N95 Mask Fit Testing and Exemption Management (UGME Clerks)

To establish a consistent, safe, and compliant process for managing N95 mask fit testing and exemptions for medical learners, aligned with:

• Saskatchewan Health Authority (SHA) Clinical Placement Agreement (CPA)
• Infection Prevention and Control (IPAC) standards for respiratory protection

Applies to all undergraduate medical students participating in clinical placements under the SHA Clinical Placement Agreement (CPA).

The Clinical Placement Agreement between the Saskatchewan Health Authority and health sciences educational programs requires that each student undergo N95 fit testing to allow for the use of an appropriately fitted N95 respirator when required to prevent exposure to airborne pathogens, including influenza, COVID-19, measles, tuberculosis, and others.

Appropriate fit for an N95 respirator requires an individual to be clean-shaven where the respirator seals to the face. SHA Occupational Health and Safety does not permit the use of powered air-purifying respirators (PAPRs).

An N95 respirator is used in clinical situations where there is a risk of airborne infection. Fit testing determines whether a specific respirator model and size provides an adequate seal and therefore effective protection. A poorly fitted respirator does not provide reliable protection.

N95 respirators may be required for aerosol-generating medical procedures (AGMPs), as identified through the SHA Point-of-Care Risk Assessment process, and in other clinical situations where there is a risk of transmission of airborne respiratory pathogens.

Prior to clerkship, all students must meet one of the following requirements:

• Successful completion of N95 fit testing;
• Approved accommodation (exemption); or
• Documentation of an unsuccessful N95 fit-testing outcome.

UGME will arrange N95 fit testing through an approved vendor and provide students with details regarding the schedule and location before the Year 3 Success in Medical School III orientation.

Students who are unable to complete fit testing for medical, religious, or other human rights-based reasons may request an accommodation through USask Access and Equity Services (AES).

Information on the accommodation process is available through the AES website, and the Office of Student Affairs (OSA) can assist students with registration. Students with an existing pre-clerkship accommodation do not need to reapply.

Students planning to continue an approved exemption into clerkship must notify UGME Clerkship Administration before the start of clerkship so that their fit-testing appointment can be cancelled.

AES accommodation documentation will be maintained within the OSA Records and shared only on a need-to-know basis for placement verification purposes.

If available approved fit-testing options have been explored, a student is unable to obtain an acceptable N95 fit, the student will be considered unable to wear an appropriately fitted N95 respirator.

Students must submit documentation of the unsuccessful fit-testing outcome to UGME Clerkship Administration. Documentation will be maintained within the student's confidential UGME file and shared only on a need-to-know basis for placement verification purposes.

An unsuccessful fit test does not, on its own, constitute a medical, religious, or human-rights accommodation and does not require registration with AES. Students seeking accommodation related to a protected ground must follow the AES accommodation process.

Students who do not have access to an appropriately fitted N95 respirator, due to an unsuccessful fit-testing outcome or are exempted from using N95, must comply with applicable SHA Infection Prevention and Control (IPAC) and Occupational Health and Safety (OHS) requirements.

Where SHA IPAC or OHS requirements identify a clinical activity, patient encounter, procedure, or environment as requiring N95 respiratory protection, these students must not participate in those activities.

This may result in:

• Restricted participation in AGMPs and other high-risk clinical environments;
• Limitations on certain placements or elective opportunities; and

UGME will make every effort to arrange Alternative learning experiences, where necessary, to support achievement of required clerkship learning objectives.

A successful N95 fit test is not permanent. Changes in facial structure, body weight, dental work, facial surgery, aging, or other factors may affect respirator fit over time.

Students are encouraged to seek repeat fit testing if significant changes occur and must comply with any fit-testing requirements established by UGME, SHA, residency training programs, elective host institutions, or future employers.

Students who wish to pursue fit testing with respirator models not available through the UGME-arranged process may arrange additional fit testing independently and at their own expense.

Many visiting electives and external clinical placements require proof of a current and successful N95 fit test.

Students are responsible for reviewing requirements through the AFMC Visiting Elective Portal and any host institution policies before applying. While some institutions may consider accommodation documentation in lieu of a fit test, acceptance of such accommodations is determined by the host institution and cannot be guaranteed by UGME.

Students should be aware that an inability to wear an appropriately fitted N95 respirator may limit eligibility for certain electives or clinical experiences.

This procedure will be reviewed every three years or updated as needed in response to changes in SHA policies, IPAC standards, Occupational Health and Safety requirements, or the Clinical Placement Agreement.