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armpit of america.
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Title says it all. Can you moonlight as an attending as a 2nd year cap fellow or regular fellow? Thank you.


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Aug 9, 2012
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yes, if your fellowship doesn't have policies against it, and if you can find a moonlighting opportunity, and if you have malpractice coverage.... may also need your own DEA license

Will definitely need your own DEA. Many places wanting moonlighters will provide the malpractice including tail (or case based) although some positions you would need to get your own coverage (which is very reasonably priced when its specifically for low hour/week moonlighting as a fellow). I really recommend doing this, its providing a huge change to my daily practice as a CF2. I enjoy being supervised a bit more now that I know what it's like to be an attending and I think I will hit the ground running a bit easier in my first full time job.


Title says it all. Can you moonlight as an attending as a 2nd year cap fellow or regular fellow? Thank you.

1. Not a stupid question
2. You can moonlight as early as your 2nd year of residency, depending on your State's licensing laws/regulations and training program's rules.
I started moonlighting as a 3rd yr resident and actually made more that year than most of the staff attendings (their salaries are public) in my program since their contracts prohibited moonlighting. Interesting how that can turn out. I do recall one attending who moonlighted despite his contract- a blind eye was turned because he was a machine and wasn't so easily replaced.
I think by fellowship it's probably the norm to be moonlighting to some degree, but I'm sure it varies.
3. True, what everyone says about having your own DEA, but I can't see how you can become a 2nd year CAP fellow and still be using the institutional DEA. But who knows, weirder things have occurred I'm sure.
4. Get out there and moonlight already- you'll be so glad once you start. It's really a necessary part of the process of becoming an independent practitioner.
5. As already mentioned, the term "attending" in a training sense refers to a physician with staff privileges at a hospital with a training program. In the non-training world, it's essentially any physician who has admission privileges at a hospital. I'd venture a guess and say that most private practice psychiatrists (who accept insurance) are technically "attendings" at their local hospital with the idea being that one would admit their own patients when they met inpt criteria. However, (and this includes myself) few shrinks actually admit and round on their own pts, and when someone needs to be admitted you coordinate care with whatever ED they're heading to. Main reason is that it doesn't pay to wake up early, commute to the hospital, then return to outpt clinic. Or having to take calls from nurses in the middle of the night. Or committee work. Or taking unattached ED call. Being an "attending" (i.e. having staff privileges), is necessary to get on some insurance panels which is why many of us have it but don't do inpt work. Re: committees, I've refused and was still given credentials, so they're negotiable on some points (being BE/BC, having a clean record, etc are likely not negotiable).
But no, you cannot be an "attending" in the training program sense while still in training- even fellowship. However, you can get paneled with some insurance companies because as a 2nd yr fellow you've completed residency. The point here being that once you're paneled you can rent an office, slap your name on a shingle, and start your journey to being your own boss!
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