Moonlighting Employment as a physician in a professional capacity outside of what is outlined in this Agreement, whether temporary special medical activity (“TSMA”) or external moonlighting, must be approved in writing, in advance, by the Departmental Chair, Program Director and Director of Graduate Medical Education (or designee). Even if approved, professional and general liability insurance as outlined in Section 5.4 is not provided to Trainee engaged in external moonlighting. Trainee acknowledges he or she has the responsibility to obtain insurance for such engagement. TSMA and external moonlighting must be included and reported as part of Trainee's hours spent on clinical experience and education. Trainee shall not be required to engage in any outside work.