Certain behaviors are inherently destructive to the relationships that are required in a community organized to provide medical and graduate education. Behaviors such as violence, sexual and other harassment, abuses of power and discrimination (based on race, color, religion, national origin, gender, sexual orientation, veteran status, age, disability, citizenship, marital status, genetic predisposition or any other characteristic protected by law) will not be tolerated.

Sexual Harassment

Sexual Harassment is defined as unwelcome sexual advances, requests for sexual favors, and/or other verbal or physical conduct of a sexual nature when:

• Submission to such conduct is made either explicitly or implicitly a term or condition of an individual’s employment or academic success.

• Submission to or rejection of such conduct by an individual is used as a basis for employment or academic decisions affecting such an individual.

• Such conduct has the purpose or effect of unreasonably interfering with an individual’s work or academic performance or creating an intimidating, hostile, or offensive work or academic environment. Sexual harassment is a violation of institutional policy and of city, state and federal laws. Sexual harassment need not be intentional to violate this policy.

• Examples of sexual harassment include, but are not limited to:

  • Sexual assault

  • Inappropriate sexual advances, propositions or demands unwelcome physical contact

  • Inappropriate persistent public statements or displays of sexually explicit or offensive material which is not legitimately related to employment duties, course content or research

  • Threats or insinuations, which lead the victim to believe that acceptance or refusal of sexual favors, will affect his/her/their reputation, education, employment or advancement

  • Derogatory comments relating to gender or sexual orientation

Discrimination

Discrimination is defined as actions on the part of an individual, group or institution that treat another individual or group differently because of race, color, national origin, gender, sexual orientation, religion, veteran status, age, disability, citizenship, marital status, genetic predisposition or any other characteristic protected by law. Discrimination or harassment on the basis of these characteristics violates federal, state, and city laws and is prohibited and covered by this policy.

Abuse

Abuse is defined, for purposes of this policy, as behavior that is viewed by society and by the academic community as exploitative or punishing without appropriate cause. It is particularly objectionable when it involves the abuse of authority. Examples of behavior, which may be abusive, include, but are not limited to:

• Habitual conduct or speech that creates an intimidating, demeaning, degrading, hostile, or otherwise seriously offensive working or educational environment

• Physical punishment

• Repeated episodes of verbal punishment (e.g. public humiliation, threats and intimidation) removal of privileges without appropriate cause

• Grading or evaluations used to punish rather than to evaluate objective performance assigning tasks solely for punishment rather than educational purposes

• Repeated demands to perform personal services outside job description intentional neglect or intentional lack of communication

• Requirements of individuals to perform unpleasant tasks that are entirely irrelevant to their education and employment that others are not also asked to perform

Purpose and Scope

This policy clarifies expectations for educator actions and behaviors related to mistreatment and other unprofessional behavior directed at students and trainees. It details how learners can report mistreatment and unprofessional behaviors directed at them and how the Icahn School of Medicine at Mount Sinai (ISMMS) Undergraduate Medical Education (UME) program, Graduate Medical Education (GME) program, and Graduate School of Biomedical Sciences (GSBS) and the ISMMS affiliated hospitals (collectively “Mount Sinai”) review and handle such reports. This policy also provides a process for reporting and recognizing positive behaviors and excellence in teaching or mentoring.

Mount Sinai is dedicated to providing its students, postdocs, residents, clinical fellows, faculty, staff, and patients with an anti-racist learning environment of respect, dignity, equity, inclusion, trust, and support that protects civil and professional discourse and is free from mistreatment and other unprofessional behaviors directed at students and trainees. Mount Sinai is also committed to ensuring an environment in which students and trainees feel free to report such behaviors without fear of retaliation.

Educators (defined broadly to include anyone in a teaching or mentoring role, including faculty, postdocs, residents, clinical fellows, nurses, staff, and students) bear significant responsibility for creating and maintaining this environment. As role models and evaluators, educators must practice appropriate professional behavior toward, and in the presence of, students and trainees, who are particularly vulnerable given their dependent status.

Everyone at Mount Sinai deserves to experience a professional learning and working environment. These guidelines supplement the institutional policies on professional conduct, discrimination, harassment, grievances, and sexual misconduct; will assist in developing and maintaining optimal learning environments; and encourage educators to accept their responsibilities as representatives of ISMMS in their interactions with colleagues and patients. This policy is closely aligned with our institution’s Cultural Transformation efforts, the ISMMS Racism and Bias Initiative, and related policies.

