Resident and Fellow Policy Manual

Appendix 1 - Request for Approval of Independent Practice Outside of Training Program:

This form requests approval for a trainee to provide patient care services in his/her board eligible/certified field outside of the duties and curriculum of their training program.  The trainee must have a secondary appointment as an Instructor or above and must request and be granted privileges in the Medical Staff organization to practice independently in the board eligible/certified field of training.  This clinical activity is covered by a separate contract and payment for services is by extra compensation.  Professional liability insurance coverage can be obtained through the URMC's insurance program upon meeting the insurance eligibility criteria.  The cost for this coverage will be paid by the Department or the Independent Practitioner.  This trainee may bill for independent services through departmental billing operations.

Generally for trainees in “approved” programs, services must take place in a Strong Health outpatient or ED setting.  Inpatient services at Highland Hospital may be allowed under specific circumstances.  Given the complexity of the regulations, please contact the Compliance Office to discuss inpatient guidelines.  The trainee must possess an unrestricted medical license and meet all other requirements of attending staff.  Services provided must be clearly identifiable as duties performed outside of the training program.  Beginning secondary appointments are initiated on the 500 form, subsequent reappointments are handled on the 510 form, with 211 forms used for extra compensation for these duties. 

For trainees in “approved” programs, to be in compliance with New York State Health Code Section 405 and ACGME regulations, the hours devoted to this extra work must be added to all work hours related to the primary training program.  These combined work hours must meet duty hour standards discussed in the GME manual – Institutional Oversight Monitoring of Resident/Fellow Duty Hours section.

The trainee may not independently bill for any activities that are part of their educational program.

Complete the form and follow the instructions on this form.