Internal versus external moonlighting by radiology trainees: differences in roles and responsibilities

Area of Science:

• Radiology
• Medical Education
• Trainee Professional Development

Background:

• Paid extracurricular activities, or moonlighting, among radiology trainees are increasingly diverse.
• Understanding the scope and nature of these activities is crucial for trainee development and patient safety.

Purpose of the Study:

• To examine the diverse paid extracurricular activities of radiology trainees in detail.
• To assess differences between internal moonlighting (at affiliated institutions) and external moonlighting (at unaffiliated institutions).

Main Methods:

• An electronic survey was distributed to trainee members of the Association of University Radiologists.
• Data focused on extracurricular clinical work, distinguishing between internal and external moonlighting.
• Descriptive and analytic statistics were employed to analyze the survey data.

Main Results:

• Trainees engage in moonlighting at approximately 75% of surveyed institutions.
• External moonlighting trainees were significantly more likely to perform final interpretations (OR 13.84, P < .05).
• 19% of external moonlighting programs reported unsupervised invasive procedures, versus 0% for internal moonlighting.

Conclusions:

• Moonlighting is viewed as desirable and financially necessary by many residents.
• External moonlighting offers experience and income but requires careful consideration of ethical and medicolegal aspects.
• Internal moonlighting opportunities and competency-based assessments are recommended to ensure patient safety and trainee professional growth.