The Collective Bargaining Agreement guarantees your right to moonlight while training at UMHS. There are differences between internal and external moonlighting. All moonlighting is subject to Program Director approval for all House Officers who are in good standing.  A program director cannot make vague statements such as, "no one in our program is allowed to moonlight."

Availability of Internal Moonlighting

GME decides on the appropriateness of adding new internal moonlighting opportunities for House Officers.  The HOA has absolutely NOTHING to do with this process.  The wage you accept to moonlight for Michigan Medicine is not bargained for by the HOA. The only language that was bargained for is your RIGHT to moonlight.  

The HOA’s position is that internal moonlighting is a win/win for House Officers and Michigan Medicine, so it is unfortunate that these opportunities seem to be limited, especially when a need is well documented.

You are encouraged to report staffing shortages that you feel pose a threat to patient safety, ANY patient safety concern should be reported. The compliance hotline should be used by Health System employees to raise financial, regulatory and patient safety concerns.

Call the University of Michigan Compliance Hotline at 866-990-0111 or submit an online report.

External & Internal Moonlighting Details

For answers to all your questions about moonlighting, please see the following FAQ:

Can House Officers Moonlight?

Details about internal and external moonlighting.

FAQ Article # 00AB8

Please see Article IX. Extracurricular Medical Practice for full contract language.

External Moonlighting

• Services provided outside of UMHS affiliated hospitals and healthcare centers.
• Your University of Michigan malpractice insurance does not cover your external moonlighting activities.
• Your Program Director must approve and monitor moonlighting activity.
• Your Program Director must provide you with the moonlighting policy and the Moonlighting Request Form.
• You must be in good standing.
• You can not be required to moonlight.
• Any moonlighting that requires the House Officer to assume continuing responsibility for patients is not permitted.

Internal Moonlighting

• Services provided within UMHS not related to your ACGME approved program.
• GME's judgment dictates the availability of internal moonlighting opportunities at U of M. The HOA has no role in this decision. (Internal moonlighting is currently very rare)
• Your Program Director must approve and monitor moonlighting activity.
• Your Program Director must provide you with the moonlighting policy and the Moonlighting Request Form.
• You must be in good standing.
• You can not be required to moonlight.
• Any moonlighting that requires the House Officer to assume continuing responsibility for patients is not permitted.
• The wage you accept to moonlight for Michigan Medicine is not bargained for by the HOA.

Program Director Approval

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 UMHS.  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?

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 workweek 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.