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This document serves as an application for residents at Vanderbilt University Medical Center seeking permission to engage in external moonlighting activities apart from their residency responsibilities.
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How to fill out REQUEST TO ENGAGE IN EXTRAMURAL PROFESSIONAL ACTIVITIES (EXTERNAL MOONLIGHTING)

01
Obtain the REQUEST TO ENGAGE IN EXTRAMURAL PROFESSIONAL ACTIVITIES (EXTERNAL MOONLIGHTING) form from your institution.
02
Fill out your personal information, including your name, position, and department.
03
Provide details of the extramural activity you intend to engage in, including the name of the organization and the nature of the work.
04
Specify the time commitment required for the external activity and how it will fit with your current responsibilities.
05
Include any potential conflicts of interest and how you plan to mitigate them.
06
Obtain the necessary approvals from your supervisor or department head.
07
Submit the completed form to the appropriate office for review and final approval.

Who needs REQUEST TO ENGAGE IN EXTRAMURAL PROFESSIONAL ACTIVITIES (EXTERNAL MOONLIGHTING)?

01
Faculty members looking to supplement their income with external work.
02
Staff who are interested in utilizing their professional skills in outside projects.
03
Researchers seeking funding or collaboration opportunities outside their primary institution.
04
Any employee whose contract or institution policy stipulates the need for formal approval before engaging in external professional activities.
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External Moonlighting: Voluntary, compensated, medically related work performed outside the institution where the resident/fellow is in training or at any of its related participating sites.
For call from home, time devoted to clinical work done from home and time spent in the hospital after being called in to provide patient care count toward the 80-hour weekly limit. Types of work from home that must be counted include using an electronic health record and taking calls.
The ACGME and UCLA GME policies require program director pre-approval of all moonlighting activity. Any residents or clinical fellows moonlighting without written pre-approval will be subject to disciplinary action. All moonlighting is voluntary. All moonlighting counts towards the weekly 80-hour maximum weekly limit.
But what exactly does it entail? At its core, moonlighting refers to working a secondary job alongside your primary role. For many in medicine, this can mean picking up shifts at different healthcare facilities, teaching, volunteering, or even exploring telemedicine opportunities.
ACGME REQUIREMENTS (Common Program Requirements VI. F. 5.): Moonlighting must not interfere with the ability of the resident to achieve the goals and objectives of the educational program, and must not interfere with the resident's fitness for work nor compromise patient safety.

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REQUEST TO ENGAGE IN EXTRAMURAL PROFESSIONAL ACTIVITIES (EXTERNAL MOONLIGHTING) is a formal request submitted by employees to seek approval for engaging in outside professional activities that are not part of their primary job responsibilities.
Employees who are seeking to undertake additional professional activities outside of their primary employment are required to file this request, especially if such activities may present a conflict of interest or violate company policies.
To fill out the request, employees should provide their personal information, details about the external activity including the nature of the work, time commitment, and potential conflict of interest, if any. It may also require signatures from supervisors or relevant authorities.
The purpose of this request is to ensure transparency and manage any potential conflicts of interest, allowing the organization to understand and regulate outside commitments that employees may have.
Employees must report their personal information, specific details about the external activity, expected hours of work, any compensation involved, and how the external work may impact their primary job responsibilities.
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