Can someone please give a definitive answer on the moonlighting situation in California?

[yungspleen]

I've seen it discussed in threads but each of my interviews at california programs have said something different. For those itnerviewing right now, what will our situation be? Do we have to wait until our pgy-4 year to moonlight? What about internal moonlighting? Can we babysit a scanner as a pgy-2 and pgy-3? Very confused by everything I've heard so far.

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[.Asterion]

Legally you have to wait, some programs are creating loopholes to allow residents to moonlight. Basically depends on the program unfortunately.

 

[yungspleen]

Legally you have to wait, some programs are creating loopholes to allow residents to moonlight. Basically depends on the program unfortunately.

So legally you couldn't start until your pgy-4 (R3) year correct? So i guess I just have to hope that my program will allow in-house moonlighting then

 

[mepo12]

really is so crazy to me that they'll allow fresh NP/PA grads to work whatever they want but not let an MD/DO/MBBS who passed step 3 moonlight lol

 

[yungspleen]

really is so crazy to me that they'll allow fresh NP/PA grads to work whatever they want but not let an MD/DO/MBBS who passed step 3 moonlight lol

Gotta love gavin newsom

 

[.Asterion]

Gotta love gavin newsom

But “doctors are rich”

 

[Almighty Saguaro]

I've seen it discussed in threads but each of my interviews at california programs have said something different. For those itnerviewing right now, what will our situation be? Do we have to wait until our pgy-4 year to moonlight? What about internal moonlighting? Can we babysit a scanner as a pgy-2 and pgy-3? Very confused by everything I've heard so far.

I found this explanation on a different forum that I think is helpful:
"To do external moonlighting, you need a full CA license, which you're only eligible for after 36 months of postgraduate training (doesn't seem like doing PGY1 in CA makes a difference). For internal (presumably within your residency program), you don't need a full license, so you can do it as early as R1."

I think that's partly/mostly (?) what explains the differences in what programs are saying: it depends on whether or not they have internal mooonlighting

 

[maxxor]

I found this explanation on a different forum that I think is helpful:
"To do external moonlighting, you need a full CA license, which you're only eligible for after 36 months of postgraduate training (doesn't seem like doing PGY1 in CA makes a difference). For internal (presumably within your residency program), you don't need a full license, so you can do it as early as R1."

I think that's partly/mostly (?) what explains the differences in what programs are saying: it depends on whether or not they have internal mooonlighting

This is peculiar, because in order to provide contrast coverage, I was under the impression you needed a fully licensed physician with a DEA and appropriate independent malpractice coverage to provide contrast coverage.

We got around this for internal-on-hospital-premesis contrast coverage at my residency program by technically saying the ER Radiologist was the person of record for contrast, despite the moonlighter handling the reactions / infiltrations / syncopes / falls independently.

However, for an outpatient imaging center where you are the only physician there, this wouldn't fly.

 

[Splenda88]

really is so crazy to me that they'll allow fresh NP/PA grads to work whatever they want but not let an MD/DO/MBBS who passed step 3 moonlight lol

You gotta love the state of medicine in the US...

 

[SeldingerFan78]

CA, like many states, requires you to have a license to moonlight - it would be hard to function in most moonlighting gigs without one. The difference, as described above, is that CA requires 36 months post-grad training to get your license. It used to be 12 months, so I got mine at the end of intern year.

The other complexity to this question is what is meant by "moonlighting." E.g. we have scanner babysitting shifts at my institution that all rad res years do. It's internal, pays well, and you can use most of the time to study, do research, watch Netflix, etc. In order to do radiology moonlighting where you're actually reading and signing scans, you need to have passed boards (e.g. R4 year/fellows) outside of rare institution-specific things. In terms of general medical moonlighting, e.g., at an urgent care clinic, you just need a license.

 

[RadsRocks!]

CA, like many states, requires you to have a license to moonlight - it would be hard to function in most moonlighting gigs without one. The difference, as described above, is that CA requires 36 months post-grad training to get your license. It used to be 12 months, so I got mine at the end of intern year.

The other complexity to this question is what is meant by "moonlighting." E.g. we have scanner babysitting shifts at my institution that all rad res years do. It's internal, pays well, and you can use most of the time to study, do research, watch Netflix, etc. In order to do radiology moonlighting where you're actually reading and signing scans, you need to have passed boards (e.g. R4 year/fellows) outside of rare institution-specific things. In terms of general medical moonlighting, e.g., at an urgent care clinic, you just need a license.

So most Cali radiology residents in the future will be able to do "internal" contrast reaction moonlighting at satellite centers (what I imagine is most popular form of moonlighting across the country)?

 

[DoctwoB]

It comes down to: are you acting as a resident or as an attending? If the latter , you need a license, period. Which requires 1-3 years of residency, 3 in California. If you are essentially getting paid for picking up extra shifts as a resident (with a supervising licensed attending) you can moonlight.

Not a radiologist, but in my research time in residency residents either chose to moonlight as a CT Surg resident (basically acting as a night float intern with a supervising fellow/attending) or go through the process of getting their independent license and DEA to moonlight as an attending at an outside facility. The latter paid better, but not enough to make it worth my while to get the state license plus DEA on my own dime plus the added liability of practicing as an attending in an area outside my primary scope of practice.