Don't forget that after you pass step III you will then have to apply for a license in that state which takes anywhere from 3 months to 10 months depending on where you are. When you are moonlighting you will also need to carry your own malpractice because your residency coverage is not valid unless it's for residency work.
The license thing is true although 10 months for a simple, first license seems a little dramatic. Assume it will take 2-4 months from start to finish though.
Malpractice is a much more variable situation. I have had 4 different moonlighting gigs. Two of them at my residency institution where I'm covered by the institutional policy. One of them was at a managed care organization hospital where I was included on their standard policy, including tail coverage. The other was at an LTAC with a similar policy. But yes, there are plenty of gigs where you do need your own malpractice coverage, but certainly not all of them.
As for rate of pay:
- University hospitalist service: $65/hr (started off cush, then they changes the admitting pattern and it started sucking pretty hard...I quit signing up for shifts shortly after that)
- University BMT/Onc service: $85-95/hr with $200/shift holiday bonus (works out to $110/h on those days)...can be easy or brutal.
Managed Care Hospitalist service: $100/hr. Constant admitting churn...I admitted 14 patients in one 12 hour shift. I didn't go back after that.
- LTAC: $50/hr for residents, $90/hr for BC physicians. I did a few shifts as a resident. It was easy but didn't pay enough for the hassle.
The best moonlighting pay I'm personally aware of was a friend of mine who moonlighted as an anesthesiologist at a rural hospital in Illinois while she was doing her pain fellowship in Chicago. She worked 1 weekend a month (7a Saturday - 7a Monday) and made $8K/weekend. Usually did a case or two each day, a few OB cases (it was a <100 bed hospital) and generally slept and watched movies.