Winking, Blinking, and Nod: A Look at the Problem of Moonlighting and Psychiatric Consultation in Graduate Medical Education

Abstract

National and state subsidization of medical schools has increased the turn-out of physicians, but attempts to reduce the total number of years in medical education have largely failed, leaving the number of poverty years in training intact. Historically and currently, moonlighting has filled a monetary vacuum for residents and unfortunately has been largely ignored, particularly as a resource for its potential in educational benefits. Institutions of graduate medical education are baffled by this problem, which, by survey, is denied (winked at), exorcised (blinked at), or ambivalently condoned (nodded at). This paper calls attention to this persistent activity (heretofore viewed as a sub-rosa, “necessary evil”), describes a capitalization on this “undesirable” in a training effort, and offers a pilot for examination and possibly modeling by other psychiatric programs and sister specialties.