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Psychiatric Resident Moonlighting

A Review and Modest Proposal

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Abstract

Moonlighting by psychiatric residents remains controversial, with debate surrounding the ethical, legal, financial, and educational risks involved in the practice. The authors present a literature review of resident moonlighting, which encompasses the policy positions of various organizations responsible for graduate medical education; surveys of various groups and specialties regarding the prevalence, form, and justification for moonlighting; and models of moonlighting programs in several institutions. The authors conclude with specific proposals for research regarding psychiatric resident moonlighting and, more importantly, emphasize the need for research on the effects of moonlighting on resident performance and education.

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References

  1. Hoad TF (ed): The Concise Oxford Dictionary of English Etymology. Oxford, England, Oxford University Press, 1986, p 300

    Google Scholar 

  2. Franaszek JB: Moonlighting. J Emerg Med 1983; 1:161–163

    Article  CAS  PubMed  Google Scholar 

  3. Divoll M, Holzer JF: Moonlighting house officers (letter). N Engl J Med 1985; 312:863

    Google Scholar 

  4. Keill SL: Moonlighting: why training programs should monitor residents’ activities. Hosp Community Psychiatry 1991; 42:735–738

    CAS  PubMed  Google Scholar 

  5. Factor RM: Moonlighting: what residents do in their free time is their decision. Hosp Community Psychiatry 1991; 42:739–743

    CAS  PubMed  Google Scholar 

  6. Draper E, Nitzberg H: Winking, blinking, and nod: a look at the problem of moonlighting and psychiatric consultation in graduate medical education. Journal of Psychiatric Education 1978; 2:197–209

    Google Scholar 

  7. Beal JM: Moonlighting: good or bad? Am J Surg 1966;111:415–416

    Article  Google Scholar 

  8. Schiedermayer DL, Simpson DE, Krueger KB: Moonlighting. Wisc Med J 1988; 87:15–16

    CAS  Google Scholar 

  9. Association of American Medical Colleges: Council of Teaching Hospitals Survey of House Staff Stipends, Benefits, and Funding. Washington, DC, Association of American Medical Colleges, 1991, pp 56–57

    Google Scholar 

  10. Moss AJ: Moonlighting house officers: the silent majority. N Engl J Med 1984; 311:1375–1377

    Article  CAS  PubMed  Google Scholar 

  11. Banahan BF, Anderson RL, Banahan BF, et al: Physicians’ evaluations of their moonlighting during residency training. Journal of Medical Education 1987;62:351–353

    PubMed  Google Scholar 

  12. Greco RS, Donetz AP, Brolin RE, et al: The influence of debt, moonlighting, practice, oversupply, and gender on career development of residents in university and independent training programs. Surg Gynecol Obstet 1987; 165:19–24

    CAS  PubMed  Google Scholar 

  13. Stange KC, Sutherland JE: Moonlighting policy and practice in family practice residencies. J Fam Pract 1987;24:63–65.

    CAS  PubMed  Google Scholar 

  14. Laskin DM: The practice of moonlighting (editorial). J Oral Surg 1975; 33:486

    CAS  PubMed  Google Scholar 

  15. Robertson MO: More on moonlighting (letter). Journal of Medical Education 1975; 50:493–494

    CAS  PubMed  Google Scholar 

  16. MacMillan AJ: Decision on moonlighting (letter). N Engl J Med 1970; 282:1379

    PubMed  Google Scholar 

  17. Fleisher DS: Questions on moonlighting (letter). Journal of Medical Education 1975; 50:415

    CAS  PubMed  Google Scholar 

  18. Association of American Medical Colleges: “Moonlighting”: a practice to be discouraged (editorial). Journal of Medical Education 1974; 49:1069

    Google Scholar 

  19. Petersdorf RG, Bentley J: Residents’ hours and supervision. Acad Med 1989; 64:175–181

    Article  CAS  PubMed  Google Scholar 

  20. Bazzoli GJ, Culler SD: Factors affecting residents’ decisions to moonlight. Journal of Medical Education 1986; 61:797–802

    CAS  PubMed  Google Scholar 

  21. Silliman RA, Dittus RS, Velez R, et al: Moonlighting and career decisions among internal medicine residents. Journal of Medical Education 1987; 62:463–469

    CAS  PubMed  Google Scholar 

  22. Cohen RL: Moonlighting (letter). JAMA 1990; 263:1065

    Article  CAS  PubMed  Google Scholar 

  23. Kelly WS, Sharp PC: Moonlighting: a practice to be encouraged? North Carolina Medical Journal 1984; 45:247–248

    CAS  PubMed  Google Scholar 

  24. McCue JD, Janiszewski M, Stickley WT: Residents’ view of the value of moonlighting. Arch Intern Med 1990;150:1511–1513

