Tuberculin Skin Testing Policy

Tuberculosis screening is required for all incoming UMMS Medical, GSN, and GSBS students. Several testing methods, either a 2 step TST or a IGRA blood test (Quantiferon Gold Test or T-spot) are accepted.

The 2-Step TST is a baseline test for adults who will periodically be retested such as healthcare workers.  A 2-Step test is defined as two TST’s (previously called PPD test) completed within three months of each other. The optimal timing between the two tests are within one to four weeks of each other. The 2-Step is performed to reduce the likelihood that a “boosted effect” will be misinterpreted as a recent infection or new conversion.  A positive reaction to the second test probably is a boosted reaction (indicating past infection with tuberculosis - or very rarely an infection with another related bacteria or a reaction to BCG vaccination). The 2-Step policy is designed to reduce the potential of overestimation of new infections.

The Quantiferon Gold Test and T-Spot are two different blood tests that also test exposure to tuberculosis. Either test is accepted as an alternative to the 2-Step TST upon entrance. This test is preferred for foreign born students who have received BCG vaccine as BCG will not interfere with the results as it may with the TST. Student Health may also use this test in certain circumstances to verify new conversions or questionable reactions or if a student has an allergy to PPD serum.

PLEASE NOTE: All Medical students are required to have a yearly tuberculin skin test (TST) or an IGRA test. It is the student’s responsibility to maintain yearly TB screening throughout his/her education at UMMS.

If you have had a positive TST or IGRA test then documentation of a chest x-ray is required to be taken after the positive TST. If it is determined that you have latent TB, it is required that you complete an annual symptom review form.

For all students travelling to a TB endemic area (contact SHS for a list of these countries) a TST between 8-10 weeks after return to the U.S. is required.

Students born outside the U.S. who have received BCG vaccine are required to meet the TST requirement as noted above.  Generally, individuals who receive a BCG vaccination usually stop having a positive TST reaction after 5-10 years (even when tested with a 2-Step TST). Consequently, an individual who received BCG in childhood who has a positive TST as an adult very likely has latent tuberculosis infection, it is recommended in these cases to check an IGRA test to verify, and to discuss recommended treatment options with a provider.

Please visit the Student Health Website for additional information and/or forms.

Applicability: All enrolled students
Date Revised:  June 2, 2015 (SHS)

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