Keill S L
Department of Psychiatry, University of Maryland School of Medicine, Baltimore 21201.
Hosp Community Psychiatry. 1991 Jul;42(7):735-8. doi: 10.1176/ps.42.7.735.
Moonlighting by psychiatric residents, or employment outside the residency program, is a longstanding and widespread practice. The author contends that moonlighting detracts from residents' ability to gain full benefit from their educational program, compromises the safety of patients treated by residents who moonlight in unsupervised settings, and exposes health care institutions to risk of costly legal actions. Although moonlighting should ideally be eliminated, a workable alternative to the current system would include oversight by residency program directors of residents' extracurricular employment to assure that the assignments complement the educational program. Institutions that employ moonlighting residents would also reimburse the residency program for selecting appropriate residents to fill the positions they offer.
精神科住院医师的兼职，即在住院医师培训项目之外的工作，是一种长期且普遍存在的做法。作者认为，兼职会降低住院医师从其教育项目中充分受益的能力，危及在无人监督环境下兼职的住院医师所治疗患者的安全，并使医疗机构面临代价高昂的法律诉讼风险。虽然理想情况下应取消兼职，但现行系统的一个可行替代方案包括由住院医师培训项目主任对住院医师的课外工作进行监督，以确保这些工作与教育项目相辅相成。雇佣兼职住院医师的机构还应就挑选合适的住院医师填补其提供的职位向住院医师培训项目进行补偿。