Mistreatment and unprofessional behaviors directed at students and trainees interfere with the learning environment, adversely impact well-being and the trainee-mentor relationship, and have the potential for negatively impacting patient care and research. Inappropriate and unacceptable behaviors can promote an atmosphere in which mistreatment and unprofessional behaviors directed at students and trainees is accepted and perpetuated in medical and graduate education. Reports relating to the clinical setting will be reviewed in accordance with the principles detailed in this policy as part of the relevant hospital’s quality assurance program.

While individuals might perceive behaviors differently, examples of unprofessional behaviors prohibited by this policy include, but are not limited to being:

• threatened with physical harm or physically harmed

• required to perform personal services

• subjected to offensive remarks related to gender, sexual orientation, national origin, race, color, religion, or any other category protected by law

• denied opportunities for training or rewards based upon membership in a protected group

• subjected to lower evaluations or grades solely because of membership in a protected group

• publicly embarrassed or humiliated

• subjected to unwanted sexual advances

• asked to exchange sexual favors for grades or other rewards

• subjected to the threat of revoking visa status for foreign nationals

Mount Sinai has a zero-tolerance policy towards unprofessional behaviors directed at students and trainees. Zero tolerance means that all reported incidents are scrutinized and result in an action plan that may include feedback, remediation, or disciplinary action. Although under certain circumstances unprofessional behavior directed at students and trainees may require disciplinary action, we recognize in such episodes an opportunity to develop, improve, and remediate behaviors that detract from a learning and working environment of which we can all be proud.

Sexual Assault ISMMS is committed to maintaining a supportive and safe educational environment, one that seeks to ensure the wellbeing of all members of its community. Those who believe that they are the victims of sexual assault should:

• Immediately call the NYC police department at 911. Also, call the Mount Sinai Security Department at (212) 241-6068.

• Get medical attention. Campus security will provide transportation or escort to the Mount Sinai Hospital Emergency Department for emergency medical treatment and evidence collection. A counselor from the Sexual Assault and Violence Intervention (SAVI) program will be available to assist victims.

Caring assistance is available for persons who have been subjected to sexual assault or sexual misconduct. They are encouraged in the strongest terms to make a report. ISMMS works closely with Mount Sinai SAVI program. More information can be found here or by calling (212) 423-2140.

Consistent with Chapter 739 of the State Education Department signed into law in 1990, information concerning prevention of sexual assault is provided to all entering students.

Students’ personal security is of paramount importance. For this reason, Security will, upon request, provide escorts within Mount Sinai and to on-campus residences. Call ext. 46068 approximately 10 to 15 minutes prior to departure.

Security measures at Mount Sinai are reviewed continuously to provide a safe environment for all who use its facilities. A committee of the Student Council addresses housing and security issues and meets on a regular basis with Security to discuss matters of concern.

Security Office Contact Information

The Security Office is located at 1468 Madison Avenue, MC level, AMC-203.

The Security Department telephone number is 46068 when dialed from a school or hospital telephone and (212) 241-6068 when dialed from off campus or cellphone.

Students can also reach Security by dialing extension “60” from a hospital or school telephone in an emergency, when suspicious activities are observed or urgent request.

Identification Badges

Photo identification badges are issued to all students at the time of registration and MUST BE WORN AT ALL TIMES in all campus buildings and upon entering any residence hall. Students may be asked to present badges for identification at any time while on campus. Lost cards may be replaced for a $20 fee, payable to the hospital main cashier. Present the receipt to Security Administration who will issue a new badge.

Emergency Alert System “Message One”

In order to allow for a more coordinated and rapid response to emergency or disaster situations at Mount Sinai, the hospital uses a messaging system, MessageOne, which has the capability of informing students of and delivering instructions regarding citywide, hospital, or student specific (e.g. student housing intruder) emergencies requiring immediate attention. Signing up for this system is mandatory for all students. During the on-line registration process, students have the option to set the method of contact (e.g. cell-phone, text message, email).

Personal Property and Property Passes

Personal property is often the object of theft and should be protected at all times. It is the policy of Mount Sinai that no equipment, personal or that belonging to Mount Sinai, will be removed from the premises without a Property Pass. Property Passes are available from the Graduate School office during weekdays. Packages, backpacks, purses, or other large bags are subject to inspection by Security Officers at entrances and exits of all Mount Sinai buildings.

