Substance Use and Drug Screening

Policy Relating to Substance Use and Drug Screening

Approved by Dean Toni Ganzel June 18, 2018

The University of Louisville School of Medicine is committed to protecting the safety, health and well-being of all students, faculty, staff and patients. It is the policy of the School of Medicine to establish, ensure and maintain a drug-free working and educational environment for medical students and a safe clinical environment for patients, and to provide for compliance with federal law1 regarding prevention of illicit use of drugs and the abuse of alcohol.

The University Of Louisville School Of Medicine also outlines technical standards required for matriculation and continuation in undergraduate medical education directed toward being graduated with the M.D. degree, and with the expectation that a student will be able to progress in training to become a licensed physician.2

It shall be a violation of this policy for any enrolled medical student to engage in the unlawful manufacture, distribution, dispensation, possession and/or use of a controlled substance. This includes, but is not limited to, being under the influence or impaired in activities anywhere in the educational environment of the School of Medicine, or affiliated institutions and clinics.

It shall be a violation of the technical standards and this policy for any enrolled medical student to engage in disordered use of legally obtained substances, whether scheduled or non-scheduled, regardless of the venue in which disordered use occurs. This includes, but is not limited to, manifestations of signs and symptoms of an active Substance Use Disorder.  For purposes of this policy, an active Substance Use Disorder is defined as any condition, whether mild, moderate or severe, within the categories listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or subsequent editions of that manual as published by the American Psychiatric Association.

An enrolled medical student’s arrest, charge, or conviction for any drug-related or alcohol related offense shall also constitute a violation of this policy.

The School shall have the right to require enrolled medical students to participate in a urine drug screen (UDS)3 administered by University of Louisville Campus Health Services at the following times:

  • Upon enrollment;
  • Progression into certain clinical settings, including but not limited to within six (6) months of a student’s required AHEC rotation; and
  • Upon reasonable suspicion.  For purposes of this policy, reasonable suspicion shall mean:
  • Observable phenomena, such as direct observation of drug use or possession and/or the physical symptoms of being under the influence of a drug or alcohol;
  • A pattern of abnormal conduct or erratic behavior;      
  • Information provided by reliable and credible sources regarding the student’s alleged violation of this policy;
  • Newly discovered evidence that the student tampered with a previous drug test;          
  • Unexplained controlled substances missing or diverted from the clinical or laboratory environment, if the medical student had reasonable access to the controlled substances or alcohol during the time of the event; or
  • Evidence of circumstances or information which may cause a reasonable person to conclude that an enrolled medical student has more likely than not engaged in conduct that violates this policy. 

Enrolled medical students shall sign a consent form allowing the results of the UDS and any additional screening to be released to the School’s Associate Dean for Student Affairs and Student Promotions Committee.  The results disclosed to the School shall be limited to “pass” or “fail”, where “pass” indicates no reasonable concern for an active problem and “fail” indicates the reasonable conclusion that an active problem is present.  Any enrolled medical student who does not participate in the drug screen process, or who refuses to submit the required consent, will not be permitted to participate in clinical activity. 

All enrolled medical students shall be relieved from patient care and clinical service pending the results of the UDS or other screening.  The results of the UDS or other screening will be reviewed by the Medical Review Officer (MRO) of Campus Health Services’ contracted vendor for determination of passage/failure.

A UDS, or other screening, is positive and the enrolled medical student has therefore failed the UDS or other screening:

  • If the sample contains drugs and/or metabolites for which the Campus Health Services’ contracted vendor concludes there is no legitimate explanation other than the use of a prohibited drug or alcohol;
  • In situations where the Campus Health Services’ contracted vendor determines that urine samples are dilute or fail to meet threshold  as measured by the vendor’s standards for adequate temperature, creatinine and specific gravity; of
  • If an enrolled medical student refuses to submit to testing, fails to report to the designated area for testing, fails to provide a sample suitable for testing and/or attempts to alter or tamper with the specimen.

All information relating to a UDS, or other screening, shall be and remain confidential, to the extent permitted by law.  An enrolled medical student’s academic file shall include only the pass/fail result from the UDS or other screening.

The Associate Dean for Student Affairs shall dispense of all positive UDS or other screenings in accordance with Section IV of this policy. 

Any enrolled medical student who violates this policy shall be reported to the Associate Dean for Student Affairs.  The Associate Dean for Student Affairs shall direct the student to an independent third party provider selected by the School for evaluation and/or treatment.  The student shall fully participate in the recommended evaluation or treatment plan determined and administered by the third party provider, or its designee, as a condition of continued enrollment in the School.  

A student’s cooperation and compliance with the third party provider and evaluation or treatment plan shall be monitored by the Associate Dean for Student Affairs.  A student’s failure to cooperate or fully participate in the evaluation or treatment plan may be reported by the Associate Dean for Student Affairs to the Student Promotions Committee for disciplinary action. 

Any matter reported to the Student Promotions Committee shall be processed in accordance with the Committee’s guidelines for disciplinary matters.  Such guidelines may include the right of the School to dismiss an enrolled medical student who has violated this policy. 

Students are encouraged to self-identify to the Associate Dean of Student Affairs when they have problems with drug or alcohol abuse. Students who self-identify may be granted a leave of absence to secure treatment without prejudice to their academic standing. In such cases, confidentiality will be maintained, to the extent permitted by law, by the School of Medicine administration.