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MUSC GME Resident Handbook

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Graduate Medical Education  2017-2018

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Resident Handbook Introduction

Letter of Commitment/
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 - Scopes of Practice

Appendix 5 - Program Resources




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.


  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

    Any moonlighting by a resident needs to be reported as part of the ACGME 80-hour weekly duty-hours limit.

  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.

  3. PGY-1 Residents are not allowed to moonlight.

  4. 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.

  5. It is the responsibility of the resident to obtain and provide professional liability insurance (malpractice) coverage for all moonlighting outside of MUSC and its affiliates. 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 a liability insurance policy with the SC Insurance Reserve Fund.  Any questions regarding professional liability coverage must be directed to University Risk Management (843) 792-3883.

  6. 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.
  7. 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 and the DIO for GME, via the Office of Graduate Medical Education Moonlighting Approval Form.  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 must be counted toward the 80-hour weekly limit for duty hours.

    d)  The Resident is responsible for reporting all moonlighting hours 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.)

  8. Residents working under J-1 sponsorship or an H-1B are prohibited from engaging in moonlighting of any kind or nature whatsoever.  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.

  9. A resident who is on formal academic remediation is prohibited from engaging in any moonlighting activities during the period of remediation.

  10. Moonlighting forms are only valid for the current academic year.  They must be renewed prior to July 1st of each academic year.

  11. Residents who are approved to moonlight outside of SC must abide by all licensing requirements established by the particular state licensing board and the facility.

  12. Non-ACGME Residents are not required to go through the GME Office for moonlighting approval.  Any action to moonlight is to take place between the Non-ACGME Resident, the department and any other applicable areas.
  13. SPECIAL NOTE:  Program Directors may set up Non-Required Elective Rotations with compensation as part of their training programs (within MUSC and MUSC-owned facilities).

    a) The rotation is to be set up in E*Value as any other with the exception that it may not be submitted to Reimbursement Services. 

    b) Goals and objectives must be developed for the rotation and attached to the approval form. 

    c) Evaluations of the non-required elective rotation must be completed in E*Value every six months (at a minimum). 

    d) The time spent in non-required elective rotations count toward the 80-hour work week.  All the rules pertaining to duty hours must be followed. 

    e) PGY levels 1 and 2 are not eligible for non-required electives with compensation.  Only PGY levels 3 through 8 may participate.

    f) Residents may not participate if they are currently on remediation. 

    g) Residents may not participate if they are currently on this service during regular rotation.

    h) A Non-Required Elective Rotation with Compensation form must be completed for each of these non-required electives.

    i)  Residents may not participate in the non-required elective rotation with compensation until all signatures have been obtained.

    j) Malpractice Insurance is covered through MUSC as part of the training program.

    k) The initiating service is responsible for underwriting the compensation for this non-required elective rotation.

  14. Residents who moonlight without permission from the DIO and his/her Program Director will be sanctioned for such actions.
    The penalties will be decided on a case-by-case basis by the DIO in consultation with the Program Director.