Purview of the Committee

The Committee is charged with addressing any complaint of harassment or abuse brought by any member of the faculty, medical or graduate student, house staff officer or postdoctoral research fellow against any other such member of the school community.

Composition of the Committee

The Committee will consist of at least 22 members. Among these will be 2 with counseling experience, 2 medical students, 2 graduate students, 2 house staff, 2 faculty with administrative appointments, and 2 research postdoctoral fellows. Faculty members of the Committee will be representative of both basic science and clinical, junior and senior faculty. Every effort will be made to have the Committee reflect the full diversity of the medical school population. The Chairperson of the Committee (the “Chairperson”) shall be a faculty member with experience in counseling and who does not have an administrative appointment. All members of the Committee, including the Chairperson, will be appointed by the Dean after consultation with relevant groups in the School. Faculty will serve staggered 3-year renewable terms; students, postdoctoral fellows and house officers will serve renewable 1-year terms.

Grievance Procedures

Any member of the faculty, any medical or graduate student, house officer or postdoctoral research fellow who believes that he or she has been harassed or abused by any other such member of the School community may contact any member of the Committee or the Chairperson to seek advice, or may submit a written complaint to the Committee. The Committee member contacted can discuss the matter with the complainant, advise the complainant of his/her/their alternatives in pursuing the complaint, including, if the complainant agrees, (and where permitted by law), helping the complainant to resolve the complaint informally without revealing the complainant’s name. Such help may include, but is not limited to, assisting the complainant in drafting a letter to the alleged offender asking that he/she/they stop the behavior, or coaching the complainant in preparation for a conversation with the alleged offender. The complainant may ask the Committee member to meet directly with the person accused to seek a resolution. If the complaint includes an alleged violation of law, the Committee member initially contacted must bring the complaint to the full Committee, the complaint must be fully documented and investigated, and a report made to the Dean.

Upon request of the complainant to the Committee member originally contacted, or upon receipt of written complaints to the Committee, or when required by law, the complaint, with the names of the complainant, respondent and department withheld, will be discussed by the Committee at its next regular meeting.

Following discussion of the complaint, the Committee has 2 options:

1. It can decide that even if the allegation is true, it does not constitute harassment or abuse. The complainant will be notified of the finding and can be offered guidance and/or assistance in resolving the matter, or be referred to another, more appropriate venue, such as Human Resources, the Faculty Relations Committee or a Tenure Review Committee to pursue the complaint.

2. It can decide that the allegation is sufficiently serious to warrant further investigation. Unless previously submitted, the complainant will be requested to submit a full written account of the complaint. Upon receipt of the written complaint, the Chairperson will appoint a five-member Board and two alternates.

The Chairperson will serve as chair of the Board (or, in case of conflict of interest or other inability to serve, appoint another Committee member) and will appoint at least 4 additional individuals and at least 2 alternates to consider the complaint. Students, postdoctoral fellows, and house staff members are to be excluded from the Board in cases involving a faculty member alleging harassment by another faculty member. In cases involving a student, postdoctoral fellow or house staff (either as an accuser or accused), at least one of the members of the Board will be from the same group. Each Board will have at least one member with experience in counseling, and at least 3 faculty.

Upon selection of the Board, the complainant will be notified of the names of Board members, and will have 48 hours from receipt of such notification to challenge, in writing, any member for cause. The respondent will be notified that a complaint has been brought against him/her, the name of the complainant, the nature of the complaint, and the names of the members of the Board. The respondent shall also have 48 hours from receipt of notification to challenge, in writing, any member of the Board for cause. In the event of a challenge, the Chairperson will decide on the merits and replace Board members if necessary. In the event that the Chairperson is unable to appoint a sufficient number of members not disqualified for cause, the Dean will appoint additional members.

The preliminary stages of the investigation may consist of meetings of one or more members of the Board with the complainant, respondent and other members of the community who might have relevant information. In the event that preliminary meetings have been held, all information obtained in these meetings will be shared with the entire Board. In all meetings, confidentiality will be stressed.

The respondent will receive the full written complaint with the supporting documentation provided by the complainant to the Board and will be afforded two weeks to provide a written response. This response will be distributed to the Board and provided to the complainant.

The Board will then hold one or more hearings, which the complainant and respondent will attend, either individually or together, along with any other witnesses the Board deems relevant to the complaint. At the hearing, each of the parties may be accompanied by an advisor, who is a member of the Mount Sinai community, but who is not a lawyer, and who will not function as an advocate during the hearing.

