemiology/math/common sense then look for them yourself. Most people reading this will accept this fact as self evident even if you don't, and that's good enough for me.

Secondly, I don't care about a mythical world where everyone adheres to their treatment regimens and behaves responsibly. We are not in such a world, so why bring up a scenario that doesn't exist and try to base policy on it? In the real world, people infect others with their HIV and hep C all the time, which is why we don't need to bring in foreigners with those disease to do even more infecting. Not only that, but treating HIV costs around $20k per year, so remind me again why we want to import a foreigner who is not only a health risk, but costs our medical system $20k a year for retrovirals alone? Seems pretty stupid, doesn't it.

Finally, I brought up lefties because it was Obama who is responsible for the change in policy, not as a direct reference to you. At any rate, I've said all I have to say on this tangent so the last word is yours if you want it.

:troll:
 
As a person working in IM/ID/HIV, there's a TON of ignorance in this thread. :(
 
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As a person working in IM/ID/HIV, there's a TON of ignorance in this thread. :(

I'd love to hear your thoughts about how being HIV+ might limit your career given your chosen career choice. Please dispel some of the ignorance. I think it would be helpful.
 
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As a person working in IM/ID/HIV, there's a TON of ignorance in this thread. :(

I would also appreciate to hear your insight. What specialities would a student with HIV be able to still pursue (specifically, EM, derm, PM&R, IM, radiology). Will there be issues in obtaining a medical license? Will there be issues in securing a residency? Thank you in advance.
 
Why don't doctors just take PrEP?
Half of everyone on the Grindr (gay tindr) does, and I think for doctors, the stakes are even higher.
As someone who has been on PEP, I wouldn't recommend it unless you're at a high risk of exposure. Granted, I was on a triple drug PEP cocktail several years ago and can't say whether PrEP is any better. Regardless, PEP is highly effective and can be used on a case-by-case basis as need.
 
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