The Accreditation Council for Graduate Medical Education (ACGME) stance on “moonlighting” or patient care activities outside of an educational program requires that program directors prospectively grant permission for all moonlighting activities, monitor their effect on resident performance and withdraw permission if the activities adversely affect resident performance.

The program director’s office must be notified of any moonlight experience or any change in moonlighting experience and approval from the program director must be obtained - a new moonlighting form must be filled out, reviewed and signed by the program director/ associate program director.

Please be aware:

1. Moonlighting is prohibited during educational program hours.
2. In-house moonlighting responsibilities occurring on weekends should end no later than 8:00 PM on Sunday evening.
3. Permission for moonlighting activities may not be granted or may be withdrawn if there is concern about a resident’s fatigue level or performance in the residency training program.

Please fill out the form below outlining your moonlighting activities:
Resident Name:
Email: Pager:

Moonlighting Location:
Days: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Times of Days:

Total Hours per month: In-house Not In-house