General Surgery Residency Policy on Moonlighting

Updated 7/25/12

The Swedish Medical Center General Surgery Residency discourages moonlighting activities for pay for its residents outside the educational program, believing that the time and effort required for training are incompatible with additional part-time work. In addition, professional liability protection is not provided for activities outside the approved educational program.

Residents with a limited license in Washington State are restricted to practice medicine in conjunction with the duties as a resident physician under the supervision and control of a physician licensed in Washington. Residents in training at Swedish Medical Center in the General Surgery Residency Program are not allowed to moonlight until their 5th year of residency; with approval of the Program Director.

Residents engaged in moonlighting MUST have a full medical license for independent medical practice in the state where moonlighting occurs. The Program Director must authorize and have full knowledge of any moonlighting activities and keep written acknowledgment of that activity in the resident’s permanent file. The resident’s performance will be monitored for the effect of these activities. If the Program Director determines there is an adverse effect on the resident, permission for moonlighting may be withdrawn.

All hours worked in any internal moonlighting setting MUST be tracked and reported in MyEvaluations and monitored by the director of the residency program on a monthly basis. Any moonlighting MUST be counted as part of the compliance with the ACGME duty-hour regulations and cannot cause the resident to exceed the regulations at any time, no exceptions.

Professional liability and conversion from limited to full licensure is at the expense of the resident. They may not use their CME allocations for any part of moonlighting.


RESIDENT MOONLIGHTING ATTESTATION FORM

This form must accompany all requests for approval of resident moonlighting. No resident may be scheduled to work a moonlighting session prior to obtaining written approval.

Resident Name:
PGY Level:
Training Program:
Facility where moonlighting will take place:
Department where moonlighting will take place:
Detailed Description of Moonlighting Activities, including number of hours:
Moonlighting Resident
I understand my responsibility to ensure that I am in compliance with ACGME regulations regarding resident supervision and work hour limitations. I engage in this activity with that awareness and I can attest that I am not violating those regulations with this work. I also understand and acknowledge that these outside activities will not violate the terms of my employment agreement. If the facility, activities and/or hours of the moonlighting change, I will immediately notify my Program Director and complete a new form.
Resident Signature:
______/ Date:
______
Program Director Approval
I understand my responsibility to ensure all house staff are in compliance with ACGME requirements regarding resident supervision and work-hour limitations. I approve this activity and attest that this request does not result in failure to comply with regulations; the Department will continue to monitor compliance.
Program Director Signature:
______ / Date:
______
Once signed by the Moonlighting Resident and Program Director, a copy of this completed form should be sent to:
Sandy Norris
DIO, Administrative Director, Medical Education and Medical Staff Services


Resident Disclosure and Request for Approval of Moonlighting Activities

Section II: Resident Certification

By signing this Request for Approval, I certify that the foregoing description of my requested moonlighting activities is accurate and true. I understand that any approval of the requested moonlighting activities is conditioned on my ongoing compliance with the following assurances, and will terminate upon failure to comply with any of the following:

·  Moonlighting outside my training program will not interfere in any way with my educational experience, performance or regular training program responsibilities as a resident.

·  I will not engage in moonlighting activities during my scheduled training program hours, including times when I am scheduled to be on-call or available for consultations as part of my approved training program.

·  I must remain in good standing in my approved training program, as documented by satisfactory evaluations, in order to continue moonlighting activities.

·  I must promptly update this Request Form to reflect any changes in my moonlighting activities.

·  I may not engage in moonlighting activities in which there may be a conflict of interest with my appointment in the Swedish General Surgery Residency.

·  My moonlighting activities outside the approved training program must comply with applicable Federal and State law and regulations.

·  I agree to be bound by the following work hour limits: My total aggregate work hours, including both my activities as part of an approved training program and my moonlighting activities shall not exceed 80 ours per week when averaged over four weeks. Further, I will not be on duty more than 24 consecutive hours, and I will have at least 10 hours off after moonlighting and before the start of my training program activities.

·  I will not be visually identifiable as a trainee, and will not hold myself out as a trainee, in a Swedish residency program when I am engaged in moonlighting.

·  I understand that failure to comply with any of the foregoing conditions may result in withdrawal of permission to engage in moonlighting or other disciplinary actions.

·  I understand that the professional liability insurance provided by Swedish Medical Center does not extend to moonlighting activities.

I certify that I will comply withal of the foregoing conditions while engaging in moonlighting activities:

Resident Signature Date

has my approval to moonlight; I have reviewed with her the expectation of compliance with the duty-hour regulations and with her commitment to her educational obligation to the Swedish General Surgery Residency Program.

Program Director Signature Date

Moonlighting Summary Sheet

Date / Hours (ie 7pm-7am)

This is reflected in my duty hour tracking and did not conflict with our moonlighting or duty hour policies.

Print name here, sign above / Date / Program Director Signature / Date

S:\SurgResFHC\WorkGroups\MedEdSurg\Program Files as of 2009\Policies\Policies 2012\Moonlighting 2011.doc Updated 7/12/12