PGME Immunization & Mask Fit Test Requirements

All new postgraduate learners must meet TB testing requirements before their training start date.

New Postgraduate Learners

If you have had a Negative Tuberculin Skin Test OR have not been tested, use the table below to identify your situation and determine what information you are required to provide on the Full Immunization Form.

Two-Step Tuberculin Skin Test Process

If you are required to complete a two-step Mantoux test, follow the process below. Please note that the entire two-step process must be completed within 4 weeks.

Note:

• A TST may be given before, on the same day as, or at least 28 days after a live virus vaccine.
• A two-step Tuberculin Skin Test can be completed by visiting a walk- in clinic, your family doctor’s office, local public health units, some pharmacies or in your home country healthcare institution

If you have had a positive Tuberculin Skin Test or an Interferon Gamma Release Assay (IGRA), you must provide on your full immunization form:

• Positive Tuberculin Skin Test or an Interferon Gamma Release Assay (IGRA) results
• A chest X-ray date and results (must be dated after the positive Tuberculin Skin Test or IGRA)
  
  Required Documents to Submit:
  • Chest X-ray report or letter from the physician specialty or TB clinic report describing the film
• Report from the healthcare provider or clinic confirming that you have been assessed and/or treated for active or latent tuberculosis.

Important notes:

• A Bacillus Calmette-Guérin (BCG) vaccination is not a contraindication for Tuberculin Skin Test
• A chest X-ray alone is not accepted as a substitute for the Tuberculin Skin Test
• Once you have had a positive Tuberculin Skin Test or Interferon Gamma Release Assay (IGRA), it is not necessary to repeat this test in the future.

Returning Postgraduate Learners

Annual TB testing Requirement

If you are a returning learner and you have NEVER had a positive Tuberculin Skin Test or Interferon Gamma Release, you must complete The Annual TB Testing Form.

You may provide either:

• one-step Tuberculin Skin Test, or
• Interferon Gamma Release Assay(IGRA)

Requirements:

• The test must be valid through your training start date.
• Returning learners must ensure their TB Testing is renewed before the next academic year if it expires.

Immunization & Proof of Immunity:

Hepatitis B immunization consists of a series of 2–3 injections.

To meet the requirement, learners must provide:

• Lab evidence of immunity (Hepatitis B antibody/HBsAb), and
• Date the titre was drawn

Titre results typically take 2-4 business days to be processed once received by the public health laboratory.

You are considered non-immune if:

• You do not have detectable Hepatitis B antibody (HBsAb)

In the case you are non-immune to Hepatitis B, you must:

Be screened for Hepatitis B surface antigen (HBsAg). 

• If HBsAg is negative:
  • You must complete a second series of Hepatitis B vaccinations and submit a repeat Hepatitis B antibody test after the series is complete.
  • Please consult your physician on vaccination timeline
• If HBsAg is positive: 
  • You must also be screened for Hepatitis B e-antigen (HBeAg).

Hepatitis B Carriers:

Learners who test positive for Hepatitis B will have a conditional registration status until their case is reviewed by the Temerty Faculty of Medicine Expert Panel on Infection Control. 

Related Guidelines & Policies:

• Procedural Memorandum for Hepatitis B Carriers
• Blood Body Fluid Exposure Policy (Needlestick Injury Procedural Guideline) 
• SHEA Guideline for Hep B,C and HIV

Proof of Immunity:

To meet the MMR requirement, you must provide either:

• Documentation of at least two doses of the MMR vaccine, with each dose given at least 28 days apart,

OR 

• Lab evidence of immunity a positive IgG antibody result for Measles, Mumps, and Rubella.

Please note that titre results may take 5–7 business days to be processed once received by the public health laboratory.

Proof of Immunity:

To meet the Varicella requirement, you must provide either:

• Documentation of two doses of the Varicella vaccine, with each does given at least 28 days apart, 

OR 

• Lab evidence of immunity a positive IgG antibody for Varicella. 

Important Note: A reported childhood illness is not acceptable evidence of immunity.

Please note that titre results may take 5–7 business days to be processed once received by the public health laboratory.

Diphtheria, Tetanus & Polio: 

• Proof of childhood primary vaccination series is required.
• Diphtheria & Tetanus booster is required within 10 years.
• If childhood vaccination records for Diphtheria, Tetanus, or Polio are not available, a repeat vaccination series is required. 

Acellular Pertussis (Tdap): 

• A single adult dose of Tdap is acceptable even without documentation of the childhood series.
• The precise type of vaccine used must be known; if this information is no longer available, repeat the immunization. Typically, tetanus/diphtheria/acellular pertussis (Tdap) or tetanus/diphtheria/acellular pertussis/polio (Tdap-Polio) will be used

Polio (IPV): 

• Primary immunization against polio is sufficient.
• No routine booster is required.

What to Complete

Full Immunization Form, acknowledged by: 

• Yourself
• And signed by
  • A healthcare professional (including clinic information)

Deadline

• You have 30 days from your training start date to submit all requirements. 

How to Submit:

• Upload your completed and signed Full immunization Form to the Registration Document Portal 
• If you are having issues accessing the Registration Document Portal, click here or contact postgrad.med@utoronto.ca
• Do not email your immunization forms.

Check Your Status in POWER: 

• Log into POWER and go to Messages on the home page to view any missing or expiring immunization requirements. 

Renewal Requirements

• Annual TB Test (if previously negative) renew every 12 months 

Submit a 1-step Tuberculin Skin Test or Interferon Gamma Release Assay (IGRA) using the Annual TB Test Form

• Mask Fit Test - renew every 2 years
  • Submit the mask fit test form
  • Must be acknowledged by you and
  • Signed by a healthcare professional (not yourself)

How to Submit:

• Upload completed forms to the Registration Document Portal
• If you are having issues accessing the Registration Document Portal, click here or contact postgrad.med@utoronto.ca
• Do not email your mask fit form

Mask fit testing is not required for initial registration; however, it must be completed and submitted within 30 days of your training start date. Complete your mask fit test at your hospital training site's Occupational Health Office.

• Upload your documentation to the Registration Document Portal. 
• If you are having issues accessing the Registration Document Portal, click here or contact postgrad.med@utoronto.ca.
• Please visit the occupational health office at your training site to complete you mask fit test.

• You must complete and submit a valid mask fit test before your training start date.
• Upload your documentation to the Registration Document Portal.
• If you are having issues accessing the Registration Document Portal, click here or contact postgrad.med@utoronto.ca.

• Ensure your mask fit test remains valid for the duration of your training. 
• Mask fit tests are valid for 24 months from the date of your last test.
• If your mask is expired or will expire during your training, please complete a new mask fit test.
• Upload the updated documentation to the Registration Document Portal before they expires.
• If you are having issues accessing the Registration Document Portal, click here or contact postgrad.med@utoronto.ca.

Please visit the occupational health office at your training site to complete you mask fit test.