Policy of the Graduate Medical Education Committee

Section:  Institutional Responsibilities

Subject: Supplemental Clinical Activities

Number: 3.400

Date Developed: 2/99

Last Review/Revision:  10/04, 10/07, 7/10, 7/2011

Replaces:  previous policy of same name, dated 7/2010

ACGME Requirement:  Institutional II D.4.j: Common VI G.2.

Purpose

The policy will define supplemental clinical activities (internal moonlighting) resulting in additional financial support, the procedure for approval of such activities, and approval for the participation of residents in these activities.

 

The policy should also serve as a guideline against inappropriate use of resident service, in activities that residents may have covered previously as part of the educational program, occurring in teaching institutions.

 

Definition

Supplemental clinical activities are voluntary, compensated, medically-related work (not related with trainee’s current required or elective curriculum) performed within the institution in which the resident is in training or at any of its related participating sites.   

Policy

Supplemental clinical activities are covered by the housestaff malpractice insurance and count toward the 80 hour week.  PGY-1s may not engage in these activities.

 

A resident must obtain a prospective written statement of permission of his/her Program Director for supplemental clinical activity. The Program Director and the individual resident must closely monitor the activity to ensure it does not interfere with the resident’s ability to achieve the goals and objectives of the educational program.  If a resident is no longer performing satisfactorily in the program, the Program Director may withdraw the permission to participate in the supplemental clinical activity.

Development of a supplemental clinical activity is made by a request from the Departmental Chairperson and/or Training Program Director to the Associate Dean for GME and must be approved by the Dean. Approval of a supplemental clinical activity is done according to the following procedure:

Procedure

1.         The Departmental Chairperson and/or Training Program Director submits a written request to the Associate Dean for GME describing the clinical activity to include the location, the responsibilities of the resident, the time commitment of the resident, supervision of the resident, and sources of additional compensation (if applicable).

2.                  The Associate Dean for GME discusses the request with the Director of FGP Risk Management regarding liability coverage and then submits a recommendation to the Dean.

3.                  Once approved by the Dean, written documentation of approval is provided to the Program Director and Departmental Chairperson.

4.                  The Associate Dean for GME maintains a file on approved supplemental clinical activities. 

5.                  Supplemental clinical activities are reviewed as part of the program’s mid-cycle internal review (type and worth of activity, number of residents participating, duty hours, etc).