Moonlighting in Residency

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I had a few questions about moonlighting during peds residency that I was hoping someone might possibly know the answer to.

1. What type of work is typically available for those moonlighting? I.e. is it outpatient, urgent care, or hospitalist/inpatient type of work?

2. For those residents with the opportunity to moonlight, how many hours per week on average do you moonlight?

3. What does moonlighting typically pay per hour? And how much more per year can one earn on top of their residency salary?

4. For the programs that allow moonlighting, do most residents participate or do they prefer to use their limited free time elsewhere?

Originally Posted by Turkelton

I had a few questions about moonlighting during peds residency that I was hoping someone might possibly know the answer to.

1. What type of work is typically available for those moonlighting? I.e. is it outpatient, urgent care, or hospitalist/inpatient type of work?

2. For those residents with the opportunity to moonlight, how many hours per week on average do you moonlight?

3. What does moonlighting typically pay per hour? And how much more per year can one earn on top of their residency salary?

4. For the programs that allow moonlighting, do most residents participate or do they prefer to use their limited free time elsewhere?

1. Generally it is hospitalist work or ER work. Most urgent care places that I know of wont take peds moonlighters unless its attached to a pediatric ER or something. I've heard of some academic or peds clinics having moonlighters, but we didnt have that at my program.

2. During elective months you might be able to get in 20 hours a week. During wards, PICU, ER or other service heavy rotations they wont let you moonlight at all and if you get caught, they could suspend/fire you.

3. I've seen pay rates from $50 per hour to $80 per hour. Its hard to estimate how much you could add to your annual salary. Remember that you can only moonlight during certain months -- you cant do it year round.

4. I'd estimate at my program that about 30-40% of the residents did moonlighting in some capacity.


Here's a few things to consider:

1. In most states you have to have a full medical license to moonlight. A training license wont be good enough.
2. Malpractice coverage policies vary; in house moonlighting is much easier to arrange due to this. If you try to go outside for moonlighting, you'll have to get your own policy
3. Many/most/all program directors wont allow interns to moonlight
4. Some program directors wont allow moonlighting at all

Originally Posted by Socrates25

1. Generally it is hospitalist work or ER work. Most urgent care places that I know of wont take peds moonlighters unless its attached to a pediatric ER or something. I've heard of some academic or peds clinics having moonlighters, but we didnt have that at my program.

I'd also add nursery coverage too. Sort of a nursery only hospitalist which would involve going to deliveries and the like.

My feeling is that moonlighting is getting very hard to do with limited work hours. Remember that you've got to fit everything into your limitations, including moonlighting hours.

Originally Posted by Turkelton

I had a few questions about moonlighting during peds residency that I was hoping someone might possibly know the answer to.

1. What type of work is typically available for those moonlighting? I.e. is it outpatient, urgent care, or hospitalist/inpatient type of work?

2. For those residents with the opportunity to moonlight, how many hours per week on average do you moonlight?

3. What does moonlighting typically pay per hour? And how much more per year can one earn on top of their residency salary?

4. For the programs that allow moonlighting, do most residents participate or do they prefer to use their limited free time elsewhere?

Keep in mind that there are some programs that have moonlighting within the program - workhours are kept in check better, but it also gives you the opportunity to earn extra money without worrying about med mal coverage or license issues. A number of programs have residents/fellows on their transport teams, and others include things like sports medicine (being on-field MD for local junior high or HS sports) or afterhours school/sports physicals. Pay ranges that I'm aware of include transport shifts that pay $10/hr if you don't go out on a call (that bumps to $70/hr while transporting a patient) or a flat $50/hr for all opportunities with in a program.

When programs have intra-program moonlighting, the number of residents that participate will depend on what the opportunities are - the gung-ho gen peds people likely aren't interested in picking up critically ill patients, while the critical care types may not be thrilled with doing well-child check after well-child check. If the program has lots of options to appease everyone, then a higher % will moonlight. Of course, if doing physicals were the only option, perhaps even those people who are going into NICU/PICU/Cards may spend significant time doing well-child checks.

Personally, I earned a little bit less than a 1/4 of my total income from moonlighting last year. But I had a number of very laid back elective months where I was aggressive in getting moonlighting shifts last year.