Moonlighting?

[RudyRayMoore]

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Can PGY2 (Rad1) moonlight and if so what type of renumeration should one expect?

If anyone has any information on the subject, please post here or send me a private message.

Any advice you can provide will be enormously appreciated.

 

[hans19]

Can PGY2 (Rad1) moonlight and if so what type of renumeration should one expect?

If anyone has any information on the subject, please post here or send me a private message.

Any advice you can provide will be enormously appreciated.

Yes, there are PGY2/R1s that moonlight.
For the best information about moonlighting, talk to the residents in your program. If you're not a resident yet, then its irrelavent until you find out where you've matched.

Whether or not PGY2/R1s can moonlight during residency depends on a variety of factors:

1. It depends on the radiology market where your residency is located.
Is there a demand for someone who basically as an R1 doesn't know jack-shizzle about radiogizzle, hasn't even taken physics, writtens, or oral board? If you are lucky enough to have a moonlighting opportunity as an R1 the type of work you do will be limited-- contrast reaction coverage or clinical work.

2. Some programs don't allow moonlighting at all. Some programs only allow seniors to moonlight. Others don't mind as long as you have the PD's blessing. If you moonlight they may want to you keep under 80 hrs/wk inclusive of your residency responsibilities.

3. Some places require you to have a state medical license and your own malpractice, others have built-in or in-house moonlighting (no extra license or insurance required).

4. The amount of renumeration varies depending on what it is you are doing (official reads vs prelim reads vs contrast reactions vs clinical moonlighting). Again, this also depends on the market for the type of radiology services in demand in your area. The amount can be anything from nice (a little extra spending cash at the end of the month) to lucrative.

Once again, if you've matched then talk to your senior residents and they'll tell you whats up. If you haven't matched yet, its totally irrelavant until you know exactly where you'll be.

 

[f_w]

As an R1, you won't find anyone crazy enough to let you moonlight in the sense that you provide actual reads.

What many people do in R1, is to 'babysit' an outpatient imaging center. According to ACR standards (and in most cases state law), a physician or other 'appropriately qualified licensed independent practicioner' has to be present during any contrast injection. This is mainly geared towards the recognition and treatment of untoward effects of iodinated contrast, but many people interpret it in a way that it also applies to Gd contrast for MRI (however unlikely a bad reaction is). In order to be able to bill for contrast MRIs and CTs after hours, many radiology groups will cough up the money to have a rads resident or family practice doc sit there and read books.

This pays far less than moonlighting in R3 or R4 (e.g. covering a smaller hospital for the weekend providing primary reads). It typically still pays far more than bagging groceries at the PigglyWiggly and it is far less painful than babysitting the CCU to make up for the IM residents who don't rotate there anymore.

You will need a state medical license for most types of moonlighting activities that are not somehow defined to be part of your residency program (typically as a USG you can get a full license after PGY-1)

Be sure to have some sort of malpractice coverage, typically on a 'locums' basis under the groups contract that owns the imaging center. If you DO have a contrast reaction and you are not covered, you might end up holding the bag. (your residency programs hospital will deny ever having met you).

 

[Amxcvbcv]

What many people do in R1, is to 'babysit' an outpatient imaging center. According to ACR standards (and in most cases state law), a physician or other 'appropriately qualified licensed independent practicioner' has to be present during any contrast injection. This is mainly geared towards the recognition and treatment of untoward effects of iodinated contrast, but many people interpret it in a way that it also applies to Gd contrast for MRI (however unlikely a bad reaction is). In order to be able to bill for contrast MRIs and CTs after hours, many radiology groups will cough up the money to have a rads resident or family practice doc sit there and read books.

What qualifies as present? I've been working as a volunteer at a local regional hospital's radiology department, and they don't have a radiologist on staff. When the techs administer contrast they're the only one in the room with the patient, and the closest physician is the ER doc that's maybe 30 seconds away if he runs. Surely radiology techs don't qualify as "appropriately qualified licensed independent practicioners".

Just curious...

I obviously don't know much about it, except to say that I'm as confident as anyone can be prior to medical school that I want to go into radiology. 😀

 

[f_w]

> What qualifies as present?

Good question. Plenty of malpractice $$ have been spent on sorting out what the semantic meaning of phrases like 'immidiately available' and 'present' is.

This is less of an issue in a hospital setting. If a patient comes from the ED and there is no radiologist in house, commonly the ED physician is considered the 'responsible physician' for the contrast administration. On inpatients in hospitals that don't have residents or hospitalists this can be a problem. An admitting private doc or the radiologist who live 30min away definitely won't qualify as 'present'. Either people act completely ignorant to the issue (most), or they have some agreement with the ED to cover these patients.

In some states (I believe NY) a rad-tech is not allowed to give IV contrast in the first place. The button on the power injector has to pe pressed by a physician or RN. And you are right, while the RT is expected to be able to recognize the signs of contrast reactions, they are not trained/credentialed to treat such a reaction.

The 'babysitting' thing is mainly for outpatient imaging centers.