Residency is an exciting opportunity to get in-depth training within your chosen medical specialty. But these years also come with challenges. Residents are typically required to work long hours while earning just a fraction of what licensed physician’s make. At the same time, you likely have living expenses to cover, plus a mountain of education debt to pay back. This leads many residents to consider medical moonlighting as a way to bring in extra income.
Moonlighting simply means working a second job in addition to a primary job. For residents, it can be a chance to not only earn extra money, but also gain experience in new settings and broaden your career horizons. But there are also some significant downsides to consider. Here’s what residents need to know about medical moonlighting.
How Does Medical Moonlighting Work?
Medical moonlighting essentially means working a second job as an independent physician while still being in residency. Residents often take on moonlighting jobs to supplement their salaries, pay down student loan debt, and to get additional experience and practice beyond their responsibilities in their residency program.
Many medical moonlighting jobs fall under the category of what’s called “locum tenens” jobs, where you substitute for other medical professionals that are out on leave or help provide additional coverage at hospitals that are temporarily short-staffed. Often, you are able to pick and choose shifts that work with your schedule.
While moonlighting might seem like the perfect solution to financial stress, the policies and restrictions on resident moonlighting can be tricky to navigate. While residents who are licensed physicians are legally allowed to take on jobs providing medical care, residency programs typically have their own policies on whether residents can take on extra work.
Some programs prohibit moonlighting entirely, while others might limit moonlighting to residents further along in the program. Many programs will require you to get prior permission from a supervisor before you start moonlighting and you may have to formally state your reasons and goals for moonlighting.
Some residency programs allow you to take moonlighting shifts at the hospital facility where you are currently working, but you may be restricted from taking work outside of your hospital network.
Also keep in mind that the Accreditation Council for Graduate Medical Education (ACGME) guidelines state that residents have an 80 hour weekly limit, on average, over each four-week period, with at least 10 hours of rest between duty hours. Plus, one of every seven days must be free of patient care duties and educational obligations.
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There Are Two Ways to Moonlight
There are two types of medical moonlighting that residents can pursue: internal and external.
Internal moonlighting involves working extra shifts at the hospital where you are primarily employed as a resident. External moonlighting, by contrast, means picking up extra shifts at a clinic, a practice, an urgent care center, or a different hospital than where you’re training.
External positions are usually locum tenens. Both residents and physicians can work locum tenens jobs, and residents often prefer these jobs to taking on an external part-time job with a single employer. For one reason, they provide flexibility and don’t require having an independent medical license (as opposed to a training license), your own malpractice insurance, or having privileges at a specific hospital.
Pros and Cons of Moonlighting in Residency
Medical moonlighting has benefits and drawbacks. Here’s a closer look at reasons for and against moonlighting in residency.
Advantages of Moonlighting During Residency
Earn Extra Income
Taking on a few moonlighting shifts per month can add up to substantial extra income — especially on a resident’s salary. As for how much money you can make moonlighting in residency, the answer will depend on the type of work you end up doing and the area you’re in. The average pay range is $100-$200 per hour, depending on the location and job duties.
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Gain Valuable Experience
You might be able to get experience that you don’t typically get in your residency program or you may get additional practice with certain skills or procedures. The extra hours in another area of the hospital — or in another hospital nearby — can give you insight into how other units operate.
The more experience you get, the more robust your resume will become. A great resume can lead to more job opportunities in the future.
Test Out Different Practice Settings
There are many types of workplaces physicians can choose to work in. Moonlighting offers the opportunity to test out some different settings, such as group practices, private practices, urgent care centers, and community clinics.
When your residency ends and it’s time to find a full-time job, having experience in more than one healthcare setting may help guide you toward (or away from) certain types of workplaces.
Expand Your Network
Moonlighting can provide the opportunity to work with more professionals in your field. If you choose external moonlighting, you may be able to develop relationships with physicians, residents, administrators, and other healthcare providers who you wouldn’t otherwise meet in your residency program. Expanding your network can expand your future career opportunities.
Disadvantages of Moonlighting During Residency
Less Free Time
As a resident, you’re likely already working long hours on a grueling schedule while also trying to hone your skills in your chosen specialty. On top of your current workload, even an extra shift here and there can mean you lose out on time with friends and family — or precious sleep.
More Stress
Taking on too much work can lead to mistakes and high stress levels. If you’re earning extra cash now but the quality of your work in your residency is compromised, moonlighting might not be worth it for you. As a resident, your first job is to learn, practice your skills, and build a foundation for your career. It can be a bit of a balancing act.
Medical Malpractice Coverage
With an internal moonlighting position, you’ll work under your training license and have liability coverage and protection under your residency program’s malpractice policy. But external moonlighting might require you to purchase a pricey professional liability insurance policy that you may or may not be able to afford.
Some locum tenens staffing agencies provide malpractice insurance but you’ll want to make sure the coverage is sufficient.
Could Raise Your Monthly Loan Payments
If you’re paying back your student loans on an income-driven repayment (IDR) plan, moonlighting can increase your monthly payments. Under an IDR plan, you pay a percentage of your income. The more income you earn, generally the higher your payments will be.
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How to Start Moonlighting in Residency
So, you’ve weighed the pros and cons, looked into your program and institution policies, and want to move forward with medical moonlighting. How do you find moonlighting opportunities?
If your hospital offers internal moonlighting shifts, that can be a good place to start your search. Internal moonlighting lets you work under your existing training license and malpractice insurance coverage.
If internal shifts are not available or you prefer to work external positions, you can find them through locum tenens staffing agencies. You can also find moonlighting opportunities through online job boards, such as:
• Moonlighting.org
• ZipRecruiter
• Indeed
• ResidentMoonlighting.com
Moonlighting jobs are available for physicians that work in a variety of medical specialties. It’s just a matter of finding ones available in your area. You might also consider using moonlighting as an opportunity to work in a more generalized specialty, like internal medicine, rather than looking for positions in their more specialized field.
The Takeaway
Moonlighting as a resident can help you earn extra money and start paying down medical school debt, while also gaining more practical experience. But before you start moonlighting in residency, you’ll want to make sure your medical school allows it. You’ll also need to monitor your working hours to ensure you’re following the ACGME 80-hour work week policy. Any internal or external moonlighting you do will be considered part of that 80-hour work week.
If you decide to move forward with medical moonlighting, you can start exploring your options and looking for a moonlighting gig that you think you’ll enjoy, that pays well, and that continues to give you more experience.
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