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Accreditation Status Disclaimer Administration & Governance - Graduate Medical Education Programs Policies & Procedures Salaries & Benefits MUSC Policies Appendix 1 - Resident Agreements (Medical and Dental) Appendix 2 - Evaluation Forms Appendix 3 - Forms Appendix 4 - Off-Cycle Residents Appendix 5 - Scopes of Practice | MOONLIGHTING POLICY STATEMENT OF POLICY Residency training is a full time educational experience. Extramural paid activities (moonlighting) must not interfere with the resident's educational performance; nor must those activities interfere with the resident's opportunities for rest, relaxation, and independent study. As a result, residents are not required to engage in moonlighting activities as a condition for appointment to an MUSC residency program. PROCEDURES
1. Definition of Moonlighting:
Moonlighting is defined as any activity, outside the requirements of the residency program, in which an individual performs duties as a fully-licensed physician and receives direct financial remuneration. This includes, but is not limited to:
a. Providing direct patient care
b. Conducting "wellness" physical examinations
c. Reviewing medical charts, EKGs, or other information for a company or an agency
d. Clinical teaching in a medical school or other educational programs involving clinical skills
e. Providing medical opinions or testimony in court or to other agencies
f. Serving as a sports team physician or medical official for an event
What counts as "internal" moonlighting and needs to be reported as part of the ACGME 80-hour weekly duty-hours limit?
Any moonlighting by a resident who is employed by any of the following organizations is considered "internal" moonlighting:
a. MUSC hospitals and its clinics
b. Ralph H. Johnson VA Medical Center
c. Roper Hospital
d. St. Francis Hospital
e. Trident Medical Center
f. Trident Ambulatory Surgery Center
g. East Cooper Regional Medical Center
h. Southeastern Fertility Center
i. Spartanburg Regional Health System
j. Georgetown Memorial Hospital
k. Kindred Hospital
l. Any physician's office, clinic or medical facility which has an affiliation agreement with the resident's program
If a resident is employed by any other organization other than those listed above, it is considered "external" moonlighting" and is to be reported as such. 2. Moonlighting privileges may be curtailed or prohibited by the Residency Program Director on any of the following grounds:
(a) If it is determined that such activities interfere with the resident's patient care responsibilities and educational performance or if such activity adversely impacts the professional reputation of the resident and/or MUSC; or
(b) If such limitation is required by the appropriate organization(s) responsible for the accreditation/certification of graduate medical education programs; or
(c) If the resident fails to abide by the procedures outlined herein. - It is the responsibility of the resident to obtain and provide professional liability insurance (malpractice) coverage for all “external” moonlighting. The Medical University bears no legal or professional responsibility for a resident while s/he is moonlighting at an outside facility (i.e. non-MUSC). Note: Per the Risk Management Department, if a resident moonlights at an MUSC/MUHA facility, supplemental liability insurance is not required. The resident will be covered under his/her normal liability insurance policy with the SC Insurance Reserve Fund.
- Moonlighting on a limited license is prohibited by the South Carolina Board of Medical Examiners. It is the responsibility of the resident to obtain a permanent South Carolina medical license.
- It is the resident's responsibility to obtain a "fee-paid" DEA registration if moonlighting at a non-MUSC site. The "fee-exempt" DEA registration issued to residents at MUSC is only to be used within their residency programs or at MUSC sites.
- If a resident moonlights, the following conditions must be met:
a) It must be clear that such activity does not violate the rules and regulations of any federal (e.g. CMS) or state agency, or patient care regulations (e.g. HIPAA) or accrediting (e.g. Joint Commission for the Accreditation of Healthcare Organizations) organizations and/or the facility's credentialing policies and procedures;
b) The resident must possess the written approval of his/her Residency Director. This written statement of permission must be kept in the resident's file in the department. The Resident's performance in the program will be monitored for any adverse effects from moonlighting. In such instances, the Program Director may withdraw his/her permission to moonlight.
c) Moonlighting that occurs within the residency program, the sponsoring institution, the non-hospital sponsor’s primary clinical site(s) and/or any sites affiliated with the residency program (i.e. internal moonlighting) must be counted toward the 80-hour weekly limit for duty hours.
d) The Resident is responsible for reporting all moonlighting hours (i.e. internal and external moonlighting) using the E*Value system. Failure to report moonlighting hours will result in suspension and/or dismissal from the residency program.
e) All moonlighting activities must be monitored by the residency program director and the documentation of this activity (i.e. hours per week) must be kept in the resident's file. NOTE: THE RESIDENT MUST HAVE APPROVAL, IN WRITING, FROM HIS/HER PROGRAM DIRECTOR and the DIO TO ENGAGE IN ANY MOONLIGHTING ACTIVITIES. (See Appendix 3 for form.)
- Residents working under J-1 sponsorship or an H-1B are prohibited from engaging in outside remunerative work of any kind or nature whatsoever in accordance with ECFMG and INS regulations. Both J-l sponsorships and H-1B petitions are employer-specific, Residents in violation are immediately considered in violation of status and are subject to disciplinary action up to and including termination from their program and deportation.
- Any resident who fails to follow the moonlighting policy of MUSC and his/her program will be sanctioned for such actions including suspension and/or dismissal from the residency program.
- A resident who is on formal academic remediation is prohibited from engaging in any moonlighting activities during the period of remediation.
- Moonlighting forms are only valid for the current academic year. They must be renewed prior to July 1st of each academic year.
Any questions regarding professional liability coverage must be directed to University Risk Management (843) 792-3883.
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