Moonlighting as a resident

[swamprat]

Any1 do any? What setting was it in? Urgent care? ER? Both? I'm looking into it currently being in my last year of residency. Also for those that have done it, was it worth it? Did you feel comfortable with your knowledge base and skills?

On the financial side of things, it seems a lot of these gigs are 1099. For those that are financial savvy, can I write off my DEA license cost as a "business expense" ? I know you can for gas and what not, just wondering general rules.

---

Members don't see this ad.

 

[Tenk]

Moonlighting is great, I think all EM residents should do it. I started moonlighting in an ER at the end of my second year. I did not like urgent care very much, so I did that for like a few shifts and got annoyed. Try to start off in a smaller hospital out in the boonies that doesn't have a lot of patients. That way 1) you won't feel overwhelmed and 2) you can work people up or hold onto them if you are unsure of your decision. Always remember your home attendings are there to back you up 24/7 if you're in a bind. From an attending view you can REALLY see the difference in a third year resident who has done moonlighting and one who hasn't. It is like night and day. Good luck.

 

[Hercules]

Any1 do any? What setting was it in? Urgent care? ER? Both? I'm looking into it currently being in my last year of residency. Also for those that have done it, was it worth it? Did you feel comfortable with your knowledge base and skills?

On the financial side of things, it seems a lot of these gigs are 1099. For those that are financial savvy, can I write off my DEA license cost as a "business expense" ? I know you can for gas and what not, just wondering general rules.

Attendants who didn't moonlight in residency will tell you it's not important. Attendings who did moonlight in residency will tell you it was a good experience for them and lucrative as well. It will help expose the holes in your knowledge base better than any residency shifts.

Having hired residents who moonlit and ones who didn't, it makes a significant difference in how long it takes them to get up to speed in their first attending job. That makes sense. If you show up on your first day of work with 1400 hrs (which would be a lot) of moonlighting experience, you're arriving with a full year of attending experience.


Sent from my iPhone using SDN mobile

 

[da8s0859q]

Any1 do any? What setting was it in? Urgent care? ER? Both? I'm looking into it currently being in my last year of residency. Also for those that have done it, was it worth it? Did you feel comfortable with your knowledge base and skills?

On the financial side of things, it seems a lot of these gigs are 1099. For those that are financial savvy, can I write off my DEA license cost as a "business expense" ? I know you can for gas and what not, just wondering general rules.

I did. ED. Very worth it. Felt comfortable doing it with the catch that it made me acutely aware of needing to "come into my own," so to speak. Makes you develop in ways residency may not. Hard to explain, best appreciated by doing.

Wasn't a 1099 gig for me, so somebody else will have to help there, but I am very glad I picked up some moonlighting before finishing residency. Valuable stuff even while still a resident -- can only assume I'll say the same for attending shifts which start next month.

 

[winkleweizen]

I did it. One more rural Er and one more community. It was A great experience and I learned more doing it then during the rest of third year, probably. I did write my dea off on my taxes

 

[The White Coat Investor]

Attendants who didn't moonlight in residency will tell you it's not important. Attendings who did moonlight in residency will tell you it was a good experience for them and lucrative as well. It will help expose the holes in your knowledge base better than any residency shifts.

Let me be a dissenting opinion here. I moonlighted for 10 shifts, all in the last 6 months of residency. The extra money was nice, but obviously not some lifechanging amount of money. I think they were 12s paid at $80 (this was a while back.) So the gross was something like $10K, and I paid a surprisingly high tax rate on that money. It certainly felt uncomfortable as I did not yet feel "fully trained" even though the amount of learning left to do as a resident was small. I certainly learned more in my first year out as an attending than I did that last six months of residency including the moonlighting. Did I learn something? Probably. Did I have a little extra money at a time in life when it was really useful? Sure. Not something to get worked up over either way. When we hire we don't care if you moonlighted or not. We care far more about the reputation of your residency. So if you want to moonlight, then moonlight. If you don't, don't and don't worry about not doing it. Not a big deal either way. We occasionally have a moonlighter work with us. Most are fellows but a few are PGY3s. We only put them on the double covered shifts so there is always one of us around. But that's mostly just for their comfort and ours. They do just fine.