At the close of the hearing(s), the Board will deliberate the findings without the presence of either the complainant or the respondent. Upon concluding its deliberations, the Board will vote on whether or not there has been a violation of this policy based on a majority vote. Recommendations for remedial actions will be discussed. A full report will be drafted, including the findings, vote and recommendations of the majority. It will then be submitted to the Dean. The Board's written report will include:

1. A determination that a violation of this policy did or did not take place

2. A listing of its findings of fact

3. A summary of the written submissions of the parties

4. A summary of testimony at the hearing

5. A summary of evidence gathered during the investigation

6. The conclusions it has drawn from this material

7. Its recommendations for action to be taken by the Dean.

The Board may recommend sanctions based on the severity of the offense. Sanctions may include, but are not limited to, verbal reprimand, written reprimand, change in job responsibilities, suspension, discharge, and expulsion. The Board and/or the Committee may, at their discretion, modify the Grievance Procedures depending on the nature of a particular complaint.

Dean's Review

The Dean may accept or reject conclusions and/or recommendations of the Board. However, in the event the Dean does not accept either the Board’s conclusions or its recommendations, he/she/they will meet with the Board to discuss the reasons for the rejection before recording a final decision on the matter. The Dean will convey his/her/their decision in writing to the complainant, respondent and the Board.

Protection from Retaliation

All individuals involved in registering a complaint, serving as representatives for the complainant or respondent, as witnesses, or on the Committee will be free from any and all retaliation or reprisal or threats thereof. This principle applies with equal force after a complaint has been adjudicated. Upon submission of a complaint or threat of retaliation, the Committee will review the facts and recommend appropriate action.

Re-Evaluation of Procedures

The Committee will review the grievance procedures periodically. Proposed changes, approved by a majority of the Committee, must be reviewed and approved by the Office of the General Counsel before being implemented.

Harassment has become an increasingly prominent national concern in the workplace and in academic institutions. ISMMS regards any behavior that is harassing, discriminatory, or abusive as a violation of the standards of conduct required of all persons associated with the academic mission of the institution. The ideal of American medical, graduate and postgraduate education is to create an environment that nurtures respect and collegiality between educator and student. In the teacher/student relationship, each party has certain legitimate expectations of the other. For example, the learner can expect that the teacher will provide instruction, guidance, inspiration, and leadership in learning. The teacher expects the learner to make an appropriate professional investment of energy and intellect to acquire the knowledge and skills necessary to become an effective physician or scientist. The social relationships required in the achievement of this academic ideal – mentor, peer, professional, staff – require the active trust of partnership, not the dependence of authoritarian dominance and submission.

ISMMS is responsible for providing a work and academic environment free of sexual and other forms of harassment. The institution may pursue any complaint of harassment known to it in order to achieve this goal. A Grievance Committee (the “Committee”) was established in 1992 to serve as an educational resource to the medical school community on issues relevant to harassment and to address complaints of sexual harassment and other forms of harassment and abuse as defined below. Complaints about implementation of school policies concerning appointment, promotion, and distribution of resources, including notification requirements associated with these policies, will not be addressed by this Committee unless they involve, in addition to those complaints, an allegation of harassment or abuse as defined below. The Committee (and an appointed Investigative and Hearing Board (the “Board”) below, if any) may only consider complaints of harassment and abuse brought by any faculty member, medical or graduate student, house staff or postdoctoral fellow against any other such member of the School community. Complaints by and against other employees of ISMMS will be handled by other appropriate existing grievance mechanisms (e.g., those available through Human Resources). The Committee may act (at the Committee’s discretion) before or after other action(s) an individual may take to exercise his/her/their rights both within and outside the institution.

The Committee will attempt, whenever possible, to emphasize mediation and conciliation. It will rely on discreet inquiry and trust in dealing with complaints that are brought for its consideration. Confidentiality will be maintained to the maximum extent possible consistent with the need to investigate complaints and with the requirements of the law. Full cooperation with the Committee and an appointed Board, if any, is required of all members of the community.

To ensure an environment in which education, work, research, and discussion are not corrupted by abuse, discrimination and harassment, the following statement has been created to educate members of the academic community about what constitutes harassment and about the mechanism for the receipt, consideration, and resolution of complaints.

Issues also may be brought up during the Steering Committee of the Student Council's monthly meetings with the Dean, the Dean for Medical Education, the Dean of the Graduate School and the Associate Deans. It must be emphasized that appropriate professional behavior is expected of all members of the School of Medicine and the Hospital. Harassment in any form will not be tolerated.

