Moonlighting and "extra hours" policies

[Jeff Levine]

Given how new the Message Board is, I don't expect many, if any replies to this query...but I'll get the ball rolling!

Does your institution allow moonlighting and, if so, must your housestaff be licensed?  I have seen policies for "extra hours," that pertain to work done within the scope of the residency, under supervision, but that is compensated and is entirely voluntary.  I'm guessing these policies are created due to CMS requirements and, perhaps, to accommodate J1 visa holders who are not permitted to moonlight.  Does your institution do anything like this?

Thanks in advance.

Jeff Levine

[Christine Flores]

We do allow moonlighting, but because we define this as work outside of the scope of their program, they must have unlimited or full licenses.  Happy to chat more. We are actively revising our policy so I'd love to hear from others on the topic as well.

[Jenn Bingham]

Hi Jeff, we allow PGY2 and above to moonlight.  If they are doing true moonlighting, without supervision, they must have an independent license and carry their own professional liability insurance and have the ability to bill.  If they are picking up extra call shifts on a rotation the participate in during their program, they are supervised and do not bill they are covered under the professional liability for their program and are paid for the extra voluntary call shifts.  I hope this helps.  I do not think J-1 Visa holders can moonlight or participate in any voluntary shift, we had this come up during COVID and while it was a gray area given the needs during the pandemic, they do not have permission to moonlight.  If you have H1-B Visa holders, they also can not moonlight as their employment Visa is for their residency training.  Hope this helps.Hi Jeff, we allow PGY2 and above to moonlight.  If they are doing true moonlighting, without supervision, they must have an independent license and carry their own professional liability insurance and have the ability to bill.  If they are picking up extra call shifts on a rotation the participate in during their program, they are supervised and do not bill they are covered under the professional liability for their program and are paid for the extra voluntary call shifts.  I hope this helps.  I do not think J-1 Visa holders can moonlight or participate in any voluntary shift, we had this come up during COVID and while it was a gray area given the needs during the pandemic, they do not have permission to moonlight.  If you have H1-B Visa holders, they also can not moonlight as their employment Visa is for their residency training.  Hope this helps.

[Venice VanHuse]

Our institution allows our trainees except PGY1s and J-1 visa holders to moonlight if they are licensed. We are reviewing our policies to see whether we should require trainees who are picking up extra shifts to be licensed to do this extra work vs. true moonlighting as mentioned above.  Our H1b visa holders are allowed to moonlight if we apply for an amendment to their visa with other requirements.

[Susan Greenwood-Clark]

They must have a full unrestricted license. We have considered the extra shifts idea but have not done this yet

[Kelli DaSilva]

We have Extra Duty and Moonlighting.  Moonlighters must have a full license.  Both get paid extra and are required to log those hours using a specific work type.  Just starting to check logged hours against the special pay forms that the PAs fill out so the residents/fellows get paid.