Not too long ago I was having a discussion with an EM attending at my medical school about moonlighting. He felt that it was inappropriate for residents to moonlight, unsupervised, in the ED because he believed that it undermines the specialty-that is, if an incompletely trained EM resident is permitted to independently practice EM then the argument for rigorous training and board certification is substantially weakened. He took it even further stating that non-EM residents were often moonlighting independently which of course, to his way of thinking, weakens further the argument that EM is unique and requires specific training. His take home point was, moonlighting is unsafe for the patient, and is bad for the maturation of the specialty. However, in talking to EM residents about this, I find that there is both a substantial financial incentive and educational incentive toward moonlighting. The financial incentive is obvious so I won't belabor it. But, I was surprised by the comments about the educational advantages. I heard comments that independent practice forces one to galvanize their knowledge base and also leads to many discussions with attendings about particular cases that substantially facilitate learning. What are your thoughts on residents moonlighting in the ED? BTW, I did a quick search about this topic and didn't really find what I was looking for. If this has already been discussed at length please excuse me and point me in the right direction. Additional disclaimer, I'm not attempting to argue a point but am genuinely interested in what people think about this issue. Personally, I see both sides and as an incoming EM resident I like the idea of being able to make extra money doing what I enjoy and what I am in training for...but, on the other hand...Thoughts?