One thing I'd consider before moonlighting is the philosophy. We say emergency medicine should be practice by those who are "fully trained" in it. That an IM or FP residency isn't accurate. When you go out and moonlight without full completing an EM residency you are denigrating the value of that residency training. Whether that bothers you or not only you can tell.

 

[swamprat]

Let me be a dissenting opinion here. I moonlighted for 10 shifts, all in the last 6 months of residency. The extra money was nice, but obviously not some lifechanging amount of money. I think they were 12s paid at $80 (this was a while back.) So the gross was something like $10K, and I paid a surprisingly high tax rate on that money. It certainly felt uncomfortable as I did not yet feel "fully trained" even though the amount of learning left to do as a resident was small. I certainly learned more in my first year out as an attending than I did that last six months of residency including the moonlighting. Did I learn something? Probably. Did I have a little extra money at a time in life when it was really useful? Sure. Not something to get worked up over either way. When we hire we don't care if you moonlighted or not. We care far more about the reputation of your residency. So if you want to moonlight, then moonlight. If you don't, don't and don't worry about not doing it. Not a big deal either way. We occasionally have a moonlighter work with us. Most are fellows but a few are PGY3s. We only put them on the double covered shifts so there is always one of us around. But that's mostly just for their comfort and ours. They do just fine.

One thing I'd consider before moonlighting is the philosophy. We say emergency medicine should be practice by those who are "fully trained" in it. That an IM or FP residency isn't accurate. When you go out and moonlight without full completing an EM residency you are denigrating the value of that residency training. Whether that bothers you or not only you can tell.

That is one thing I agree with. I however still think a PGY3 EM resident is better at EM than a FP or IM doc just by nature of all we do is EM. The moonlighting opportunity I have will be urgent care, which I feel is a nice middle ground and the pay is ok, not great. Do you have any idea about 1099 and DEA # being a work related expense that can be written off?

 

[bravotwozero]

Licensing expenses, including DEA numbers, are all completely tax deductible as a 1099/IC, even if you are an employee at another gig


Sent from my iPhone using Tapatalk

 

[The White Coat Investor]

That is one thing I agree with. I however still think a PGY3 EM resident is better at EM than a FP or IM doc just by nature of all we do is EM. The moonlighting opportunity I have will be urgent care, which I feel is a nice middle ground and the pay is ok, not great. Do you have any idea about 1099 and DEA # being a work related expense that can be written off?

Most residents, particularly PGY2s, overestimate their ability to do EM. Stay humble, lots to learn even after residency. Those first two years out have a steeper learning curve than your PGY3 year.

 

[RustedFox]

I didn't moonlight during residency. I just valued my time off a lot. I didn't want to wake up early to go to some urgent care/ER out in the sticks. My then-girlfriend (now wife) and I both were working, and we weren't totally strapped for cash. We lived in a very affordable midwest city and had a small but adequate apartment. I didn't feel "naked and afraid" when I hit attendinghood. YMMV.

 

[Mighty Mouse]

I worked in a pretty middle of nowhere ER, 24 hour shifts, 1-2 times per month, $110/hr (2009-2010). money was nice, but wouldn't have broken me if I didn't do it. did find value in getting comfortable making decisions without the safety net of an attending. would have gotten there anyway, but perhaps this accelerated it. definitely feel like it made me more confident and able to staff residents and students when hired into an academic job right out of residency. the volume in this place was pretty chill -- i don't think the degree of acuity is what's important. it was the realization that I could turn and burn an ear infection in 2 minutes. it was the realization that I didn't have someone saying "are you sure you want to send this person home?" or "are you sure they don't need a scan?"

some of my residency colleagues put themselves in bad positions. moonlighting at other shops desperate for coverage for ridiculous cash ($250+/hr) but putting themselves in very dangerous positions -- malignant admitting staff causing them to discharge patients they weren't comfortable sending home, working overnight shifts elsewhere and then showing up directly for a morning shift in the residency ED. don't be that guy.

if afforded the opportunity, pick the right shop, make some cash, gain experience, and don't get greedy or push the boundaries of what is reasonable for you to be doing for your level of training.

