Resident moonlighting

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bkell101

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For those residency programs out there with moonlighting, what is the pay structure? How much do you get paid to hold the pager and how much do you get paid to come in? Thanks!!

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My program used to pay $50/hr for one 8-10hr shift doing anesthesia during the day on Sat/Sun. Anyone with good academic standing was eligible after the first 6months of CA1 year. On rare occasion they had CTICU nights available for around 1000-1200/night (I never took any of these shifts). They used to occasionally have home pager call on weekends at one of the smaller hospitals $100/24hr pager call plus $50/hr if you got called in but that went away my CA2 year. I finalized my spreadsheet a few months ago, I moonlighted just shy of 350 hours over a two year period. It's not much $$ but an extra 8-10k/year really helped when I was raising a family on a resident salary.
 
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At Wake we get $60 an hour to cover a small hospital who does predominantly day surgeries but has to keep some people in house. Weekdays its from 6:00pm til 5:15 am and weekends are 24 hour shifts. Pays $500 post tax for week day shifts and $1000 for weekend shifts. Pretty sweet gig. We are literally only here (I am here now) for emergencies because they must keep a physician in house and we are cheaper than the alternative. I'd say I get called one in every fifteen shifts and it is usually for an unobtainable IV that I put an 18 gauge into in five minutes and go back to my call room. Have had one serious call (likely PE) in doing it for about a year and a half now. I use this time moonlighting predominantly studying or doing work on my research (or watching college/NFL football if its that time of year).

You can also moonlight internally for $75 an hour on Fridays and weekends, but you will work for that. Or carry peds pager for $10/hr and make $75/hr if called in.
 
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My program made us take so much f*cking call (about 72 calls per year for every damn year) there was no time or energy left to moonlight. And it was prohibited anyway so we would be free to take more call.

We did get OT for being stuck in the OR after 5pm, but it was just $50/hr and often for less than 2h over, so I usually just tried to run away at 3pm and never get forced into OT. F*uck that ****.

However, there are programs where seniors take call a few times per year (instead of a few times per week), and they can moonlight all the time and make $100k per year.
 
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At my program, do in-house moonlighting (late-duty) for $60 per hour for a 4 hour block (5-9pm). If it is a light day and we get done with cases before 9 then we still get paid for the block. If we stay past 9 then we get paid for a full two hours (whether we work two hours or not).

Our program is now starting to phase in a program where the pre-call resident is late duty (works till 9pm) and gets paid $240 pre tax. The following day the resident comes in at 3pm and is on call in-house until 7am the following day.
 
$70/hr after 3pm starting CA-1 yr. 5 residents per day, released on a staggered schedule until cases are done. Also beeper liver and critical care transport at the same rate.
 
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My program... Ccf... Was 80$/hr past 6pm. I think it was 800$ for sat or sun day call... 7-5ish. They also offered seniors some extra ICU call depending on need for the same rates.
 
Holy crap. I'm totally getting screwed. We have CA1 late call and you're in the OR till 8-9pm and that is at least once maybe twice a week. No options for moonlighting or making extra dough. LAME.
 
Why is the moonlighting rate in Anesthesia so low? Psych residents get 100-120 an hour.
 
Because it just needs to be slightly better than slave labor.
 
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We didn't have regular late moonlighting at my program. It was all extra call that was paid depending on your year. Weekdays was 7p-7a and weekends were 24h or 12h split. It was only extra if beyond 6 calls per month (Beyond 2 weekends).

I took a lot of call ... But sometimes what made doing this worth it was the post-call day in addition to the extra cash.
 
$70/hr after 3pm starting CA-1 yr. 5 residents per day, released on a staggered schedule until cases are done. Also beeper liver and critical care transport at the same rate.
Thats a pretty sweet deal
 
Careful, external moonlighting is often explicitly forbidden in a lot of residency and fellowship contracts. I know of two (non-anesthesia) residents at my institution who had their contracts terminated at the end of the year for violating the policy. I know a lot of people do it, but be smart.

... did you really resurrect a 3 year old thread to post about this?
 
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why does anesthesia tend to pay lower moonlighting rates relative to EM (200-300/hr), FM ( 100ish/hr), or psych moonlighting rates?
 
why does anesthesia tend to pay lower moonlighting rates relative to EM (200-300/hr), FM ( 100ish/hr), or psych moonlighting rates?
That's what people will work for. If people won't work for those rates, the rates will go up. Supply vs demand.

