Alex Brooks London

Current and potential medical students who are shown to carry hepatitis B should not be prevented from studying medicine, according to the British Medical Association. Lizz Corps, the chair of the medical students’ committee of the BMA, said that while “patient safety has to be at the forefront” of any decisions, “modified courses should become available.”

The BMA voted at its annual general meeting in July that the current policy should be changed. A subsequent meeting between members of the General Medical Council’s education committee, chaired by Professor Grahame Catto, and members of the medical students’ committee, was described as “very positive.”

The GMC, which is responsible for regulating the medical profession, has opposed allowing carriers to continue studying because of the “potential risk to patients of becoming infected.” Patients are considered at risk of infection during invasive procedures when health workers are working blind and may injure themselves on sharp instruments or body parts. Specialties considered high risk include cardiothoracic surgery and obstetrics.

Although some students perform “risky” procedures such as appendicectomies, there is disagreement as to whether these are part of the core medical curriculum. Dr Swann, director of occupational health at Imperial College, London, maintains that there is “nothing a medical student has to do that would create a risk” and that appropriate career counselling should be offered during training. Most procedures carried out by students, such as venepuncture, are not considered high risk.

Students are normally tested for hepatitis B when they enter medical school. Those testing positive for the E antigen cannot continue with the course, although qualified doctors who test positive are allowed to continue working except in certain areas such as surgery. It is difficult to know exactly how many students are affected, although the number is thought to be around five annually, as not all cases are reported to the BMA.

If medical courses do have to be modified to accommodate carriers, then hepatitis B may have to be reclassified as a disability. Procedures are already in place for students with specific impairments such as deafness.

The risk of infection with hepatitis B after exposure is high, and there have been a number of transmissions from health workers to patients. Concerns about other viruses such as HIV are not as great because the risk of transmission is much lower. Dentists would not be affected by the new proposals as dentistry is considered high risk with regard to bloodborne virus transmission.