Chief vs. moonlighting

[Hayduke]

This is for the attending types-
I have a crack at getting a chief spot in my 3rd year. The job is appealing in the service to the program/improve on great training kind of aesthetic. I would also like to see that line on my CV.
My job goal is to land a spot with a democratic group in a busy community center possibly with an off site residency rotation.

Moonlighting has its own appealing characteristics-My family could really use the money and I feel like I need the practice experience before I look at a new job.
At our place, the chief job is a time sucker. Our current gurus clock insane hours for the residency. They have both assured me that moonlighting is not possible with the role as currently designed.

When looking at an applicant, what trumps? Would you rather have a prior chief or someone with independent work experience?

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[turtle md]

I can't answer from the employer POV, but I was not chief and I did a fair amount of moonlighting, and I had many an offer. So I really don't think it matters. Chief looks good, and may be good for academics, but extra $$ is nice and learning to be independant from residency is a huge bonus.

For what it's worth...

 

[kungfufishing]

I work in a community ED with some residency affiliation. I moonlit a lot my last 18 months of residency. In some respects it was the best thing I did educationally during that time. There is no substitute for the buck stopping with you.

 

[txterp98]

This will be the only time in your life to have the opportunity to be a chief resident. If the job is appealing to you, I say go for it. If your family is truly strapped for cash and you need a supplemental income immediately, then that's different and the decision has already been made for you. If you're getting by and things are fine, then don't worry, the money will come.

Moonlighting is great, but the learning curve at a new job is the same for everyone - those that moonlighted and those that did not. That is, how to order labs/imaging, how to follow-up on test results, how to chart, how to admit to medicine, how to call consultants, etc. Even if you do not moonlight, don't worry about it. The job offers will be there and the training you received in residency will have served you well.

 

[emergiQ]

Moonlighting is great, but the learning curve at a new job is the same for everyone - those that moonlighted and those that did not. That is, how to order labs/imaging, how to follow-up on test results, how to chart, how to admit to medicine, how to call consultants, etc. Even if you do not moonlight, don't worry about it. The job offers will be there and the training you received in residency will have served you well.

I think you mean the curve is the same whether you start during residency moonlighting or on day 1 after residency? I mean, this is the point -- do you want to be ready on day 1 because you were moonlighting during residency, or do you want to be post-residency for 6 months first? Personally, I'd rather moonlight and be ready July 1st. And if I'm an employer, I take the gal who was moonlighting 2-3 shifts a month for the last year of residency as opposed to the person who didn't and isn't going to be battle tested until at least September or October.

If you're gonna chase academics, then do the chief year if you're at a program where the PD isn't controlling enough to reduce your job to schedule bit*ch. I do know of one place in metro DC that *only* hires chief residents.

 

[Jeff698]

I was chief and moonlit. It was a double time sink for me but worth it. Toward the end of the year I cut back on my moonlighting to spend more time with my family though.

As for the immediate post-residency learning curve, I felt mine was pretty steep despite moonlighting.

Take care,
Jeff

 

[Hercules]

I was chief and moonlit. It was a double time sink for me but worth it.

Same here. I can't speak for the OP's program, but a chief year and moonlighting are usually not mutually exclusive. Our chiefs are some of our heaviest moonlighters. So I'd recommend having your cake and eating it too if possible.

 

[deleted65604]

I neither moonlit, nor was chief resident. I don't think either would have prepared me better for my job. I'm glad I spent extra time with my family, studied, and exercised rather than moonlighting and wasting time doing the schedule, going to meetings, etc.

 

[roja]

If its one or the other, and you want to work in an academic or semi-academic center, you should place chief first. Jobs will assume you have gotten plenty of experience in your residency (otherwise they shouldn't be graduating you).

In the academic world, here is how the trump cards fall:

fellowship>chief>residency>moonlighting.

The issue of money may take more precedence and only you can ascertain this.

 

[GeneralVeers]

As a former chief, I can say having the title on your application will help you get a job in some more competitive areas. If you are not a chief, you will probably have no problem getting an interview at 99% of all jobs.

Moonlighting is great, and if you bank that extra salary you can buy a house/car immediately after residency.

I wasn't able to moonlight during residency, and ended up having to wait 6 months to purchase a home.

 

[Speed Racer]

I keep dreading that I am going to be offered a chief spot because as it stands now, I would have to find a way to delicately turn it down. I'm just not interested. Maybe I can auto sabotage and drop hints that I dont want to be one.

Not that I'm wonderful and think I deserve it, but other people have been dropping hints that I may land in the spot.

I respect the chiefs and think its a tough job, just not for me.

If you do not see yourself doing academics, then I think you may have answered your question. Make some money and take care of your family. Good Luck.

 

[GeneralVeers]

I keep dreading that I am going to be offered a chief spot because as it stands now, I would have to find a way to delicately turn it down. I'm just not interested. Maybe I can auto sabotage and drop hints that I dont want to be one.

Not that I'm wonderful and think I deserve it, but other people have been dropping hints that I may land in the spot.

I respect the chiefs and think its a tough job, just not for me.

If you do not see yourself doing academics, then I think you may have answered your question. Make some money and take care of your family. Good Luck.

If I could go back in time, I would not have done the job. The amount of crap I had to take, the constant whining from interns, and the pointless busiwork which consumed hours of my time only to be overturned by the PD, made it not fulfilling.

 

[12R34Y]

I'm currently one of the chiefs at my program and moonlight quite heavily at 3 different places.

I wouldn't trade moonlighting for anything. I do stuff on my own that we always consult for in our academic ED. Very procedure heavy experience.
Nice to get the private practice feel and working with a totally different patient population.

Enjoy the money tremendously AND it is invaluable to me to help hone my "how will I practice" feel to my training.

I enjoy having autonomy and it definately keeps the last part of my residency training bareable as I look forward to seeing "the real world" from time to time.

I say do both if you want.

the good thing about being a chief is that you generally (at least we do) get a shift break and have MORE time away from clinical work to do admin stuff, but if you are time efficient you can easily moonlight.

I wouldn't change a thing and have no regrets (neither does my back account).

later

 

[Aloha Kid]

Poor reasons to be chief: "It looks good on my resume"

Poor reasons to moonlight: "I'm not confident in my skills (aka my program FAILED ME), My Mercedes needs repairs."

 

[EctopicFetus]

FWIW im a chief and moonlight as well. Also, I looked into some jobs and the one I accepted is incredibly competetive and has only hired chiefs in the past 5 years. That job is the exception but everywhere I went it was mentioned.

All that being said everyone mentioned moonlighting as well and everyone i spoke with thought it was a good idea.

 

[Hayduke]

Thank you.
What great responses. I very much appreciate your time and input.

I want both. Now I just need to see if it is realistic.

Does anyone else find it interesting that there are at least 5 frequent posters who also have the chief belt?
H