Revised March 2009
UCSD GME TRAINEE ADDITIONAL EMPLOYMENT POLICY
OBJECTIVE
This purpose of this policy is to create a mechanism for UCSD clinical departments to provide additional employment for trainees who are enrolled in Graduate Medical Education (GME) training programs that are accredited by the ACGME or alternatively that are not accredited, but for which an ABMS Subspecialty Certificate is offered.
Under the guidelines set forth below, trainees may function as members of the Time Limited Medical Staff of UCSD Medical Center, may receive additional compensation and may, under specific circumstances, bill for their services. (Reference:“Flow Chart to Evaluate GME Fellow Eligibility for Billing” from Kathleen Naughton at )
Adherence to this policy will assure the University’s compliance with applicable regulatory agency requirements including the ACGME Institutional Requirements, the ACGME-RRC Program Requirements, HCFA Guidelines, the standards of the JCAHO, as well as the UCSD Medical Staff Bylaws.
ADDITIONAL EMPLOYMENT GUIDELINES
- The selection and approval of a trainee for additional employment will be based upon his/her demonstrated skills and competence in providing quality services consistent with the community standard of care.
• Trainees cannot work on more than one MSP contract at the same time.
- With respect to patient care, the physician will be a licensed trainee who shall be appointed as a member of the Time Limited Medical Staff of UCSD Medical Center and shall be credentialed pursuant to the Bylaws of the Medical Staff. The trainee will not have attending admitting privileges.
- Supervision of the trainee will be specified in a position description document.
- Participation by the trainee in additional employment must be compatible with the current policies/terms of the trainee’s GME program and with the policies of the program’s accrediting body.
- Clinical and/or administrative responsibilities undertaken as additional employment shall be separate and distinct from the physician’s training program. Such responsibilities shall not fulfill the requirements of the GME training program.
- Clinical responsibilities undertaken as additional employment shall be specified in a delineation of clinical duties document.
- Participation in additional employment is voluntary and is limited to no more than four 12 hour shifts per month or an equivalent 48 hours per month.
- The trainee will be permitted to bill for activities undertaken through additional employment only under the following circumstances:
Additional employment is conducted under a GME/ABMS Fellow Agreement (MSP Contract)
The appropriate MSP contract template to be used is entitled:
"UNIVERSITY OF CALIFORNIASAN DIEGO
GME Accredited Program Residency/ABMS Certification Fellow Employment Contract (Time Limited Privileges)
Management and Senior Professional (MSP)"
Activities are performed during the trainee’s off-hours, separate from duties of the training program and cannot exceed 20% time in any work year.The hours worked under this contract cannot exceed any of the ACGME Duty Hours Regulations when combined with the requirements of the Member’s House Staff training program. [80 hours per week * 48 available work weeks each year * 20% = 768 hours within the allowed 80 hours that can be worked per week.]
Activities are performed in an outpatient setting or emergency department in the UCSD enterprise
- Payment for additional employment will be processed through the GME/ABMS Fellow MSP “moonlighting” contract and will be paid in PPS on a PNB DOS code.
- Additional employment must be approved by the physician’s training Program Director, the Director, Office of Graduate Medical Education and when clinical duties are requested, the Credentials Committee and the Medical Staff Executive Committee.
PROCEDURE FOR PROCESSING REQUESTS FOR ADDITIONAL EMPLOYMENT THAT WILL INCLUDE CLINICAL ACTIVITIES
REQUIRED DOCUMENTATION: For Trainees performing unsupervised activities, please submit 1, 2 and 3 below. For trainees performing only supervised activities, only 1 and 2 are required.
- GME/ABMS FellowMSP Contract
The annualized compensation rates will be determined based on MSP Salary grades for an Assistant Physician B or an Associate Physician C. (Note: Rarely does a GME MSP contractor qualify for the MSP Grade C, since a Grade C physician must be able to function as an Attending.) [See: Series Concepts for MSP Staff Physicians on the SOM MSP Staff Physicians Contracting Website for additional requirements:
The contract will be signed by the trainee, the Program Director, the Director, Office of Graduate Medical Education and the Vice Chancellor-Health Sciences Designee.
- Position Description – Template Attached
The Position Description shall address:
Term of Employment
Requirements for Employment
Scope of Practice, Duties and Responsibilities
Supervision and Proctoring
Employment Distinct and Separate from GME training program
The Position Description shall be signed by the trainee, the Program Director and the Service Chief.
3.Application for Appointment to the Time Limited Medical Staff – Appointment Packet Attached (Duration should be specified at time of appointment and may be for a term up to two years.)Applicant will be required to complete proctoring.
The following material must accompany the Application:
Copy of current California medical license
Copy of current DEA (as applicable)
Signature of Residency Program Director, certifying good standing, competency and qualifications
Delineation of Privileges
Department Request for Action (DRA) Form
C.V. in month/year (mm/yyyy) format
TB skin test
Respirator Fit Test
Medical Staff dues. Make check payable to U.C. Regents - $350
SUBMITTING REQUEST
The trainee’s Program Director will submit the documentation noted above under items 1 through 3 to Cindy Slaughter, Director, Office of Graduate Medical Education, Mail Code: 8829.
The Office of Graduate Medical Education will process the GME/ABMS Fellow MSP Contract and Position Description for required signatures. When the Medical Director signs these two documents a copy will be made for Medical Staff Administration and will be forwarded to MSA with the original Application for Appointment to the Time Limited Medical Staff packet of materials.
Medical Staff Administration will prepare the application material for review by the Credentials Committee pursuant to the Medical Staff Bylaws. Following review by the Credentials Committee, the documentation will be forwarded to the Medical Staff Executive Committee and to the Governing Body for final review/approval.
PROCEDURES FOR PROCESSING REQUESTS FOR ADDITIONAL EMPLOYMENT NOT INVOLVING CLINICAL ACTIVITIES (Example: Tutoring)
- Trainees for additional employment will be selected by the relevant UCSD employer, in consultation with the Program Director. Approval of the Program Director for any additional employment is required.
- Expectations of the trainee will be specified in a position description document that includes: scope of work, duration of the commitment, and time requirements.
- Responsibilities undertaken as additional employment will be compensated via a UCSD GME MSP Contract (title code 0772, Grade B). This title code will be given in addition to the appropriate trainee title code for each individual.
4.Participation in additional employment is voluntary and is limited to no more than 20% of the total annual hours assigned to training. The hours worked under this contract cannot exceed any of the ACGME Duty Hours Regulations when combined with the requirements of the Member’s House Staff training program. [Formula: 80 hours per week * 48 available work weeks each year * 20% = 768 hours within the allowed 80 hours that can be worked per week.]
5.Participation in additional employment in non-clinical activities should not interfere with any of the trainee’s clinical responsibilities.
REQUIRED DOCUMENTATION
GME Fellow MSP Contract:
The appropriate rate of compensation will be determined by the UCSD employer in consultation with the Program Director and must be within the approved MSP Staff Physician pay grades.
The contract will be signed by the trainee, the Program Director, the Director, Office of Graduate Medical Education and the Vice Chancellor, Health Sciences Designee.
Position Description
The Position Description should address:
Term of employment
Requirements for employment
Nature of duties
Expected time commitment
SUBMITTING REQUEST
The trainee’s Program Director will submit the GME/ABMS Fellow MSP contract and Position Description to Cindy Slaughter, Director, Office of Graduate Medical Education, Mail Code: 8829.
The Office of Graduate Medical Education will process the documents for required signatures.