Moonlighting Policy

Summary

Description of University at Buffalo Graduate Medical Education’s (UB GME) moonlighting requirements, including eligibility, resident/fellow responsibilities, program director responsibilities, and applicable requirements.

Policy Statement

This policy: applies to residents/fellows in UB-sponsored, ACGME- and CODA-accredited training programs; is compliant with ACGME and New York State Department of Health (NYS DOH) requirements and regulations; is published on the UB GME website; and is available for review by residents/fellows at all times.

  • Moonlighting must not interfere with the ability of the resident/fellow to achieve the goals and objectives of the ACGME- or CODA-accredited educational program, and must not interfere with the resident’s fitness for work nor compromise patient safety.
  • Moonlighting is strictly prohibited during scheduled work hours.
  • The University at Buffalo and its residency/fellowship training programs are not responsible for supervision of residents/fellows while performing moonlighting activities
  • Program Directors may choose to prohibit moonlighting by all residents/fellows in the program.

Eligibility

  • Residents on J-1 and H-1 visas may not moonlight.
  • Residents on a TN visa are only permitted to moonlight in research or teaching activities (with patient care incidental to those activities).
  • University Dental Residents on a TN visa must apply for a concurrent TN visa for the moonlighting position.
  •  PGY-1 residents in UB-sponsored, ACGME-accredited programs are not permitted to moonlight.
  • PGY-1 residents in UB-sponsored, CODA-accredited programs are eligible to moonlight in accordance with the stipulations specified in this policy (including advance approval from the program director). 

Resident/Fellow Responsibilities

  • Obtain the advance written approval of the Program Director prior to engaging in any Moonlighting activities.
  •  Abide by all applicable work hour requirements and regulations (See Clinical and Educational Work Hours Policy)
  • Log work hours in the Residency Management System (RMS) as instructed by the Program Director
  • Obtain and Maintain professional liability insurance coverage while engaging in any moonlighting activities (moonlighting duties are not covered under the professional liability insurance arrangements for residency/fellowship program activities) 
  • Obtain and maintain a license as a physician or other health professional for unsupervised practice in the state where the moonlighting occurs while engaging in any moonlighting activities

Failure to adhere to this policy may result in the dismissal of the resident/fellow from the program, in accordance with UB GME’s Academic Action and Misconduct policies.

Program Director Responsibilites

  • Ensure that residents/fellows are not required to engage in moonlighting
  • Monitor the effect(s) of moonlighting on resident performance
    • Permission for a resident/fellow to moonlight may be withdrawn if adverse effects are noted
  • Provide, and maintain in the resident’s/fellow’s file, advance written approval for the resident/fellow to moonlight in accordance with this policy
  • Ensure that resident/fellow schedules, inclusive hours engaged in moonlighting, are compliant with all relevant work hours requirements and regulations (See Clinical and Educational Work Hours Policy)

The impact of moonlighting activities on individual and aggregate resident performance should be assessed by the program’s Clinical Competency Committee (CCC) and Program Evaluation Committee (PEC), respectively.

Applicable Requirements

ACGME Institutional Requirements effective 7/1/2022 (IV.K.1.- IV.K.1.d)):

  • Moonlighting: The Sponsoring Institution must maintain a policy on moonlighting that includes the following:
    • residents/fellows must not be required to engage in moonlighting; (Core)
    • residents/fellows must have written permission from their program director to moonlight; (Core)
    • an ACGME-accredited program will monitor the effect of moonlighting activities on a resident’s/fellow’s performance in the program, including that adverse effects may lead to withdrawal of permission to moonlight; and, (Core)
    • the Sponsoring Institution or individual ACGME-accredited programs may prohibit moonlighting by residents/fellows. (Core)

ACGME Common Program Requirements (Residency) effective 7/1/2022 (VI.F.5.- VI.F.5.c)):

  • Moonlighting
    • Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program, and must not interfere with the resident’s fitness for work nor compromise patient safety. (Core)
    • Time spent by residents in internal and external moonlighting (as defined in the ACGME Glossary of Terms) must be counted toward the 80-hour maximum weekly limit. (Core)
    • PGY-1 residents are not permitted to moonlight. (Core)

Established:  1996
GMEC Approved Date: May 17, 2022