Moonlighting and Independent Clinical Practice

To arrange the process of working outside of residency training programs through Moonlighting and Independent Clinical Practice.

Residents’ primary responsibility is to their training program.

Moonlighting/Independent Clinical Practice is a privilege, not a right.

The Residents must not allow Moonlighting/Independent Clinical Practice to impact negatively on their training or patient care.  

Moonlighting refers to extracurricular medical activities that are characterized by the following features:

1)      Usually measured in terms of shifts or hours;

2)      Clear and immediate access to supervision including the availability of direct (on-site) supervision when necessary;

3)      The Resident functions under the direct supervision of the most responsible physician (MPR) - who retains primary responsibility for the patient. The Resident is not a replacement or substitute for the MRP.

 

Independent Clinical Practice refers to extracurricular medical activities that are characterized by the following features:

1)      Measured in terms of shifts or blocks of time;

2)      No direct supervision;

3)      The Resident functions as an MRP substitute or equivalent, even if only on a temporary basis;

4)      The responsibilities undertaken in the context of the Independent Clinical Practice activity would require a regular practice license (not educational license).

This policy applies to Residents enrolled in residency training programs at the College of Medicine, University of Saskatchewan.

Residents’ primary responsibility is to their training program. Should Residents wish to work for remuneration over and above the hours of training and call they are expected to do as a Resident, this is generally acceptable to the College of Medicine.

The Resident must not allow Moonlighting/Independent Clinical Practice to impact negatively on their training.

Moonlighting and Independent Clinical Practice are a privilege and are approved by the Program Director and the Associate Dean, Postgraduate Medical Education for “extracurricular” medical activities.

Residents on a leave of absence or suspension from their residency training program are deemed “inactive” and are not approved to engage in Moonlighting or Independent Clinical Practice during the leave/suspension period.

Residents are not allowed to engage in Moonlighting or Independent Clinical Practice during remedial training. Should a Resident appear to be in academic difficulty, serious consideration will be given to withdrawing Moonlighting/Independent Clinical Practice privileges.

Residents must have passed the relevant national exams (minimum MCCQI) in order to request moonlighting or independent clinical practice privileges.  Individual programs have the discretion to set additional examination requirements.

Patient care, quality and safety are very important issues; therefore, the Postgraduate Medical Education Office will closely monitor all Moonlighting/Independent Clinical Practice activities. Should a Resident fail to adhere to an approved Moonlighting/Independent Clinical Practice plan, serious consideration will be given to withdrawing Moonlighting/Independent Clinical Practice privileges.

In the interest of Resident well-being and patient safety, Resident call is not to exceed the numbers stipulated in the collective agreement (Moonlighting plus regular residency training call, or Independent Clinical Practice plus regular residency training call).

Moonlighting/Independent Clinical Practice will not exceed 75 hours per month in total. Individual programs have the discretion to set lower limitations.

Requests for Moonlighting/Independent Clinical Practice privileges can be made for up to and including six months.

Moonlighting/Independent Clinical Practice must not be coercive. Residents must not be required by their residency program or other agencies to engage in Moonlighting/Independent Clinical Practice.

Residents should not Moonlight/work as Independent Practitioners on the same unit or service to which they are currently assigned as Residents.

The Resident’s duties while Moonlighting/Independent Clinical Practice are limited to clearly defined responsibilities as outlined by the Moonlighting/Independent Clinical Practice Plan, and they cannot provide specialty services as per their training.

Instances or concerns of non-compliance with this policy should be brought to the attention of the Associate Dean, PGME.

Should a Resident fail to adhere to the approved plan or appears to be in academic difficulty, serious consideration will be given to withdrawing Moonlighting/Independent Clinical Practice privileges. It is the responsibility of the Program Director to advise the Resident to cease Moonlighting/Independent Clinical Practice activities.

If a Resident fails to voluntarily withdraw their Moonlighting privileges within the given deadline, the Postgraduate Medical Education Office will request the termination of the Moonlighting endorsement with the CPSS. This will then remain as part of their record with the CPSS.

Procedure for Obtaining Moonlighting Privileges

Procedure for Obtaining Independent Clinical Practice Privileges

Coordinator, Academic and Non-academic Processes, PGME Office

Phone: 306-966-6145