Can House Officers Moonlight?
Article IX - Extracurricular Medical Practice (moonlighting), of the Collective Bargaining Agreement, guarantees your right to work and receive compensation as a physician, in addition to your on-the-job training responsibilities at UMHHS. However, in order to protect patient safety, and ensure your training isn't compromised, only a house officer in good standing who wishes to moonlight is permitted to do so.
A Program Director must provide concrete reasons why a particular House Officer should not be allowed to moonlight. Reasons may include poor in-service exams, incident reports, poor performance reviews. Vague statements such as "moonlighting will impair your training here" are not valid criteria to use in denying the House Officer's request.
If your Program Director denies your request to moonlight and has a blanket policy of not allowing moonlighting, given the scenario above, please discuss this with your program director. Once your performance has been evaluated, and you have demonstrated your good standing, you should be granted moonlighting privileges in accordance with the Collective Bargaining Agreement. Not granting you moonlighting privileges if you are in good standing is a violation of the CBA.
Does my membership in the HOA affect my ability to moonlight?
The easy answer -- Yes and No.
The more detailed answer -- If you are a resident or a fellow, with some very unique exceptions for a few of the non-ACGME accredited programs, you are classified by the medical staff bylaws as a CPT (clinical program trainee). All CPTs work for UM based on the contract negotiated by the HOA, regardless of official "membership" in the HOA. So, even if you elect to rescind your HOA membership you are still under the same contract with the University (just without all of the benefits and protections of being part of the HOA). The eligibility and process rules surrounding moonlighting remain the same for all CPTs regardless of HOA membership -- this includes 80 hour work week restrictions, completion of eligibility forms, etc.
Separate from the HOA, the ACGME has certain restrictions on moonlighting with regards to what services a resident/fellow can provide as a moonlighter if they are still in training. The language from the ACGME, having nothing to do with the HOA or even UM specifically, restricts moonlighting in the same specific specialty of your training program.
That's not to say that anesthesiologists can't moonlight in any area of anesthesiology; rather, pain fellows can't moonlight to cover the pain service [same specific specialty training], but critical care fellows can moonlight to cover GA cases in the ORs [different specialty components of anesthesiology]. All moonlighting is still subject to program director approval.