After finishing internship I would locum for $300/hr as basically an intern in ED. Was absolutely ridiculous, but that's what the demand was.
 
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why does anesthesia tend to pay lower moonlighting rates relative to EM (200-300/hr), FM ( 100ish/hr), or psych moonlighting rates?

That's what people will work for. If people won't work for those rates, the rates will go up. Supply vs demand.

After finishing internship I would locum for $300/hr as basically an intern in ED. Was absolutely ridiculous, but that's what the demand was.

Also depends on attending rates. It's supply vs demand but also how much it compares to attending salary. 300/hr is 2x+ attending's hourly salary for anesthesiology. So they aren't going to offer anesthesia resident 300/hr ...

And at the same time, at least we have moonlighting. Many specialties do not have much opportunity to moonlight at all.. many surgical specialties would go over 80 hrs/week if they moonlighted so they can't moonlight. Medicine moonlight pays more, but is also harder to come by and often only give it to senior residents.
 
why does anesthesia tend to pay lower moonlighting rates relative to EM (200-300/hr), FM ( 100ish/hr), or psych moonlighting rates?

Highly, HIGHLY variable among institutions. I moonlit in the ED a few times, and it paid worse than our own internal moonlighting ($60 vs $90/hr). I don’t know much about FM or Psych moonlighting (how does one moonlight in primary care?), but even my external ED gig in fellowship doesn’t net me $300/hr at a community center and that’s as staff. At rates that high hospitals are better off just hiring mid levels to fill the gaps.

And agreed about having moonlighting opportunities. Several of my co-fellows trained at programs where there were no opportunities at all.
 
We sure as **** can't moonlight in the Army...then again we are paid better...especially with 8 years of prior service and BAH. Muahahahahaha #IsoldmylifetotheArmy.
 
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That's what people will work for. If people won't work for those rates, the rates will go up. Supply vs demand.

After finishing internship I would locum for $300/hr as basically an intern in ED. Was absolutely ridiculous, but that's what the demand was.

I didnt know you could moonlight in the ED as an anesthesia resident! Interesting to know.
 
Can moonlight in ICU for $100/hr.

Or carry pager for a small nearby hospital on weekend. $5/hr for weekend and then $45/hr if you get called in for a case, which is usually a Lap Chole or Appy cause any big stuff goes to the mothership
 
Can moonlight in ICU for $100/hr.

Or carry pager for a small nearby hospital on weekend. $5/hr for weekend and then $45/hr if you get called in for a case, which is usually a Lap Chole or Appy cause any big stuff goes to the mothership
The 45 bucks an hour that’s not internal moonlighting sounds terrible.
 
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I'm surprised there isn't more interaction with anesthesia in the ED here... Boggles my mind actually.
 
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We get $100/hr on weekend in the ICU or OR. There are some that go to our smaller hospital and get $125 for doing hospital medicine admissions, def not worth the next 2/hr IMO.
 
The program I matched to "doesn't allow moonlighting" even though all of the CA-3's do it and were open about it. It was external and 2 of them found sweet gigs at a low key urgent care that paid $125 an hour to send anything serious down the road to the ED.

Hoping these opportunities are still there for me when the time comes because I just got my total student loan debt number from my mortgage application and holy ****.
 
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The program I matched to "doesn't allow moonlighting" even though all of the CA-3's do it and were open about it. It was external and 2 of them found sweet gigs at a low key urgent care that paid $125 an hour to send anything serious down the road to the ED.

Hoping these opportunities are still there for me when the time comes because I just got my total student loan debt number from my mortgage application and holy ****.

I'm hoping for same but I'm not counting on it. Random flotsam and jetsam shifts where they take any "officially qualified" warm body seem like they'll be among the first casualties of exploding midlevel numbers. Why pay an EM resident $200/hr when you can get a PA or NP to staff that shift for $50/hr. The only thing that's limiting this phenomenon so far is that midlevel numbers are still relatively small compared to the physician workforce, but as their numbers grow they'll begin to absorb more and more workload which will seriously erode opportunities in low acuity, low volume settings that are the bread and butter of resident moonlighting.
 
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Why pay an EM resident $200/hr when you can get a PA or NP to staff that shift for $50/hr.

Because a lot of places still require a doc to be in the house. That's exactly the case where current residents at my program are working.
 
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