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Internal medicine residents' monitoring of their colleagues' moonlighting activities at the University of Cincinnati

The University of Cincinnati Department of Internal Medicine instituted in 1989–90 a peer review moonlighting committee of residents to (1) design departmental guidelines for work activities and number of work hours, (2) confidentially document work activities of fellow residents, (3) identify discrepancies between the recommended guidelines and residents' work activities, and (4) initiate control policies. Quarterly self-report questionnaires documenting moonlighting activities were given to each of the 35 residents in the second and third postgraduate years (20 and 15 residents, respectively). There was a 98% compliance rate by the residents through the initial 12 consecutive months. The completed questionnaires indicated that there were four first-time violators of established guidelines. The authors suggest that a peer review moonlighting committee may help in establishing mutually acceptable work activity guidelines while maintaining the accountability of the residency review committee and the program director.