 

[Hercules]

Let me be a dissenting opinion here. I moonlighted for 10 shifts, all in the last 6 months of residency. The extra money was nice, but obviously not some lifechanging amount of money. I think they were 12s paid at $80 (this was a while back.) So the gross was something like $10K, and I paid a surprisingly high tax rate on that money. It certainly felt uncomfortable as I did not yet feel "fully trained" even though the amount of learning left to do as a resident was small. I certainly learned more in my first year out as an attending than I did that last six months of residency including the moonlighting. Did I learn something? Probably. Did I have a little extra money at a time in life when it was really useful? Sure. Not something to get worked up over either way. When we hire we don't care if you moonlighted or not. We care far more about the reputation of your residency. So if you want to moonlight, then moonlight. If you don't, don't and don't worry about not doing it. Not a big deal either way. We occasionally have a moonlighter work with us. Most are fellows but a few are PGY3s. We only put them on the double covered shifts so there is always one of us around. But that's mostly just for their comfort and ours. They do just fine.

One thing I'd consider before moonlighting is the philosophy. We say emergency medicine should be practice by those who are "fully trained" in it. That an IM or FP residency isn't accurate. When you go out and moonlight without full completing an EM residency you are denigrating the value of that residency training. Whether that bothers you or not only you can tell.

I think it helps to hear the differing personal experiences and viewpoints. My personal experience was that I mainly worked 24s in about 7 different rural ED for $150+/hr netting an extra $100k+ moonlighting in residency. That was a significant amount of extra income for me and a significant amount of experience.

It sounds like your group has had a very different hiring experience than we have. We have docs from a variety of residency programs (Carolinas, Arizona, UAB, Jacksonville, etc) and the training program and its reputation so far have had no major relation to their ability to function at a high level on arrival. The only variable that seems to impact that for us is moonlighting experience.

As far as the philosophical argument, I think it sounds great philosophically but I trained in a state that was predominantly rural and only had about 1 in 6 ED physicians that are EM trained. Having worked in many of these rural EDs I can tell you that having a senior EM resident in those places is vastly superior to having the retired alcoholic ophthalmologist (not kidding). I feel that a senior EM resident is actually promoting the specialty as the nursing staff and house staff saw the major differences in our skill sets compared to their usual non-boarded docs. I also am firmly of the opinion that some EM residents are ready to practice independently after 2 to 2.5 years and some might not truly be ready after 5 years. Unfortunately you can't individualize training length and have to pick an arbitrary amount of time. So the difference to me in moonlighting on the last day of your residency program or working as an attending the first day after graduation is not significant.

I'm certainly not saying my viewpoint is the only correct one, but it's always interesting to see how each of us come to our differing viewpoints on this issue.

 

[leviathan]

^^ Interestingly in Canada the residencies are moving towards competency-based evaluations, so you finish residency when deemed 'competent' for everything in your specialty, which could be shorter or longer than what the length is currently set at.

 

[Got Em]

Didn't want to start a new thread.

Have residents moonlighted in a different state before? For example, if your residency is on the East Coast and you would like to moonlight in Texas, how difficult would this arrangement be?

 

[gutonc]

Didn't want to start a new thread.

Have residents moonlighted in a different state before? For example, if your residency is on the East Coast and you would like to moonlight in Texas, how difficult would this arrangement be?

How exactly, from a logistical perspective, are you going to work this? Are you planning to go (I assume home) to TX all 3 of your weeks of vacation and moonlight during them?

I guess if you can get your TX license, and find a place to hire you like that, it's possible that it could happen. Seems unlikely though.