Consistent with Sections 6432 and 6436 of the New York State Education law, information concerning prevention of sexual assault, domestic violence, stalking, and bias crimes will be provided to all entering students. A Student Safety Committee meets annually with Security to address student safety concerns.

Reporting and Consulting Mechanisms

Students can learn about the process of reporting mistreatment on the Mistreatment and Unprofessional Behaviors Directed at Students and Trainees website.

Students can report mistreatment through the ISMMS Experience Report.

Students and trainees may seek advice and guidance about how to handle mistreatment and unprofessional behaviors directed at them and are encouraged to formally report these incidents. There are several ways for learners to share their concerns, including through real-time reporting mechanisms and mechanisms for periodic review (course evaluations or periodic surveys). All reports, whether made in real-time or during periodic review, must be submitted via the Feedback Form or as specified on this page. Reports will be reviewed by the respective office that oversees the learner/trainee. The person submitting a real-time report can also designate whether he or she wants to have the concern addressed immediately or to delay the review until a period of time has passed. Anonymous reports of mistreatment and unprofessional conduct may be submitted; however, Mount Sinai’s ability to investigate an anonymous report may be limited. Reports of alleged mistreatment and unprofessional behavior directed at students and trainees will be reviewed and handled in a timely manner. Seeking advice or guidance is not considered filing a report. Reports may only be made through the Feedback Form referenced above or the avenues specified on this page.

Mount Sinai prohibits sex discrimination in any education program or activity that it operates. Individuals may report concerns or questions to the Title IX Coordinator. The notice of nondiscrimination is located at Title IX | Icahn School of Medicine (mssm.edu).

Protection for Retaliation

Retaliation against or intimidation of any individual who seeks advice, raises a concern, or reports unprofessional misconduct or mistreatment in good faith will not be tolerated. Anyone who deliberately makes a false accusation with the purpose of harming or retaliating against another member of the ISMMS community will be investigated and appropriately addressed.

Contact Information

Compliance Hotline: 800-853-9212

GME Office: 212-241-6694

Office of Human Resources: 212-241-4097

Ombuds Office: 212-659-8848

Title IX Coordinator: Rebecca Anderson 212-540-8669 or TitleIX@mssm.edu

One of the most serious issues facing the Mount Sinai Hospital students, employees, and patients is the threat of fire. The risk is increased because work conducted in clinical, research and other laboratories may involve flammable liquids and other hazardous substances. In addition, the use of specialized equipment such as lasers and other ignition sources utilized in oxygen-enriched atmospheres increases the threat of fire. This threat is far more critical in patient care areas since patients are often incapable of self- preservation. It is critical to student safety as well as patient well-being that students know what to do in the event of an actual fire. This knowledge is imparted through participation in fire drills and fire safety training in-services.

The ISMMS Intranet, http://intranet1.mountsinai.org/, under Core Administrative Services and Fire Safety Tabs, includes a link to the MSMC video entitled “CODE RED”. Students should take the time to view this important informational video and participate in local fire drills.

The Clery Act (otherwise officially known as the Jeanne Clery Disclosure of Campus Security Policy and Campus Crime Statistics Act) is a federal law requiring US colleges and universities receiving Title IV funding to disclose information about particular crimes on and around their campuses as well as safety related policies. ISMMS publishes annual security reports to fulfill this requirement. These reports are available on the ISMMS Consumer Information website as well as in the Security Department.

The following statement describes ISMMS’s policy regarding substance abuse for all employees, which include faculty, administration, house staff, students, graduate students, fellows, bargaining and non-bargaining unit employees. The school has a significant interest in ensuring that the educational and work environment is free from the hazards to patients, employees, students, and visitors that are created due to the unauthorized use of alcohol, drugs, or controlled substances.

The illegal sale, manufacture, distribution, or unauthorized use of drugs or controlled substances off-duty whether on or off medical school premises or reporting to classes or clerkships under the influence of un-authorized drugs or controlled substances may constitute grounds for immediate dismissal.

The unauthorized use or possession of alcoholic beverages on medical school premises or reporting to School under the influence of alcohol also may constitute grounds for immediate dismissal.

The school may in its discretion take appropriate disciplinary action up to and including dismissal or termination from employment against anyone who has violated the above rules.

