Pre-Rotation Requirements for Experiential Placements

Students must comply with immunization, CPR, first aid, mask fit testing, and professional liability requirements (items A to F). Students who have not complied with these requirements will not be permitted to proceed to experiential placements (i.e., EPE-1, EPE-2, APPE). In addition, any site-specific requirements such as a Police Record Check/Vulnerable Sector Screening must be completed in order to proceed to experiential placements (see section G below).

Students are responsible for all fees associated with the requirements listed below. Requirements (A to C) are to be uploaded to the secure system, Synergy Gateway Verified and students must use the Faculty of Pharmacy approved forms. Further information on the forms and system will be provided to students in the Fall. Requirements must remain valid while on EPE or APPE rotation. 

1. Immunization Policy

   Prior to the first year of experiential placements, students must provide documentation to indicate compliance with the ‘Policies on Communicable Disease and Immunizations for Pharmacy Students’. Students will be asked to renew specific immunizations throughout their studies as indicated by the Immunization Policy.

   1. Requirements:

      1. Tuberculosis:

         Students whose tuberculin status is unknown, and those previously identified as tuberculin negative (with only ONE single-step Mantoux), require a baseline two-step Mantoux skin test with PPD/5TU. However, if the student has a documented negative PPD test during the preceding 12 months a single-step test may be given.

         For students who have had ≥2 previously documented negative single step PPD tests or 1 previously documented 2-step PPD test, a single-step test may be given.

         Annual TB testing is a requirement for individuals who have previously tested negative.

         Students who have had previous Bacille Calmette-Guerin (BCG) vaccine may still be at risk of infection and should be assessed. A history of BCG vaccine is not a contraindication to tuberculin testing.

         Documented positive tuberculin skin test

         If a student has a previously documented positive tuberculin skin test, the student does not need to receive another tuberculin skin test, but requires additional documentation. Chest x-ray’s are required every 24 months.

         A chest X-ray should be taken on students who:

         1. are TB skin test positive and have never been evaluated for the positive skin test;
         2. had a previous diagnosis of tuberculosis but have never received adequate treatment for TB; and/or
         3. have pulmonary symptoms that may be due to TB
         4. last CXR was done over 24 months ago.
             

      2. Measles, Mumps, Rubella, Varicella:

         Proof of 2 vaccinations with documented date for Measles, Mumps and Varicella, and proof of 1 vaccination with documented date for Rubella, OR positive titre results for antibodies is required.

      3. Diphtheria/Tetanus/Acellular Pertussis:

         Documented history of a primary series and dates of boosters are required. In the absence of documentation of an original series, the learner should be offered immunization with a full primary series. Immunization against diphtheria/tetanus is effective for approximately ten years. If the most recent booster is not within the last 10 years, a booster must be given.
          
         A single dose of Acellular Pertussis in the form of a Tdap (Adacel® vaccine) is given if not previously received as an adult (18+). The adult dose is in addition to the routine adolescent booster dose (age 14-16). There is no contraindication in receiving Tdap in situations where the learner has had a recent Td immunization.

      4. Polio:

         Proof of a complete primary series of polio vaccinations is required. Should immunization be required prior to the commencement of experiential placements, inactivated poliomyelitis vaccine (IPV) is indicated rather than oral poliomyelitis (OPV) vaccine because people receiving OPV may shed the virus and inadvertently expose immunocompromised patients to live virus. Persons who have not received a full primary course should have the series completed with IPV regardless of the interval since the last dose.

      5. Hepatitis B:

         Documented immunization of a complete series of Hepatitis B, including lab evidence of immunity Antibodies to HBsAg (Anti-HBsAg over 10 IU/L = immune) must be provided at least one month after the vaccine series is complete (Lab evidence is sufficient if documentation of primary series unavailable).

         1. Individuals who are non-immune (i.e., do not have the antibodies against HBsAg after immunization), must be screened for the surface antigen (HBsAg). If the HBsAg result is positive, a further screen for e-antigen (HBeAg) must be performed.
         2. Individuals who are non-immune and HBsAg negative must have a booster dose of HB immunization, and subsequent lab results recorded completed 30 days after the booster dose. If lab evidence (anti-HBs) does not demonstrate immunity after the booster dose, the complete series (doses 2 & 3) should be completed with labs done 30 days after the third dose. If non-immune (‘non-responder’), individual consideration should be given to the case, depending on the professional requirements.
             
         Routine booster doses of vaccine are not currently recommended in persons with previously demonstrated antibody as immune memory persists even in the absence of detectable anti-HBs, however periodic testing should be conducted in hepatitis B responders who are immunosuppressed to ensure they are maintaining their anti-HBs titre.