    Article  CAS  PubMed  Google Scholar 

  25. Cohen SN, Leeds MP: The moonlighting dilemma: balancing education, service, and quality care while limiting risk exposure. JAMA 1989; 262:529–531

    Article  CAS  PubMed  Google Scholar 

  26. Gallup EM, Schmittling G: Liability insurance for moonlighting by family practice residents. J Fam Pract 1991; 66:705–706

    Google Scholar 

  27. Association of American Medical Colleges: Executive Council, Association of American Medical Colleges, Resident Supervision and Hours. Journal of Medical Education 1988; 63:421–426

    Google Scholar 

  28. New York State Department of Health. Section 405.4, Medical State, in New York State Medical Code. Adopted by the New York State Hospital Review and Planning Council, June 1988

    Google Scholar 

  29. American Medical Association: American Medical Association Policy Compendium. Chicago, IL, American Medical Association, 1983, p 77

    Google Scholar 

  30. American Medical Association: American Medical Association Policy Compendium. Chicago, IL, American Medical Association, 1993, p 280

    Google Scholar 

  31. Mitchell TB (ed): American Medical Association board acts to limit resident work hours: resident forum. JAMA 1989; 262:2970

    Article  Google Scholar 

  32. Petersdorf RG: Regulation of residency training. Bull N Y Acad Med 1991; 67:330–337

    CAS  PubMed Central  PubMed  Google Scholar 

  33. American Medical Association: 1992–1993 Directory of Graduate Medical Education Programs. Accreditation Council for Graduate Medical Education. Chicago, IL, American Medical Association, 1992, pp 11–18, 119–125

    Google Scholar 

  34. Stein S: Regulation of residency training in New York state: implications for other states. Hosp Community Psychiatry 1990; 41:273–275

    CAS  PubMed  Google Scholar 

  35. Mitchell TB (ed): States continue to look at work hours and supervision: resident forum. JAMA 1989; 262:3218

  36. Thompson RR: Moonlighting house officers (letter). N Engl J Med 1985; 312:862–863

    Article  Google Scholar 

  37. Karnad A: Moonlighting house officers (letter). N Engl J Med 1985; 312:863

    Google Scholar 

  38. Frumkin K: “What’s in a name? moonlighting for fun and profit”: reflections on the state of emergency medicine—a goal for 2000 and beyond. Ann Emerg Med 1992; 21:862–864

    Article  CAS  PubMed  Google Scholar 

  39. McLaughlin MA, Daugherty SR, Rose WH, et al: The impact of medical school debt on postgraduate career and lifestyle. Acad Med 1992; 67:700–707

    Article  Google Scholar 

  40. Kassebaum DG, Szenas PL: Relationship between indebtedness and the specialty choices of graduating medical students. Acad Med 1992; 67:700–707

    Article  CAS  PubMed  Google Scholar 

  41. Buch D, Swanson MS: Moonlighting by psychiatric residents. Journal of Psychiatric Education 1986; 10:247–254

    Google Scholar 

  42. Piening RB: Moonlighting: making a buck, compassion, and quality control (letter). JAMA 1990; 264:454

    Article  CAS  PubMed  Google Scholar 

  43. Yingling KW, Hattemer C, Rouan GW, et al: Internal mediane residents’ monitoring of their colleagues’ moonlighting activities at the University of Cincinnati. Acad Med 1991; 66:705–706

    Article  CAS  PubMed  Google Scholar 

  44. Kay J: The influence of the curriculum in psychiatry residency education. Psychiatr Q 1991; 62:95–104

    Article  CAS  PubMed  Google Scholar 

  45. Samkoff J, Jacques CH: A review of studies concerning effects of sleep deprivation and fatigue on residents’ performance. Acad Med 1991; 66:687–693

    Article  CAS  PubMed  Google Scholar 

  46. Condon RE: Sleep deprivation and resident call schedules. Current Surgery 1989; 46:361–364

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Stephen Ruedrich M.D. (associate professor of psychiatry)

  2. University of Texas at San Antonio, USA

    Kenneth Matthews M.D. (associate professor of psychiatry)

  3. Medical College of Wisconsin, Milwaukee, USA

    Carlyle Chan M.D. (professor of psychiatry)

  4. University of Texas Southwestern Medical Center, Dallas, USA

    Paul Mohl M.D. (professor of psychiatry)

Authors
  1. Stephen Ruedrich M.D.
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  2. Kenneth Matthews M.D.
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  3. Carlyle Chan M.D.
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  4. Paul Mohl M.D.
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Ruedrich, S., Matthews, K., Chan, C. et al. Psychiatric Resident Moonlighting. Acad Psychiatry 18, 189–196 (1994). https://doi.org/10.1007/BF03341407

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