Additional Work Policy

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Purpose Circumstance may arise in which a department/division/institute would wish to ask a resident/fellow to perform clinical duties that are outside their normal duties. In such a situation, it would be fair and appropriate to provide remuneration for this work. The purpose of this policy is to describe the principles to be used by a program director to develop a policy for their program and determine if compensation is allowable.  Principles Each program that wishes to provide compensation for additional work under this policy must develop their own policy consistent with this policy, institutional policy, ACGME/RRC requirements, and relevant state/federal law, which provide details of the process for allocating these duties and the remuneration. This policy should be distributed to the residents and fellows of the program and be available for their review.  Additional Work policies should be used only for brief and self-limited staffing needs.  All requests for Additional Work must be provided to the Office of Graduate Medical Education. The request must include a justification for the additional work, a description of the duties and compensation, and the plan for solving the service-need issue. The Office of Graduate Medical Education reserves the right, after review, to terminate any Additional Work policies felt not to comply with this policy or to otherwise not serve the best interests of the residents/fellows or the institution. Residents and fellows cannot be paid for doing additional work that would, under other circumstances, be part of their training. This would include such things as taking call or covering a shift for another resident who has become sick, injured, or is on vacation/leave. Under no circumstances can a resident or fellow be required or obligated to take on additional work under this policy. Under no circumstances can a resident or fellow violate ACGME work hour rules by taking on additional duties. J-1 physicians are authorized to engage in “supplemental clinical activities” within their training institutions, provided certain conditions are met. Intealth EVSP Form (Form completed by Program Director) Supplemental clinical activity must occur at the same institution/primary clinic site or participating clinical site where the physician is engaged in their training program. Supplemental clinical activity cannot extend beyond the J-1 physician’s current training year end date. (The approval is valid for one training year only.) Remunerated work hours performed under this policy must be tracked and included as duty hours. The program director must indicate that the resident is in good standing and that this additional duty will not interfere with their didactic training or educational needs (e.g., this would not be appropriate for a resident who is on academic probation and needs to spend more time reading). Residents and fellows cannot work outside their scope of practice, i.e., they must be appropriately supervised by qualified faculty. Fellows can work independently in the area of their qualified underlying specialty, consistent with hospital policy concerning licensure and privileging. Approved by GME Committee: Jan. 14, 2013  Revised: February 2026

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