 

[Boatswain2PA]

Let me be a dissenting opinion here. I moonlighted for 10 shifts, all in the last 6 months of residency. The extra money was nice, but obviously not some lifechanging amount of money. I think they were 12s paid at $80 (this was a while back.) So the gross was something like $10K, and I paid a surprisingly high tax rate on that money. It certainly felt uncomfortable as I did not yet feel "fully trained" even though the amount of learning left to do as a resident was small. I certainly learned more in my first year out as an attending than I did that last six months of residency including the moonlighting. Did I learn something? Probably. Did I have a little extra money at a time in life when it was really useful? Sure. Not something to get worked up over either way. When we hire we don't care if you moonlighted or not. We care far more about the reputation of your residency. So if you want to moonlight, then moonlight. If you don't, don't and don't worry about not doing it. Not a big deal either way. We occasionally have a moonlighter work with us. Most are fellows but a few are PGY3s. We only put them on the double covered shifts so there is always one of us around. But that's mostly just for their comfort and ours. They do just fine.

One thing I'd consider before moonlighting is the philosophy. We say emergency medicine should be practice by those who are "fully trained" in it. That an IM or FP residency isn't accurate. When you go out and moonlight without full completing an EM residency you are denigrating the value of that residency training. Whether that bothers you or not only you can tell.

To piggyback on what Hercules said...my state has well over 100 hospitals, and I believe only TWELVE of these use BC EPs. Of these twelve, I believe only three exclusively use BC EPs (I work at one of them). Few of these hospitals could afford to pay a BC EP what you demand an hour while you sleep and see just a few patients a day. Many of these hospitals will take anyone with a license and a pulse...and the pulse may not necessarily be required.

 

[Got Em]

How exactly, from a logistical perspective, are you going to work this? Are you planning to go (I assume home) to TX all 3 of your weeks of vacation and moonlight during them?

I guess if you can get your TX license, and find a place to hire you like that, it's possible that it could happen. Seems unlikely though.

Some of the 4 year programs I'm looking at has 4 weeks of vacation and 8 weeks of electives for both 3rd and 4th year. Also, PGY-4 year is usually a lot lighter which allows for ample moonlighting opportunities.

I guess this isn't commonly done.

 

[deleted77919]

…

 

[SansaStarkMD]

^^ Interestingly in Canada the residencies are moving towards competency-based evaluations, so you finish residency when deemed 'competent' for everything in your specialty, which could be shorter or longer than what the length is currently set at.

Sounds like getting a phd in the states. Residents would be abused here.

 

[heroesinahalfshell]

I moonlighted at 3 different places during my 3rd year, an urgent care center, freestanding ED, and a decent sized community hospital to not only make money but also experience a few different work environments and see what I like/don't like. I enjoyed the experience and helped me figure out some of the non-medicine side of running an ED. One thing I will caution you is to be careful in regards to what you are paid. I feel many places take advantage of residents yet expect them to do just as many patients as fully trained docs.

 

[Got Em]

Vacation sure.

I don't think most places will allow you to choose "moonlighting" as an elective.

This is not what I'm implying. I can do my electives in a different state and will have more time to moonlight.

It seems like this isn't really common, so my question is has anyone done this before?

 

[swamprat]

Some of the 4 year programs I'm looking at has 4 weeks of vacation and 8 weeks of electives for both 3rd and 4th year. Also, PGY-4 year is usually a lot lighter which allows for ample moonlighting opportunities.

I guess this isn't commonly done.

I have a better idea. Go to a 3 year program and work as an attending in the fourth year. Problem solved.


Sent from my iPhone using SDN mobile

 

[hundreddaysoff]

Didn't want to start a new thread.

Have residents moonlighted in a different state before? For example, if your residency is on the East Coast and you would like to moonlight in Texas, how difficult would this arrangement be?

I'm doing exactly this, and it was pretty straightforward to set up. Many programs (both 3 and 4-year) have elective month(s) in the last 1--2 years. Most residents in my program choose to use this as a reading month to prep for the boards and vacation in some exotic place for a month. I'm gonna take this reading month and also moonlight on the side. My PD, at least, was completely cool with this.

Of course, you'll need a license in the state where you want to moonlight...

 

[namethatsmell]

Of course, you'll need a license in the state where you want to moonlight...

