Moonlighting as PGY-1?

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Can this be done?

I have heard of people doing this, but I don't see how it's possible without medical licensure and you can't get that until you have a year of PGY training under your belt.

There are some programs who offer internal moonlighting opportunities, usually cross-cover or overflow admits that allow PGY1s. They usually pay pretty poorly but some is better than none. We used to have 2 such programs at my institution but they've gone away and all of the moonlighting here requires a full license. I think these programs are pretty much disappearing.

I was actually offered to work with an attending that I worked with earlier as a moonlighter. When I made it clear to him that I do not have a license as a PGY-1, he said as long as I'm working within the hospital that I'm a resident at, it is okay and that he would pay me by providing education material instead of checks. I still turned it down because it seemed a little too shady for me.

At our program, we have an "unreferred" saturday each month in which we usually get slammed, so an intern gets 100 bucks just to put their name down as the backup intern and, if they come in, $100 for each admission.

You need a license to moonlight and most states are moving away from allowing PGY 1's to have a license. Even New Jersey the most screwed up state in the country now makes you wait until the begining of your PGY 3 year to apply for a license. T

Originally Posted by thesauce

Can this be done?

I have heard of people doing this, but I don't see how it's possible without medical licensure and you can't get that until you have a year of PGY training under your belt.

I've seen first years moonlight in IM, and in general from the instances I've seen, it's pretty inappropriate on the part of the hospital. Ends up being people unfamiliar with the patients, inept at procedures because of lack of seniority, and yet they are brought in because nobody else on that service is around they can get help from -- they end up consulting the hell out of other services, calling others for every single line and generally get paid a lot for making work for a lot of other departments. Maybe it works differently elsewhere, but the way I've seen it, it shouldn't be allowed.

At my hospital there is "moonlighting" opportunities on the hospital owned helicopter service. Generally it's reserved for PGY2 and PGY3 but they allow it on a case by case basis for PGY1s because the work that's done in the air is all protocol driven anyways. We do a few scheduled shifts per month as PGY1s so it's work we're familiar with.

After we've rotated through the ER, we're allowed to sign up for extra shifts during non-call months. I think it's $50/hr, and most of the shifts are 6-8h. I'm valuing my time off too much to do it though.

this question might be for aPD, but does non clinical work such as teaching/tutoring(Kaplan MCAT etc) count as moon lighting? and do residents/interns need to report that to the program?
or would be considered a common courtesy to report to the PD?

Originally Posted by doc20

this question might be for aPD, but does non clinical work such as teaching/tutoring(Kaplan MCAT etc) count as moon lighting? and do residents/interns need to report that to the program?
or would be considered a common courtesy to report to the PD?

It is contract dependent, and hospital policy dependent, not courtesy dependent. The contract you sign for each year of residency can generally be pretty clear about what additional work you are allowed to do, IF ANY, and what kind of permission you need to get before doing it. Some disallow ALL gainful endeavors without explicit written permission by the PD. Some focus only on work that counts toward your duty hour limits. Either way, nobody can answer this for you without taking a gander at your program's contract/hospital policy. There is no global rule.

Originally Posted by Ashers

After we've rotated through the ER, we're allowed to sign up for extra shifts during non-call months. I think it's $50/hr, and most of the shifts are 6-8h. I'm valuing my time off too much to do it though.

That sounds dangerous. I'm an EM resident and we aren't allowed to moonlight unlight PGY3

Originally Posted by Cerberus

That sounds dangerous. I'm an EM resident and we aren't allowed to moonlight unlight PGY3

our local em residency lets folks moonlight as pgy-2's. most of them moonlight in urgent care though, not in hard core em depts although I don't think they are limited to urgent care, that's just where the convenient shifts are.

Originally Posted by emedpa

our local em residency lets folks moonlight as pgy-2's. most of them moonlight in urgent care though, not in hard core em depts although I don't think they are limited to urgent care, that's just where the convenient shifts are.

Well, honestly, I don't see the problem with letting EM PGY 2s moonlight. I think a PGY2 EM resident is far more capable in an EM setting than a PGY 2-3 IM or FM resident. I think the reason my program doesn't allow it is partially geographic and partially due to keeping us in the 60hr work week.

Originally Posted by Law2Doc

It is contract dependent, and hospital policy dependent, not courtesy dependent. The contract you sign for each year of residency can generally be pretty clear about what additional work you are allowed to do, IF ANY, and what kind of permission you need to get before doing it. Some disallow ALL gainful endeavors without explicit written permission by the PD. Some focus only on work that counts toward your duty hour limits. Either way, nobody can answer this for you without taking a gander at your program's contract/hospital policy. There is no global rule.

so what if the contract states to report all moonlighting activities to the PD defining moonlighting as all professional activities outside of the hospital training program! now what the heck professional activity mean here? what if i was running my business or teaching a kaplan class? which are all non medical?

Originally Posted by doc20

so what if the contract states to report all moonlighting activities to the PD defining moonlighting as all professional activities outside of the hospital training program! now what the heck professional activity mean here? what if i was running my business or teaching a kaplan class? which are all non medical?

all good points. IMO what a resident does with his free time is his own business.

moonlighting...as a gensurg prelim I would never do it and I would go over work hours anyway

Originally Posted by HarryGary

... IMO what a resident does with his free time is his own business.

Since your program is limited by duty hours performed outside of your residency, technically its all their time, to dispense with as they see fit. And whether you get to moonlight is up to them, and put in your contract. They own you, professionally, for that year. As for non medical work, it's up to what the contract says and how a court will interpret any ambiguities. Which basically means if you can get PD permission you are home free and if you can't you are running a risk.

Per the ACGME Common Program Requirements:

VI.G.2.c) PGY-1 residents are not permitted to moonlight

Originally Posted by megawhizz

Per the ACGME Common Program Requirements:

That certainly explains a lot. That said, hundreds of PGY-1 residents do it across the country so not only is it not enforced by the ACGME, but some program directors show flagrant disregard for this "common program requirement."

I also wonder if that is a requirement due to the licensing issue. If you are not truly moonlighting in that you are not acting as the attending, then perhaps the activity is not officially "moonlighting."