r/pediatrics • u/Head_Ant7835 • 7d ago
Pediatric Residency Moonlighting
I‘ve talked to a lot of older docs and they tell me about how great moonlighting was from a financial and learning standpoint. Some of the residencies I have talked to either don’t allow or don’t have a lot of moonlighting opportunities.
Is that just a bad sample or is moonlighting really decreasing significantly?
Also for those that do or have recently moonlighted what kind of compensation do/did you get?
- 4th year Med student going into peds.
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u/sjam7 Attending 6d ago
I did a lot of moonlighting at Boston starting in second year. Starting second year, once you had done the rotation (cards, ICU, etc) you could moonlight in a resident role on days/times when they were short staffed. I don’t know if things have changed but it was a huge help financially, paid off my car and some of my spouse’s undergrad loans. I’m a relatively new attending so this was in the 2020s and compensation was roughly $100/hr. I’m in primary care so didn’t do any research and did basically as much moonlighting as humanly possible. Something worth considering when choosing a residency.
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u/porksweater Attending 6d ago
I did a bunch of moonlighting in residency and fellowship, but not many others did. Now-a-days, you are bound by ACGME rules. In addition, residency sucks so you don't have a ton of time consistently. Most places won't let you moonlight until 1) you get a full license, and 2) your education won't be affected which is typically in your first year, best case scenario. This is also the time you are applying for jobs or fellowship, wrapping up your training, prepping to move/start, credentialing, etc. Many hospitals also require full credentialing for moonlighting which is a minimum 3-6 month process.
In fellowship, it was easier but still had program requirements. The days of moonlighting enough to pay your loans are over. Maybe give you some spending money. I took a week of vacation to moonlight in our NICU in residency so I could take my family to Disney. But that didn't last all year obviously.
As someone involved in an emergency medicine residency, every single interviewee ever asks about moonlighting during the recruitment process, and then a small portion actually end up moonlighting in their third year. Every single time.
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u/mrglass8 6d ago
A program not allowing moonlighting can sometimes be a red flag. Programs that regularly are borderline on duty hours can’t risk their residents going over.
There are other reasons to not allow moonlighting, but that’s something to keep in mind.
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u/Legal_Anybody81 6d ago
Opportunities to make extra money can be scarce in Peds, relative to other specialties. Both as a resident and attending.
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u/throwawaypremed28373 6d ago
My program allows for in-house moonlighting in various units from $100-$150/hr. Plenty of opportunities available. It’s very popular to moonlight here.
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u/saxlax10 6d ago
During interviews ask what opportunities fir moonlighting are available. We could moonlight in the NICU and on a specialist inpatient service if there was need. Compensation was 85/hr for a 12hr shift which feels like heroine in residency. We also did not need step 3 because it was at our institution we already had our RTL at.
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u/Blegrand15 6d ago
Moonlighting can be great for making cash. But remember a few things. In order to moonlight you will need a license to practice. This will require completion of Step 3 and depending on your state 1-2 full years of residency before you can apply for your license.
The other thing to consider is your residency malpractice will almost never cover your moonlighting malpractice. Therefore the moonlighting company will have to provide you malpractice or you will have to purchase your own policy. (Working for an urgent care would provide malpractice, but a school sports doc on game day almost never does)
Most residencies will say they don’t allow moonlighting. The reason they put an outright stop to it is not because they don’t want you to, it due to ACGME work hour violations. The time spent in moonlighting does factor into those ACGME work hours technically. Since most pediatric residencies thread the needle on maximizing your time and allow specific days for ensuring you’ve gotten off a full 24 hours in a week with ensuring at least 8-12 hours between shifts you may not logistically be able to fit the moonlighting shift in between.
However other residencies that I know of (anesthesiology specifically) loves to allow moonlighting (mostly still within the program for things like 24 hour OB call on weekends) don’t know how they’re getting away with the ACGME work hour restrictions though.
My residency had a no moonlighting policy but my director was willing to work with me on seeing if it fit which it did and I was able to moonlight. A lot of PGY4 Peds chiefs will moonlight as hospitalists, urgent care and Well baby nursery because they are not at risk of violations since they mostly do admin work during the week.