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Moonlighting by Psychiatric Residents

Dr. Matthews is Professor of Psychiatry and Residency Education Director at The University of Texas Health Science Center at San Antonio. Dr. Ruedrich is Staff Psychiatrist at the Case Western Reserve/Metro Health Medical Center, Cleveland, Ohio. Dr. Chan is Director of Residency Education at the Medical College of Wisconsin in Milwaukee. Dr. Mohl is Professor of Psychiatry and Residency Education Director at the University of Texas Southwestern Medical School in Dallas. Address reprint requests to Dr. Matthews, Director of Psychiatry Residency Education, Department of Psychiatry, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284–7792.

Much of the literature on resident moonlighting has been editorial in nature. Very little information on psychiatric residents' moonlighting practices and attitudes exists. The authors developed an instrument that was mailed to survey the chief residents of all 203 Accreditation Council for Graduate Medical Education–approved psychiatry residencies, with 137 (67.5%) programs responding. According to the responses, the percentage of residents moonlighting increased with each successive year of training, with an average of 31 hours per resident per month. The two major reasons given for moonlighting were payment of living expenses (58%) and repayment of student loans (24%). No supervision was provided to 22% of the moonlighting residents. Only 10% of the programs proscribed moonlighting by their residents. To better assess the positive and negative effects of moonlighting, it is time to truly monitor and guide the moonlighting experience for both residents and their programs.

Key Words: Moonlighting • Residency • Work Hours

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