And check your residency state's Medical board rules since many make you replace your training license with a full license if you get one in another state.


Sent from my iPhone using SDN mobile

 

[Snowdon48]

I got civilian deferred for EM this year (AF) and read in my contract that you aren't allowed to moonlight during residency. Is there any way around this? I'd love to have that option like my civilian counterparts will.


Sent from my iPhone using SDN mobile

 

[Doctor Bob]

I got civilian deferred for EM this year (AF) and read in my contract that you aren't allowed to moonlight during residency. Is there any way around this? I'd love to have that option like my civilian counterparts will.

Get your PD to lie about it. At the beginning of every year your PD will have to fill out a form attesting to your current academic standing. The form also says that your PD cannot allow you to moonlight and they have to sign the form agreeing to that. So they need to sign the form, then let you do it anyways.

 

[Snowdon48]

Get your PD to lie about it. At the beginning of every year your PD will have to fill out a form attesting to your current academic standing. The form also says that your PD cannot allow you to moonlight and they have to sign the form agreeing to that. So they need to sign the form, then let you do it anyways.

I see. I wonder what their reasoning is for prohibiting moonlighting. Doesn't seem like they would be taking on any liability if I'm not in a mil program or sponsored by the military.


Sent from my iPhone using SDN mobile

 

[deleted547339]

I see. I wonder what their reasoning is for prohibiting moonlighting. Doesn't seem like they would be taking on any liability if I'm not in a mil program or sponsored by the military.


Sent from my iPhone using SDN mobile

Yea, but if you screw up and lose your ability to practice, they lose. Also, they have some incentive to keep you from moonlighting in that they could feel it will detract from your training ultimately.

 

[zero0]

I think it helps to hear the differing personal experiences and viewpoints. My personal experience was that I mainly worked 24s in about 7 different rural ED for $150+/hr netting an extra $100k+ moonlighting in residency. That was a significant amount of extra income for me and a significant amount of experience.

It sounds like your group has had a very different hiring experience than we have. We have docs from a variety of residency programs (Carolinas, Arizona, UAB, Jacksonville, etc) and the training program and its reputation so far have had no major relation to their ability to function at a high level on arrival. The only variable that seems to impact that for us is moonlighting experience.

As far as the philosophical argument, I think it sounds great philosophically but I trained in a state that was predominantly rural and only had about 1 in 6 ED physicians that are EM trained. Having worked in many of these rural EDs I can tell you that having a senior EM resident in those places is vastly superior to having the retired alcoholic ophthalmologist (not kidding). I feel that a senior EM resident is actually promoting the specialty as the nursing staff and house staff saw the major differences in our skill sets compared to their usual non-boarded docs. I also am firmly of the opinion that some EM residents are ready to practice independently after 2 to 2.5 years and some might not truly be ready after 5 years. Unfortunately you can't individualize training length and have to pick an arbitrary amount of time. So the difference to me in moonlighting on the last day of your residency program or working as an attending the first day after graduation is not significant.

I'm certainly not saying my viewpoint is the only correct one, but it's always interesting to see how each of us come to our differing viewpoints on this issue.

Sorry to necrobump, but as someone who's halfway through med school and really doesn't feel like putting life on hold for another 5+ years, I'm wondering how feasible is it to moonlight for an extra 100k, or even 50k a year? It's always been down to gas and EM for me, even before med school, and this might just tip the odds in EM's favor. Fickle maybe, but it's the truth.

 

[Money Moniker]

Sorry to necrobump, but as someone who's halfway through med school and really doesn't feel like putting life on hold for another 5+ years, I'm wondering how feasible is it to moonlight for an extra 100k, or even 50k a year? It's always been down to gas and EM for me, even before med school, and this might just tip the odds in EM's favor. Fickle maybe, but it's the truth.

Very interested in this as well, for precisely the same reason.

 

[OneTwoThreeFour]

Sorry to necrobump, but as someone who's halfway through med school and really doesn't feel like putting life on hold for another 5+ years, I'm wondering how feasible is it to moonlight for an extra 100k, or even 50k a year? It's always been down to gas and EM for me, even before med school, and this might just tip the odds in EM's favor. Fickle maybe, but it's the truth.