   2. Students with a Communicable Disease:

      1. All students are expected to be in a state of health such that they may participate in the academic program, including patient care, without posing a risk to themselves or to others. Students with a communicable disease may participate in experiential placements as long as their continued involvement does not pose a health or safety hazard to themselves or others.
      2. Students who acquire a communicable disease are required to seek medical opinion.
      3. In addition to complying with other regulations, students with tuberculosis, hepatitis B, hepatitis C or HIV infection must provide documentation to Synergy Gateway Verified, from their primary care provider confirming the disclosed condition is being appropriately managed.

      4. Student Participation in Care of Patients with Communicable Diseases:

         1. Students are required to participate in the care of all patients assigned to them, including patients with communicable diseases, to a level commensurate with their level of training. Such participation is necessary for the student’s learning as well as for satisfactory completion of academic requirements.
         2. All students are expected to understand and adhere to infection control policies, including the principles of body substance precautions, when participating in the assessment and care of all patients, regardless of the patient’s diagnosis.
         3. Students are responsible for conducting themselves in a manner which is consistent with the health and safety of themselves and others and shall be given appropriate training to do so. Students who fail to meet these responsibilities may, depending on the circumstances, face sanctions under the provisions of the Standards of Professional Practice Behaviour for All Health Professional Students.
         4. Students are required to comply with the immunization policies of the Faculty

         The health status of the students shall remain confidential.

2. Standard First Aid and Level C/BLS CPR

   It is mandatory that all students be able to perform Standard First Aid and Level C CPR. To meet this requirement all students must submit:

   1. prior to experiential placements in Year 1 of the program, evidence of currently valid certification or re-certification and,
   2. prior to experiential placements in Year 2 of the program, evidence of currently valid certification or re-certification and,
   3. prior to experiential placements in Year 4 of the program, evidence of re-certification that is valid to the end of Year 4. Students are held individually accountable for submission of required documentation.
   4. PharmD for Pharmacists Program only: students must have evidence of currently valid certification or re-certification that is valid throughout their rotations.

3. Mask Fit Testing

   Students must have a valid mask fit test prior to APPE experiential placements.  Students in Year 1 and 2 of the program may require mask fit testing depending on the site requirement of their placement.
   
   If a student is unable to complete a Mask Fit Test, they may request a waiver from the Office of Experiential Education.

4. Student Declaration of Understanding (Workplace Safety and Insurance Board or Private Insurance Coverage for Students on Unpaid Placements)

   Students of the Leslie Dan Faculty of Pharmacy are eligible for Workplace Safety and Insurance Board (WSIB) coverage of claims while on unpaid placements as required by their program of study. Each year students must sign to confirm that they have read and understand the coverage provided while on placement, through the electronic form ‘WSIB Student Declaration of Understanding Form’ on the Office of Experiential Education database CORE ELMS.

5. Personal Professional Liability Insurance

   Students must acquire Personal Professional Liability Insurance. It is each student’s responsibility to purchase this insurance prior to any experiential placement and to maintain this insurance coverage throughout their degree.

6. Students in the PharmD for Pharmacists Program Only: Registration with the Ontario College of Pharmacists

   PharmD for Pharmacists students will be required to register as a 'Part A' Pharmacist or a Pharmacy Intern with the Ontario College of Pharmacists (OCP) prior to any experiential placements occurring in Ontario. Students must acquire liability insurance for the duration of the registration.

7. Site Specific Requirements

   Students must comply with institutional/corporate policy of the site to which they are assigned. Individual institutions and practice sites may have immunization, testing or documentation requirements for student placements beyond those required by the Faculty. Information regarding these requirements will be provided to students when site assignments are confirmed on CORE ELMS

   1. Police Record Check / Vulnerable Sector Screening (PRC/VSS):
      
      Pharmacy students, as part of their curriculum, will have experiential placements (rotations) at various pharmacy practice settings where they may work directly with, or in close proximity to, children or vulnerable persons. To protect these groups and maintain their safety, sites may require Pharmacy students to obtain a Police Record Check and/or Vulnerable Sector Screening. A Police Record Check is more comprehensive than “Criminal Record Checks” and “Clearance Letters”.
       
   2. Mandatory Site Training:
      Some sites may require students to complete orientation and other training documents. Students may be required to sign off on confidentiality forms and Non-Disclosure Agreements
       
   3. Additional Immunization Requirements (Influenza and COVID-19 Vaccination):
      1. Influenza vaccination:
         Influenza vaccination is strongly recommended for all pharmacy students participating in experiential placements. Students who choose not to have an annual influenza vaccination should be aware that they will not be able to participate in rotations at sites requiring the influenza vaccination.
      2. COVID-19 vaccination:
         Pharmacy students participating in experiential rotations are recommended to receive updated COVID-19 vaccinations as per current public health guidance. Note that sites may have specific vaccination requirements.