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Moonlighting is allowed during PGY-4 if you are doing well in the program and you have permission from the program director.
Moonlighting During Fellowship
Because graduate medical education is a full-time endeavor, fellows must ensure that moonlighting does not interfere with their ability to achieve the goals and objectives of their educational program.
You are responsible for ensuring that moonlighting and other outside activities do not result in fatigue that might affect patient care or learning. You are also responsible for complying with your program's clinical experience and education policy, which is approved by the Graduate Medical Education Committee (GMEC) and is consistent with the GME policy on clinical experience and education.