Any employee or student who is suspected of being under the influence of any alcoholic beverage or drug while on duty and who refuses to be medically evaluated or to release the results of such evaluation to the medical school (as employer) or appropriate administrative officer of the School will be relieved from duty and will be subject to disciplinary action up to and including dismissal.

The Drug-Free Workplace Act of 1988 requires ISMMS, as a Federal grant recipient and contractor, to certify that it will provide a drug-free workplace. This is accomplished by providing to each employee or student engaged in a federal grant or contract, a copy of the School’s Drug-Free Workplace policy and statement, and requiring that as a condition of employment under such a grant or contract the employee will:

• Abide by the terms of this Statement; and

• Notify the Director of Human Resources and Labor Relations or his/her/their designee of any criminal drug statute conviction for a violation occurring in the workplace no later than five (5) days after such conviction.

A Drug-Free Awareness Program has been established to inform all employees about the dangers of drug abuse in the workplace, The School's policy of maintaining a drug-free workplace, the available drug counseling, rehabilitation and employee assistance programs, and the potential penalties for drug abuse violations.

The Employee Assistance Program (EAP) offers professional guidance counseling and a referral service for substance abuse, as well as other concerns, to students, employees and their immediate families free of charge. For confidential information, contact EAP at (212) 241-8937.

The policy of the School of Medicine regarding alcoholic beverages in the Patricia and Robert Levinson Student Center is to maximize student utilization of the Center while assuring that clear policies are in place. Alcohol is permitted in the Student Center at events sponsored by student organizations or Departments within ISMMS under the following circumstances:

• A student-run organization that is recognized by Student Council is sponsoring the event.

• No student or guest under the age of 21 will be served or permitted to consume any alcoholic beverage.

• Alcoholic beverages are not sold at the event.

• Alcohol must not be taken out of the Student Center into other areas of Mount Sinai.

• Serving alcoholic beverages is always in the context of serving food and non-alcoholic beverages. A specific student (or students) is identified as responsible for the event.

• The responsible student will monitor the event so that anyone who is clearly intoxicated is not served any more alcohol.

• If a person has become intoxicated, steps should be taken to try and help the individual sober up prior to leaving the party.

• The responsible student monitoring the event must make certain that any person that has become intoxicated will not be allowed to drive. Cab fare should be provided, if necessary, or an escort should be provided to ensure that the person gets home safely.

• The Administrative Director of Student Affairs is notified in writing about the event at least one week in advance with the clear statement that alcoholic beverages are planned as part of the food and beverage service serving as the application for a permit.

• Funding for alcoholic beverages will not come from tuition resources or the Department of Medical Education budget.

• There MUST be a written permission from the Event Coordinator of Student Affairs prior to the event. The person(s) responsible for the event must have the permit with them at the event.

• The Security Department will be notified that alcohol will be served at the event.

Under no other circumstances should alcoholic beverages be used or available in the Levinson Student Center. Please contact the Event Coordinator of Student Affairs with any questions.

All incoming students are required to undergo drug/alcohol screening. Subsequently, drug/alcohol testing may be requested of any student, at any time, including:

• When concerns about substance use issues arise.

• When any student returns from a leave of any kind.

• When a student self-reports a problem.

Failure to undergo testing as requested will result in dismissal from the school. A positive test will result in disciplinary action, which may include dismissal from the school.

All students are held to the Mount Sinai Health System’s Infection Control Policies and Procedures. During orientation, students will be introduced to these policies and procedures. Further training is coordinated by each degree program. Students who experience needle stick accidents and accidental blood/body fluid in the medical school will be supported (An exposure may be a percutaneous injury, such as a needle stick, cut with a sharp object or bite, contact of mucous membranes, contact of tissue, contact of skin when the exposed skin is chapped, abraded, or afflicted with dermatitis, or the contact is prolonged or involving an extensive area with blood or tissue or body fluids.). It is expected that students follow the published protocols immediately as anti-retroviral therapy for HIV exposure, if recommended, should commence immediately. Exposure to hepatitis B or C may require therapy or further follow-up. Care, evaluation, and expert advice must be available to students regarding relative risks, options for therapy, and follow-up. Coordination of multiple affiliate sites has been accomplished so that students have a clear idea of the protocol to follow and students receive state-of-the-art care. Students must attend annual seminars conducted by infection control experts and documentation of attendance will become a permanent part of the student's file. Students must follow protocol after a needle stick or other blood/body fluid exposure. All exposures should be reported to Student Health. For complete information, view the Infection Control Handbook.