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Resident and Fellow Policy Manual

Appendix 1 - Policy on Moonlighting:

This document can also be found at http://extranet.urmc.rochester.edu/urmc-mso/credentialing/MoonlightingApplication.pdf.

Moonlighting is defined as clinical activities outside of a residency or fellowship training program, for which the trainee is paid on an hourly or other rate, in addition to the approved salary for a trainee at his/her training level. 

Professional activities outside the training programs are prohibited to the extent that they may interfere with training program responsibilities.  Each department must have its own policy on outside activities, which may be more restrictive than that of the institution.  No resident may be required to moonlight.

Prior to seeking such employment, Residents and fellows who wish to engage in outside  activities (moonlighting):

  1. are required to have written approval from the Chairman or Program Director using the Moonlighting (extra shift) Request Form and the Credentials & Privilege Review forms (pages 1-7)
  2. must be in good standing in the residency program
  3. should seek written assurance of malpractice and workers’ compensation coverage from any outside employer
  4. must have a valid New York State medical license
  5. may use the institutional DEA number assigned to the affiliated hospital at which the resident is moonlighting as well as your own suffix; alternatively, obtain your own Federal DEA number
  6. must hold a MD, DO, DDS or DMD degree
  7. MDs and DOs clinical training shall include completion of at least one year in an approved residency training program, which may include a Transitional Year or a year in a designated subspecialty
  8. must have a primary appointment in an accredited residency or fellowship program sponsored by the University of Rochester
  9. must have his/her performance monitored to ensure that he/she remains in good standing in his/her training program as documented by satisfactory evaluations (semi-annually).  If the trainee receives an unsatisfactory evaluation at any time, the appointment will be immediately terminated and may not be renewed for the remainder of the training program

Approval to moonlight (assume extra shifts) is granted through the end of the current academic year and must be requested for each subsequent year.

If a Resident or Fellow engages in professional activities outside of the training program, the hours devoted to that activity must be added to the training program work hours and must be reported on the Office for Graduate Medical Education work hours survey, and to the Chair and Program Director on any departmental work hours surveys.  The trainee is responsible for reporting all moonlighting activity to the program director.  The program director is responsible for monitoring the trainee's moonlighting (extra shift) activity and maintaining records of the activity in the trainee's departmental file.  The total hours must comply with the number of hours a resident may work as detailed in the University's duty hour policy.  Usual trainee duty hours plus moonlighting (extra shift) hours added together must not cause trainees to violate duty hour limits.  (See Institutional Policy on Resident/Fellow Duty Hours.)

Residents/fellows must be supervised by a member of the attending staff at SMH and Highland Hospital for all Strong Health moonlighting (extra shift) activities.  That attending physician will be the physician of record for all patients cared for by the moonlighting trainee.  Supervision will be comparable to that required when residents/fellows engage in activities which are part of the training program.  The moonlighting (extra shift) activities may be under general supervision if the resident/fellow has been appropriately credentialed to perform the specific activities under general supervision; if not, the resident/fellow must be directly supervised by the attending physician.

Residents/fellows may moonlight (take on extra shifts) in their own or other Departments at SMH and HH.  The employing Department is responsible for maintaining records that the trainee has been appropriately credentialed (see Policy on Credentialing for All Clinical Activities) and privileged to perform the relevant moonlighting activities under general supervision.  The employing Department is also responsible for (extra shift) monitoring the status of the appointment through the Credentials & Privilege Review Office,