Most programs don't allow moonlighting until the last year of residency and even then you aren't allowed to violate ACGME duty hours while doing so. It would be unlikely to have the chance to do more than 1, maybe 2 shifts a week (particularly in a 3 year residency when that last year is pretty packed). Even then the rates aren't amazing from what I've heard-tops at $120/hr if I remember my residency interviews correctly. 120*8=1000 a shift, after taxes closer to 500- if my back-of-the-napkin math is at all accurate you could top out at an extra 20-30k if you're religious about finding & taking the opportunities.
I think the opportunity to moonlight in the last year is a nice plus to EM, especially in the four-year residencies when the last year is a little lighter-but shouldn't be a deciding factor for anyone.

 

[alpinism]

You could moonlight for around $80 per hour at some of the community hospitals near my residency.

Assuming you work an extra 4 shifts per month that's only an extra 30K per year best case scenario.

 

[hundreddaysoff]

Sorry to necrobump, but as someone who's halfway through med school and really doesn't feel like putting life on hold for another 5+ years, I'm wondering how feasible is it to moonlight for an extra 100k, or even 50k a year? It's always been down to gas and EM for me, even before med school, and this might just tip the odds in EM's favor. Fickle maybe, but it's the truth.

First you need to get into a program that either allows moonlighting or whose PD and multiple attendings are willing to lie about it. You'll probably need 3 letters of rec from attendings to moonlight.

(At the end of the day, this will be the biggest hurdle since for most of us mere mortals, which EM residency you match into is basically a crapshoot. This is also the most important reason why you shouldn't choose EM over gas for residency moonlighting potential, unless you only plan to apply to the EM programs that allow moonlighting, which would be a silly decision.)

Then you need a medical license in all the states in which you want to moonlight as well as DEA number(s). Pretty easy assuming you've finished intern year and went to a US medical school. If you're FMG, might be harder.

Assuming you can do that, $50--100K/y is quite feasible, especially if you are OK violating duty hours and either hiding it from your PD or your PD is complicit. (I did not do this myself and am not recommending this, mind you... I'm just saying. You will get in big trouble if your PD cares and catches you doing this, since the PD will get in big trouble if ACGME catches you doing it. I think most PDs probably care quite a lot about this.)

The second-biggest hurdle to making the big bucks is that for various silly reasons, your residency work schedule for each month will likely be published *after* the schedules for your moonlighting places have been published. So you risk being double-booked on your moonlighting shifts. Having the chops to arbitrarily trade shifts with other residents as well as being willing to violate duty hours (I am not recommending this!) goes a long way. As I mentioned in my post above, most residencies also have a reading month in the final year during which you can basically go wherever you want and moonlight a bunch.

I went to residency in the northeast and moonlighted at one local site for $130/h and another for $170/h and then at my attending job in TX for significantly more. Pulled ~80K in R3, much of it tax-free directly to my retirement accounts. Could easily have pulled six figures if I was less scrupulous about duty hours and didn't land a girlfriend halfway through R3.

BTW, if you want to FIRE and start building your nest egg a little early, this is a minor argument in favor of signing the early attending contract as an independent contractor. Then you'll have access to your very own 401(k) and cash balance plan that you can start filling up in residency, both with the sign-on bonus and with possible moonlighting at your attending job and any other IC gigs you can land.

Good luck!

 

[swamprat]

Well I was the original poster - I would def moonlight. It was nice having extra cash. Good experience made it more comfortable transitioning to attendinghood. I think I did violate hours but I never logged my moonlighting hours I just got permission to moonlight signed off by the powers that be and then no one asked or said anything to me. Money isn’t great in comparison to when you are done and working as a full fledged attending but it’s way more than what u have as a resident so I felt rich.

 

[emergentmd]

I would definitely put moonlighting as a top priority when picking residencies. You can prob find places that will pay $100/hr. I started in my 2nd yr doing moonlighting but I think most should wait til 3rd

 

[deleted109597]

And check your residency state's Medical board rules since many make you replace your training license with a full license if you get one in another state.

