Tuberculosis screening in medical students

The Liaison Committee on Medical Education and the Association of American Medical Colleges have issued recommendations for screening medical students for tuberculosis. This report describes the initiation of a tuberculosis screening program at the F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences (USUHS).

A screening program was instituted in 1993 that included intradermal purified protein derivative, the "booster phenomenon," inter-reader variability, risk factor analysis, and administrative policy to improve compliance.

There were 501 students screened (classes of 1996-1998). Initially, 19 (3.8%) students' tests were classified as positive, and 14 additional students tested positive when tested again 2 months later, due to the booster phenomenon. The subsequent conversion rate was 2.5% for those students who were followed for the next 3 years of medical school. All these students were placed on prevention therapy with isoniazid. No active cases of tuberculosis have been identified since the inception of the screening program.

Only recently has the importance of screening medical students been emphasized. The USUHS program was designed to address the factors for a successful screening program, such as increased compliance, standardization, and documentation. With modifications according to resources, medical schools can offer an efficient tuberculosis screening program to students, faculty, and staff.