Moonlighting without Program Director's Approval

[trjb]

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If I were to moonlight without letting my program know, how would they ever find out?

 

[elwademd]

depends on where you moonlight.
if you moonlight in the same hospital or group of hospitals, someone might see you.
if you were to be sued, potentially your program would find out.

with that said, i don't ask my program's permission nor my program director's permission to moonlight- sort of a "don't ask, don't tell" policy so to speak.

 

[Blade28]

Are you attempting to moonlight during your clinical years, or research years?

 

[docB]

If I were to moonlight without letting my program know, how would they ever find out?

Medicine is a pretty small community. Program directors tend to know everyone in their areas because they get called when their graduates go out jobhunting. It's likely they would find out just throgh casual conversation. If you get sued at your moonlighting job you will be obligated to tell your program (check your contract) because you're obligated to report the suit to your residency malpractice carrier as well as the state license board. That's true even though the suit would presumably not be against your residency's carrier. It would be against the carrier you're using at your other job.

You should not moonlight if your PD and program don't approve. The financial rewards are not worth the possible/likely badness associated with getting caught.

 

[Midwest Medic]

Bad idea. Had a friend of a friend almost get kicked out of his residency for moonlighting without consent. Like the above poster mentioned, the risks FAR outweigh any financial benefits.

 

[I am Hans]

I was lucky because I got along well with my PD, but somehow he found out...I'm not sure how, but obviously someone saw me, or heard about it (not from me) and spilled the beans. I figured I was safe because I was still under 80 hrs (on an easy rotation) but it was against the program's rules (and they were pretty serious about it, having been on probation for work hour violations).

Its not worth the risk because if the PD or some faculty DO have a problem with you, this is all it takes to legitimately get rid of you.

 

[Bobblehead]

Don't. Do. It. Get approval, if you can't, find some other way to make money.

 

[trjb]

Are you attempting to moonlight during your clinical years, or research years?

Both. From the responses though, seems like they will eventually find out. Do insurance companies send reports from patients who have seen me and been billed back to the program?

 

[Tired]

Medicine is a pretty small community. Program directors tend to know everyone in their areas because they get called when their graduates go out jobhunting. It's likely they would find out just throgh casual conversation. If you get sued at your moonlighting job you will be obligated to tell your program (check your contract) because you're obligated to report the suit to your residency malpractice carrier as well as the state license board. That's true even though the suit would presumably not be against your residency's carrier. It would be against the carrier you're using at your other job.

You should not moonlight if your PD and program don't approve. The financial rewards are not worth the possible/likely badness associated with getting caught.

Can you clarify what right the PD would have to punish you for actions during your off time? My situation is different (military), but I was under the impression that residency contracts in the civilian world couldn't ban you from working in your off time.

 

[NotAProgDirector]

Can you clarify what right the PD would have to punish you for actions during your off time? My situation is different (military), but I was under the impression that residency contracts in the civilian world couldn't ban you from working in your off time.

Tired beat me to the punch. Many residency contract seem to contain a clause forbidding moonlighting, but that seems uninforcible. What you do with your free time is your own business. However, perhaps someone more versed in contract law would disagree -- maybe if you sign a contract stating that you won't moonlight, then you can't? Seems crazy -- what if you want to work weekends at your Uncle Vinny's car repair shop?

Several caveats:

1. You need your own full license and DEA to moonlight. Doing so under a training license clearly would fall under my jursidiction.

2. If you fall asleep at work, do badly on a project, miss a morning report, arrive late, etc -- moonlighting is never an excuse. If you use it as an excuse, I can fail you for the project / rotation. It is your responsibility to be sure that your moonlighting activity does not impact your training in any negative way.

3. If your performance is not completely satisfactory, I would consider moonlighting a serious issue in regards to Professionalism, or Practice Based Learning. If you're not doing well in the program, you have no business moonlighting.

4. If you moonlight in your home institution, then I probably get some say in the matter -- this is because you will need to be credentialed, and I'll have some role in that.

 

[I am Hans]

a Prog Director is probably right...I knew that my program could not really enforce what I did when I was not on call or on vacation (yes, they even tried to prevent us from moonlighting while on holiday) and there was no stipulation in our contracts that we couldn't.

