Muslim medical students are refusing to obey hygiene rules brought in to stop the spread of deadly superbugs, because they say it is against their religion.
Women training in several hospitals in England have raised objections to removing their arm coverings in theatre and to rolling up their sleeves when washing their hands, because it is regarded as immodest in Islam.
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Universities and NHS trusts fear many more will refuse to co-operate with new Department of Health guidance, introduced this month, which stipulates that all doctors must be "bare below the elbow".
The measure is deemed necessary to stop the spread of infections such as MRSA and Clostridium difficile, which have killed hundreds.
Minutes of a clinical academics' meeting at Liverpool University revealed that female Muslim students at Alder Hey children's hospital had objected to rolling up their sleeves to wear gowns.
Similar concerns have been raised at Leicester University. Minutes from a medical school committee said that "a number of Muslim females had difficulty in complying with the procedures to roll up sleeves to the elbow for appropriate handwashing".
Sheffield University also reported a case of a Muslim medic who refused to "scrub" as this left her forearms exposed.
Documents from Birmingham University reveal that some students would prefer to quit the course rather than expose their arms, and warn that it could leave trusts open to legal action.
Hygiene experts said last night that no exceptions should be made on religious grounds.
Dr Mark Enright, professor of microbiology at Imperial College London, said: "To wash your hands properly, and reduce the risks of MRSA and C.difficile, you have to be able to wash the whole area around the wrist.
"I don't think it would be right to make an exemption for people on any grounds. The policy of bare below the elbows has to be applied universally."
Dr Charles Tannock, a Conservative MEP and former hospital consultant, said: "These students are being trained using taxpayers' money and they have a duty of care to their patients not to put their health at risk.
"Perhaps these women should not be choosing medicine as a career if they feel unable to abide by the guidelines that everyone else has to follow."
But the Islamic Medical Association insisted that covering all the body in public, except the face and hands, was a basic tenet of Islam.
"No practising Muslim woman - doctor, medical student, nurse or patient - should be forced to bare her arms below the elbow," it said.
Dr Majid Katme, the association spokesman, said: "Exposed arms can pick up germs and there is a lot of evidence to suggest skin is safer to the patient if covered. One idea might be to produce long, sterile, disposable gloves which go up to the elbows."
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