Yes it's almost 2 years old, but I feel like this needs clarification.
Unless you're moonlighting in-house, you'll need a full license to moonlight anywhere, regardless of whether it's in another state. You'll need a full license in every state you work.

 

[GonnaBeADoc2222]

I really don't think the ability to moonlight should be a deciding factor in what specialty you choose to pursue (all else equal, I don't think it's an unreasonable differentiating factor to use between individual training programs within a said speciality). This is pretty foolish. You're really going to let the potential ability to generate an extra 80k in one year of residency determine your life's career path???

Moonlighting was great for me. I picked up 2-4 shifts a month in an urgent care type setting for a little over $100/hr. Gave a nice little income cushion.

I think it gives you great experience in making independent decisions. However, do not be fooled. This is NOT a training ground. If you choose to moonlight, you choose to assume the full responsibility for everything that happens. I don't think it's wise for anyone below PGY-3 to moonlight.

Also, please don't violate duty hours - it's just not worth it. And don't be that person who calls out sick to their residency shift so that they can go work their double booked moonlighting shift. You just risk ruining it for everyone if you do this.

 

[emergentmd]

There was a doc in my program that moonlighted 5-8 shifts a month during her ER months. Crazy and she would pay docs to cover her residency shifts for her.

Everyone knew about it, the program included and no one really cared.

It was much more wild wild west back then but it was common knowledge she was pulling in around 150K/yr

 

[GonnaBeADoc2222]

There was a doc in my program that moonlighted 5-8 shifts a month during her ER months. Crazy and she would pay docs to cover her residency shifts for her.

Everyone knew about it, the program included and no one really cared.

It was much more wild wild west back then but it was common knowledge she was pulling in around 150K/yr

If they were allowing this, why require her to show up to shifts at all? Why not just graduate after PGY1?

What's the point of residency training then? Are we just going to concede that residency training doesn't matter? If that's the case, then we've just completely cheapened the value of our degree and training and should just hire midlevels for pennies / hour to staff every ED position.

 

[zero0]

I would definitely put moonlighting as a top priority when picking residencies. You can prob find places that will pay $100/hr. I started in my 2nd yr doing moonlighting but I think most should wait til 3rd

It does feel a little silly but yeah I intend to make it a top priority. The main attraction of any EM residency to me is that it will make me board eligible in 3 years. Otherwise, as long as they aren't notorious for working their residents to death, I don't care how bad their cafeteria food is or how much there is to do in Winston-Salem. Beach would be nice but my guess is those EDs would have no shortage of help and moonlighting rates would be low.

 

[Jlaw]

Moonlighting will make you a stronger resident, nothing is going to make you think harder than knowing you are alone. It is very easy to phone it in and under or over work pts when you aren't the one signing the chart, especially as a third year who knows their attendings and can ape their practice style and get through a shift without having to think. I personally think everyone should moonlight outside their depts as third years for a few shifts, if for no other reason than to scare them into working and studying harder during third year. Moonlighting gigs pay varies depending on responsibility. PGY3's can moonlight at my shop for 60-100/hr (dependent on how desperate the dept is)...you act as a MLP in this capacity and will present every patient to an attending so you take no risk. You can drive a few hours out of town and clear 200-250 acting as an attending and signing your own charts.

 

[emergentmd]

If they were allowing this, why require her to show up to shifts at all? Why not just graduate after PGY1?

What's the point of residency training then? Are we just going to concede that residency training doesn't matter? If that's the case, then we've just completely cheapened the value of our degree and training and should just hire midlevels for pennies / hour to staff every ED position.

Not saying this was right and surely admin turned the other way. But it was the wild wild west back then and would surely not fly now. Also, it was just one resident that I knew who did this and I don't believe she did it very often. I am sure she only did this when they gave some big bonus and she may have just switched ER shifts..... but for the right $$$, I am sure she had some covered.

Jlaw - Moonlighting was as much and sometimes more educational than doing residency. I learned so much about decision making and being confident when moonlighting.