Policy Statement
Moonlighting is a privilege that may be permitted in certain circumstances.
The following limitations apply to any consideration of moonlighting:
- PGY-1 residents are not permitted to moonlight.
- Residents or fellows on J-1 visas are not permitted to be employed outside their training program and are not permitted to moonlight.
- Residents and fellows must not be required to engage in moonlighting activities.
- The Program Director determines the moonlighting policy for all trainees within their program.
- Programs are not required to permit moonlighting for their residents or fellows, and programs may choose to disallow these activities as a matter of program policy.
- Program directors will acknowledge in writing (via approval of the moonlighting form) their awareness that a trainee is moonlighting and will include this information in their training file.
- Program Directors may withdraw permission to moonlight for any given trainee or group of trainees at their discretion.
- Moonlighting activities are not considered to be part of the educational curriculum in University of Minnesota residency and fellowship programs.
- Moonlighting must not interfere with the residents or fellows ability to achieve the goals and objectives of the training program, and must not interfere with their fitness for work nor compromise patient safety.
- University of Minnesota professional liability insurance coverage for trainees only covers activities that are a part of their program’s educational curriculum.
- It does not cover moonlighting or any other activities outside the curricular components of the training program.
- Trainees must obtain separate liability coverage for moonlighting activities.
- Time spent moonlighting (internal or external as defined by the ACGME Glossary of Terms) must be counted toward the 80-hour maximum weekly limit, reported as a part of duty hours monitoring and must be included in assessments of compliance with ACGME duty-hour requirements.
When programs permit moonlighting, the following steps must be followed:
- Trainees must seek and receive written permission from their Program Director BEFORE engaging in moonlighting activities. Written permission is obtained by completing the University of Minnesota Graduate Medical Education Standard Moonlighting Request Form and having all parties (resident or fellow and the program director) sign and date the form. By signing the form all parties agree to the terms of the form.
- If the program director does not approve the moonlighting request, the trainee cannot moonlight.
- Trainees on H-1B visas must obtain separate H-1B visas for each facility where the trainee works outside the training program.
- The program must retain a copy of the fully executed University of Minnesota Graduate Medical Education Standard Moonlighting Request Form in the trainee's personnel record in RMS.
Reason for Policy
The purpose of this policy is to provide residents/fellows (trainees) and their programs with information on managing moonlighting in compliance with ACGME requirements, CMS regulations, immigration law and the Minnesota Board of Medical Practice. If statements in this policy contradict those of ACGME, CMS, immigration law or the Minnesota Board of Medical Practice, those policies take precedence.
Forms/Instructions
University of Minnesota Graduate Medical Education Standard Moonlighting Request Form
Definitions
Moonlighting: Any activity that is not an explicit expectation of the curriculum of the training program and for which a trainee receives compensation.
Participating Site: an organization providing educational experiences or educational assignments/rotations for residents/fellows. Examples of sites include: a university, a medical school, a teaching hospital which includes its ambulatory clinics and related facilities, a private medical practice or group practice, a nursing home, a school of public health, a health department, a federally qualified health center, a public health agency, an organized health care delivery system, a health maintenance organization (HMO), a medical examiner’s office, a consortium or an educational foundation.
Trainees: This policy applies to medical residents and medical fellows in ACGME accredited programs. It may also serve as a guide to non-accredited programs.
Related Information
Professional Liability:
University of Minnesota professional liability insurance coverage for trainees only covers activities that are a part of their program’s educational curriculum.
- It does not cover moonlighting or any other activities outside the curricular components of the training program.
- Trainees must obtain separate liability coverage for moonlighting activities.
Other:
Trainees engaged in moonlighting activities must be properly licensed and credentialed as determined by the organization hiring them to provide the service. It is the hospital's or clinic's responsibility to determine whether billing is appropriate.
- When moonlighting occurs in an inpatient facility that is an educational site for University of Minnesota residency and fellowship training, neither the hospital, a clinical group, nor a physician should bill for services provided by the trainee.
- When moonlighting occurs in an emergency department or outpatient clinic at a facility that is an educational site for residency and fellowship training, the hospital may be able to bill for services provided by the trainee, if the trainee:
- is licensed and credentialed to practice in that hospital; and
- has a separate contract which identifies how the moonlighting duties are separate from regular resident duties and not part of the educational program.
- When moonlighting occurs at a facility that is not an educational site for University of Minnesota residency and fellowship training, the facility may be able to bill for services provided by the trainee.