QUESTION:
One of our current fellows applied for appointment and clinical privileges at our facility, is this allowed?

OUR ANSWER FROM HORTYSPRINGER ATTORNEY HALA MOUZAFFAR:
Fellows are physicians that have already successfully completed a residency training program and are choosing to further specialize their medical training through a fellowship. By virtue of this, if a fellow were not pursuing this extra training, they would likely be an independently practicing physician. Because of this, fellows are typically eligible to apply for appointment and clinical privileges under the Medical Staff Bylaws and Credentials Policy.

However, there are a couple additional items to consider before granting them appointment and privileges.  The first is, why are they applying for privileges? For an accredited fellowship program, fellows do not need to obtain independent appointment and clinical privileges at a facility to participate in the program. On the other hand, if a fellow is seeking to moonlight, then they will need to be granted privileges outside of the fellowship program for which they are qualified based on the residency program they completed.

The next big question is, what privileges are they applying for, and should you grant them?  Fellows still need to demonstrate the minimum competence and skill for those privileges for which they apply.  They are under the same expectations you would have of any other provider.  So, while they are probably eligible to be privileged for procedures and skills they learned during residency, it wouldn’t make sense to grant them privileges for something they are actively learning in their fellowship.

From there, additional considerations may come up depending on your Medical Staff Bylaws and other policies. For instance, will you have to waive any threshold eligibility criteria?  What Medical Staff category will they be eligible for?  Will you have to waive any criteria of that category?

For more information on this topic, I suggest checking out our recent Grand Rounds Audio Conference on Moonlighting Residents and Fellows!

If you have a quick question about this, e-mail Hala Mouzaffar at hmouzaffar@hortyspringer.com.