Moonligting- How are you guys doing it?

[gclax30]

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Right now there is no internal or external moonlighting allowed for anesthesia residents at my particular institution. It has been brought up year after year by residents and always hits a roadblock somewhere beyond our program admins.

So I'm wondering, for those of you who are allowed to moonlight, how are you doing it?

Are you moonlighting in anesthesia doing cases? It would be ideal for us to get more case experience, but I think there would be some interest in covering the ICU or ED.

I've even heard of "moonlighting" to consist of doing a bunch of preops once your cases are done for the day.

Would like to hear about some different set ups, and how you've navigated the medico/legal and reimbursement issues.

 

[periopdoc]

In my experience...

External moonlighting is essentially impossible since you are not boards eligible and you need to be to get privileges. Internal moonlighting is possible, but you have to convince your program. This is really hard unless you have a program that is spending a ton of money on night coverage by non-residents. With all moonlighting activities counting toward your work hours, combined with the increasingly ridiculous work hours restrictions, there is little time available to give to moonlighting. If the residency program can increase your hours without going over the limit, there is nothing to keep them from just doing that as part of your residency work.

You could always look at covering a long-term vent weaning facility that needs a physician on staff at night in case a trach falls out.

I was only able to moonlight during fellowship, because I was board eligible and I was able to hide my moonlighting activity from my program. Had my PD found out, he would have, and should have, come down hard on me for doing it.

- pod

 

[MErc44]

We can moonlight covering OB shifts, in fact it is encouraged and several fellow residents did it multiple times a month. 400 and change for a 12 hour shift, you could also sign up for 24 hours.

 

[gclax30]

Indeed we are shelling out hefty coin for "late" CRNAs who work until 7:00, 9:00, or 11:00 p.m. They start late add-on cases or help finish up late running rooms. We could certainly supplant them with residents who would be MORE than happy to get case experience and make a little extra money. But when your department trains and actively seeks to increase the position of CRNAs in general, it's probably an uphill battle.

 

[Corwin29]

Careful telling your program you would be happy getting the experience of the late cases the CRNA's are paid for, they will let you for free! Periopdoc hit it correctly in my experience you aren't board eligible and would be a huge liability externally doing anesthesia. So internal moonlighting within your program is the safest. Also as he alluded to what your PD doesn't know won't hurt you. You are eligible in most states as an American grad to obtain a license and DEA after intern year/step 3. There are plenty of small town ER's that would appreciate your knowledge of critically sick individuals compared to the family docs they currently work with. Disclaimer this is totally against ACGME and usually your hospitals residency contract, so tsk, tsk.