Internal and external moonlighting by radiology trainees: a survey of the extent of participation by current residents and fellows.

RATIONALE AND OBJECTIVES: Time devoted to internal moonlighting is constrained by various components of Accreditation Council for Graduate Medical Education (ACGME) duty hour regulations. Hours spent in external moonlighting, however, are not necessarily tabulated in accordance with ACGME requirements. This study sought to gain a better understanding of the extent of both internal and external moonlighting.

MATERIALS AND METHODS: A survey was sent to all members of the Society of Chairs of Academic Radiology Departments. Respondents were asked to indicate the number of trainees in their program and whether they participated in internal or external moonlighting. If internal moonlighting occurred, the chair was asked in which postgraduate year residents were permitted to moonlight internally. If external moonlighting was permitted, the respondents were asked which postgraduate year trainees were permitted to moonlight outside of their institution.

RESULTS: Response rate for the study was 36% (62 of 172 chair), who together supervised 1726 (37.9%) of current radiology residents. Eighty-seven percent of respondents allowed internal or external moonlighting. Sixty percent allowed internal moonlighting, predominantly permitting senior residents this privilege. Fifty-eight percent acknowledged external moonlighting: 13.7% of residents and 24.6% of fellows. Of the programs who allowed residents, 20% allowed second years, 68.6% third years, 85.7% fourth years, and 65.7% fellows. Forty-three percent of programs accounted for hours worked externally and only three programs accounted for travel time.

CONCLUSIONS: Moonlighting is a means for radiology residents and fellows to decrease their financial burdens. Its practice appears to be widespread and it is at tolerated by most chair of radiology, although programs differ in their support of moonlighting and their acceptance of external moonlighting.