Postgraduate practising licence (internal moonlighting)

Preamble

The College of Physicians and Surgeons of Nova Scotia (the College) understands that postgraduate trainees may wish to provide coverage for another trainee on the same or different service in the tertiary care teaching hospitals in Halifax.

Purpose

This policy describes the criteria that must be met when a postgraduate trainee applies to provide peer coverage at a facility or health care centre external to their primary site of training.

Scope

Postgraduate training Program Directors and trainees have a shared responsibility to ensure that moonlighting must not:

1. interfere with the ability of the trainee to achieve the goals and objectives of their postgraduate training program; or
2. interfere with the trainee’s fitness to train; or
3. compromise patient safety.

This policy applies to postgraduate trainees satisfactorily and actively participating in a postgraduate training program at Dalhousie University.

Policy

Postgraduate trainees must only practise to the extent that is justified by their competence and experience.

1. Supervision
   Trainees must:
   • function under the direct supervision of the most responsible physician (MRP) who retains primary responsibility for the patient; and
   • have clear and immediate access to supervision including the availability of direct (on-site) supervision when necessary.
2. Eligibility
   Applicants must submit an application approved by the Registrar satisfying all of the following criteria to be deemed eligible for a postgraduate practising licence:
   1. Trainees must have satisfactorily completed a rotation on the same service and at the same level for which they will be moonlighting.
   2. Be in good standing in their postgraduate training program. ​Postgraduate trainees on a leave of absence or suspensions from their training program are not eligible to engage in moonlighting during the leave/suspension period. At the discretion of the Registrar, exceptions may be granted for trainees on a pregnancy, parental, or adoption leave.​ Postgraduate trainees in a remedial training program or those who appear to be in academic difficulty are not eligible for a postgraduate practising licence.
   3. Be a Licentiate of the Medical Council of Canada (LMCC) or hold an acceptable alternative to the LMCC¹.
   4. Be deemed competent by their Program Director. The College must have written confirmation and approval from the Program Director confirming the postgraduate trainee has demonstrated the required competence to practice under appropriate supervision. The approval must be site-specific for each location in which the applicant wishes to provide peer coverage. This confirmation must be sent directly to the College of Physicians and Surgeons of Nova Scotia (the "College"). Approval may be revoked at any time if there is any indication that the trainee is in academic difficulty or may compromise patient safety.
   5. Have a College approved Supervisor. The Department Head at the hospital or his/her designate must be accountable for the appropriate supervision of the trainee. It is intended that the postgraduate trainees will be supervised in the same fashion as they are during their postgraduate training program.
   6. Responsibility to obtain privileges with Nova Scotia Health (NSH) or the Izaak Walton Killam (IWK) Health Centre rests with the postgraduate trainee.
   7. Provide evidence of appropriate liability protection².

At the discretion of the Site Lead of the Health Care Centre/Facility seeking staff-physician coverage, postgraduate trainees may be required to provide confirmation of the following if required by the health authority:

• Adult Medicine - Advanced Cardiac Life Support (ACLS)
• Pediatric Medicine - Pediatric Advanced Life Support (PALS)
• Neonatal Medicine - Neonatal Resuscitation Program (NRP)
• Trauma Medicine - Advanced Trauma Life Support (ATLS)

Resources

1. Acceptable Alternatives to the LMCC
2. Liability Protection Requirements