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Office of Graduate Medical Education
School of Medicine  :  Office of Graduate Medical Education

Moonlighting

Residents wishing to moonlight must first request permission from their Residency Program. Once the Program has approved the moonlighting activity, the Office of Graduate Medical Education must grant final approval. Please use the following form to request authorization for moonlighting.

Each program will develop its own policies to govern moonlighting practice activities by its residents. These program policies will conform to any RRC guidelines and to the following general principles:

  • Eligibility. Each program will determine the point at which its residents may begin to moonlight. A program may prohibit such activities by all of its residents as a matter of policy. Individual residents may be prohibited from moonlighting at the discretion of their Program Director or Chair, but the reasons for such individual prohibition must be presented to the affected resident in writing. In any case, the resident must be in good standing with the Medical Center and their program and must have been promoted to at least the PGY-2 level before being allowed to moonlight. The resident is responsible for reporting as income the reimbursement for his/her moonlighting and for payment of all resulting state and federal taxes.
  • Licensure and Registration. The resident must have a full-unrestricted license to practice medicine in the jurisdiction where the moonlighting activities are to occur. The resident must also have a valid individual DEA registration and any local or state registrations required within that jurisdiction.
  • Professional Liability Insurance. Because the Medical Center and program teaching faculty have no direct role in the supervision of the professional activities of residents engaged in moonlighting, the state self-insurance program does not cover moonlighting. Therefore, the resident must obtain his/her own individual professional liability policy. The policy must provide claims made coverage with basic coverage of $200,000/$600,000 and excess coverage of $800,000/$2,400,000 and provide tail insurance. Such insurance may be purchased by the resident or may be arranged by another individual or agency (i.e. the entity engaging the resident’s services). Regardless of the means of obtaining insurance, a certificate of insurance documenting the existence of an in-force policy must be provided to the resident and a copy filed with the program. Residents moonlighting at Veteran’s Administration facilities do not need to purchase additional insurance to cover their VA moonlighting acts if they have signed "fee basis agreements" that result in their appointment to the VA Medical Staff. As such, these residents are covered by the Federal Tort Claims Act and do not require individual professional liability coverage.
  • Supervision. Because the Medical Center and program teaching faculty have no direct role in the supervision of the professional activities of residents engaged in moonlighting, as a general principle, any facility at which emergency patients are seen should provide on site supervision and back-up. Facilities providing nonemergent care should provide supervision and back-up on an on-call basis within a reasonable time, generally no more than 15 minutes. If immediate supervision is not available, the moonlighting experience must be restricted to senior residents.
  • Approval. Moonlighting privileges must be specifically requested from and approved in advance by the Program Director and Department Chair in writing. Requests must be submitted and approved before the commencement of the services. After the departmental approval is obtained, the request is forwarded to the Dean’s office for final approval.
  • Hours. Because moonlighting assignments generally run concurrently with the routine obligations and responsibilities of the resident to the program, the Medical Center limits the number of hours that can be spent moonlighting to no more than 72 hours in any two consecutive months. Occasional instances may arise that require the resident involved in moonlighting to be in a community away from the medical center, in which case the resident must use vacation and can participate in no more than two weeks of moonlighting in a 12 month period.
  • Priority. Moonlighting must never interfere with a resident’s primary responsibilities to his/her program. Moonlighting residents are expected to be present, appropriately rested and prepared to carry out their obligations to their educational programs. The Program Director or Department Chair will summarily suspend the privilege to moonlight should a resident’s performance in a program deteriorate.