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Tuberculin Skin Testing in Medical Students: A Survey of U.S. Medical Schools
- Mark J. Fagan, MD; and
- Gregory A. Poland, MD
- From Rhode Island Hospital, Providence, Rhode Island and Mayo Clinic and Foundation, Rochester, Minnesota. Requests for Reprints: Mark J. Fagan, MD, Division of General Internal Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903.
The recent increase in the incidence of tuberculosis in the United States [1, 2] and the appearance of multidrug-resistant tuberculosis associated with a high mortality rate have increased the risk for tuberculosis in health care workers, including medical students [3]. Several studies have shown occupationally acquired tuberculosis and multidrug-resistant tuberculosis among health care workers [4-7].
In response to the resurgence of tuberculosis, the Centers for Disease Control and Prevention (CDC) has recommended that all health care workers have annual tuberculin skin testing with purified protein derivative and that health care workers who may be frequently exposed to patients with tuberculosis have more frequent testing (at least every 6 months). We determined whether the tuberculin skin testing policies of U.S. medical schools meet the CDC guidelines for yearly testing and whether medical schools are experiencing purified protein derivative conversions among their students.
Methods
In May 1992, we mailed a 20-item survey to each of the 126 Deans of U.S. medical schools listed in the Directory of the American Association of Medical Colleges [8]. If we received no reply from the Dean or his or her designee within 3 weeks of the first mailing, we sent a second copy of the survey. The questionnaire inquired about the medical school's policies on tuberculin skin testing at matriculation as well as during medical school. We asked for information on skin-test conversions in medical students and specifically asked for an estimate of the yearly rate of skin-test conversion in the …
