is volunteering moonlighting?

[futuredo32]

Does volunteering at a clinic for the indigent constitute moonlighting? Do I need my program's permission to volunteer? The clinic for the indigent covers malpractice insurance. I would be supervised by an attending.
The situation is that I'm currently a psych resident and want to do a second residency in primary care so I want to continue to get exposure to primary care to increase my chances of matching into a primary care residency after psych. I actually volunteered at this clinic before between the year between med school and starting my TRI.
I asked my psych residency (we are between pds at the moment) if I could volunteer and they said I have to wait until the new PD comes and see what he says.
But now that I've asked, I feel that I shouldn't have needed to ask because it's not really moonlighting.

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[NotAProgDirector]

Moonlighting is whatever your program says it is. You are much better off asking. It would seem ridiculous to say no. But, if your PD does refuse it, then if they found out about it on their own, you know you'd be in trouble,

 

[futuredo32]

Thanks

 

[VenusinFurs]

It does seem kind of silly to not be able to volunteer wherever you want, but I can understand the program's concern if someone gets hurt or something because a doctor in their training program was practicing somewhere without their knowledge. Hopefully they shouldn't care because the insurance is covered and you'd be supervised.

 

[NotAProgDirector]

This assumes that 1) you're actually insured, and 2) you're actually adequately supervised. There's no guarantee of either. The site says you're insured, but what if they've skimped on medmal insurance? News stories suggest that the fertilizer plant in TX was seriously underinsured -- I expect none of the townspeople were aware of that before the accident. And who knows if you'll really be supervised well.

Personally, I think it's none of your PD's business. What you do on your own time is your business, and no one else's. You remain responsible for your actions. If your moonlighting interferes with your training, that's on you. If a local news camera crew shows up at your moonlighting site to do some sort of "expose" and you end up on TV looking bad, then your program would be free to fire you to save their reputation. But if you have a great experience, then that's yours also.

 

[cpants]

I don't think they really can forbid you from doing this, though it might not be a wise battle to fight. This definitely should count as duty hours, so you could run into trouble there.

 

[thesauce]

Does volunteering at a clinic for the indigent constitute moonlighting? Do I need my program's permission to volunteer? The clinic for the indigent covers malpractice insurance. I would be supervised by an attending.
The situation is that I'm currently a psych resident and want to do a second residency in primary care so I want to continue to get exposure to primary care to increase my chances of matching into a primary care residency after psych. I actually volunteered at this clinic before between the year between med school and starting my TRI.
I asked my psych residency (we are between pds at the moment) if I could volunteer and they said I have to wait until the new PD comes and see what he says.
But now that I've asked, I feel that I shouldn't have needed to ask because it's not really moonlighting.

Your own program told you that you need to ask and you're coming here to ask if you need to ask?

 

[Law2Doc]

I don't think they really can forbid you from doing this, though it might not be a wise battle to fight. This definitely should count as duty hours, so you could run into trouble there.

It depends on what your residency contract deems moonlighting, but yes they can often forbid it.

As you mentioned some volunteer activities can impact duty hours, which means for example that in a lean program where you might need to be called in on a moments notice to replace someone, they can't have you up against the duty hour ceiling. They own up to 80 duty hours (monthly average) of your time and have the right to nix any activity that impacts duty hours even if they don't expect you to be above hours when they draw up the schedule. Dibs on your time is some of what they've purchased when they sign a contract with you.

 

[cpants]

It depends on what your residency contract deems moonlighting, but yes they can often forbid it.

As you mentioned some volunteer activities can impact duty hours, which means for example that in a lean program where you might need to be called in on a moments notice to replace someone, they can't have you up against the duty hour ceiling. They own up to 80 duty hours (monthly average) of your time and have the right to nix any activity that impacts duty hours even if they don't expect you to be above hours when they draw up the schedule. Dibs on your time is some of what they've purchased when they sign a contract with you.

Exactly, and practicing medicine under the supervision of an attending with malpractice insurance cannot be spun as not duty hours whether you are paid or not. If you were volunteering to work at the first aid tent at a fun run or something it would be different.

 

[Law2Doc]

...If you were volunteering to work at the first aid tent at a fun run or something it would be different.

except it might not be considered different under your residency contract. They may have a monopoly on all healthcare related hours, paid or not.

 

[LucidSplash]

except it might not be considered different under your residency contract. They may have a monopoly on all healthcare related hours, paid or not.

I think mine says something like this. All healthcare/clinically-related activities count towards my 80-hours, on paper.

As others have pointed out, if your own residency program said you'd have to clear in through the new PD, then nothing anyone says here matters much. Even if your residency contract considers it work-hours related, it is always possible that your PD will be ok with it. Also possible that from a risk-management standpoint they might not want you to. One of our ED residents here was a paramedic prior to med school but finally let his license lapse because no one would hire him because the legal waters were too murky for scope of practice for an MD working as a paramedic. Everyone felt it was basically asking to get sued.

 

[45408]

One of our ED residents here was a paramedic prior to med school but finally let his license lapse because no one would hire him because the legal waters were too murky for scope of practice for an MD working as a paramedic. Everyone felt it was basically asking to get sued.

I was tempted to do this. I renewed my EMT license at the end of M1 year and worked as an EMT that summer and intermittently as an M2. It wasn't something I was going to tell my patients, but it was fun to do. I let my license go instead of doing another renewal class, but it would be funny to introduce myself as "I'm Dr. Prowler, and I'll be your EMT-Basic today."