However, what they can legally do to you and what else they might try to do, are two completely different matters, IMHO. As I said earlier, my PD liked me, so just slapped my wrist and I told him I wouldn't do it again. However, I would imagine that if a resident were caught moonlighting and they were not a favorite around the wards, it could be used to shore up a "cases" against you, especially if it impacts on your work (as noted by aPD above in numbers 2 and 3).

Therefore, they might not legally be able to prevent you from working elsewhere during your time off, unless you agreed to it in your contract (my fellowship contract had to have my PD sign off that it was OK for me to moonlight), but I would not want to run the risk of losing favor if I was asked not to do it and I violated that.

 

[docB]

Tired beat me to the punch. Many residency contract seem to contain a clause forbidding moonlighting, but that seems uninforcible. What you do with your free time is your own business. However, perhaps someone more versed in contract law would disagree -- maybe if you sign a contract stating that you won't moonlight, then you can't? Seems crazy -- what if you want to work weekends at your Uncle Vinny's car repair shop?

Several caveats:

1. You need your own full license and DEA to moonlight. Doing so under a training license clearly would fall under my jursidiction.

2. If you fall asleep at work, do badly on a project, miss a morning report, arrive late, etc -- moonlighting is never an excuse. If you use it as an excuse, I can fail you for the project / rotation. It is your responsibility to be sure that your moonlighting activity does not impact your training in any negative way.

3. If your performance is not completely satisfactory, I would consider moonlighting a serious issue in regards to Professionalism, or Practice Based Learning. If you're not doing well in the program, you have no business moonlighting.

4. If you moonlight in your home institution, then I probably get some say in the matter -- this is because you will need to be credentialed, and I'll have some role in that.

In my residency (which was before the 80 hour stuff) we were contract bound to get approval prior to moonlighting. I suppose if I had not gotten approval and got caught and got fired I could have hired a lawyer and fought it. It was easier to get approval.

 

[trjb]

Therefore, they might not legally be able to prevent you from working elsewhere during your time off, unless you agreed to it in your contract (my fellowship contract had to have my PD sign off that it was OK for me to moonlight), but I would not want to run the risk of losing favor if I was asked not to do it and I violated that.

In my contract, it does say the PD has to sign off but I'm not certain that she will even though I am doing well clinically & am well liked. I'm sure to get the "moonlighting will affect your clinical work" speech.

 

[Blade28]

In my contract, it does say the PD has to sign off but I'm not certain that she will even though I am doing well clinically & am well liked. I'm sure to get the "moonlighting will affect your clinical work" speech.

This is the main reason most of us can't moonlight until our research years.

 

[manman2]

This is the main reason most of us can't moonlight until our research years.

?????

 

[Blade28]

?????

We don't have enough time, or energy, to moonlight while working. I'm currently in my first of two research years, so will have plenty of time now.

 

[Pilot Doc]

I figured I was safe because I was still under 80 hrs (on an easy rotation) but it was against the program's rules (and they were pretty serious about it, having been on probation for work hour violations).

External moonlighting (e.g. moonlighting at St. Elsewhere when you are in a residency at County General) doesn't count against your 80 hours. That's only an issue when the program hires its own residents to take extra shifts.

 

[Winged Scapula]

External moonlighting (e.g. moonlighting at St. Elsewhere when you are in a residency at County General) doesn't count against your 80 hours. That's only an issue when the program hires its own residents to take extra shifts.

We had the same rules that we couldn't work at any other hospital, even if we were under hours, and the explanation was that since we were on probation for hours violations, they didn't want to risk looking bad to the RRC. Being the sheep/Kool-Aid drinker that I am, I didn't question it at the time.

They also "barred" us from working during vacation. I doubt that they could enforce that since we never signed a contract saying we wouldn't moonlight but since the program had a history of firing non-compliant residents, most of us were too sheepish to go against the PD's requirements.

 

[Pilot Doc]

the program had a history of firing non-compliant residents, most of us were too sheepish to go against the PD's requirements.

Agreed. In practice, unless your program is doing something that the cops will actually jail someone for, the PD is going to win. The power balance is so vastly tilted in their favor that you'd be a fool to fight. If not fired outright they can mess up your call schedule, fellowship recs, future credentialling requests; the list goes on and on.