Moonlighting 101

Though opportunities to moonlight are on the upswing, fewer residents and young doctors are taking advantage of them, creating a messy void. Residents who do moonlight, however, can significantly boost their income and lessen the financial strains nearly all face.

By By Marcia Layton Turner | Fall 2010 | Feature Articles


Brett Yockey, M.D.

Brett Yockey, M.D., moonlights at a rural hospital in addition to his residency rotations. Both the extra money and extra responsibility that moonlighting can provide can be beneficial to young physicians.

Two weekends a month, Brett Yockey, M.D., a third-year radiology resident at Indiana University in Indianapolis, gets in his car and drives two hours south to run the emergency room at a rural hospital.

Although he earns $4,000 a month as a resident, one 12-hour shift at the community hospital generates an additional $1,260—$105 per hour. And with a wife, two children, and $170,000 in student loans, that extra money isn’t just nice—it’s necessary.

Yockey isn’t the only doctor to tack additional shifts onto his already busy residency rotations. In fact, other residents from his program make the same two-hour trek to that hospital, although not all residents at Indiana University are permitted to moonlight.

Emergency residents, for example, are prohibited from performing any additional medical services outside their residency, which may be why the need for emergency room help existed in the first place at the community hospital.

Leon Aussprung, M.D., J.D., LLM, moonlighted during his residency at Thomas Jefferson University Hospital in Philadelphia and later as an attending physician while enrolled in law school. Aussprung often picked up extra shifts generally filled by residents. There simply weren’t enough residents to meet the hospital’s need for coverage, he explains, and his pediatric residency program permitted moonlighting. So he worked a few night shifts at Thomas Jefferson and other hospitals in the Christiana Care system.

To qualify for these additional shifts, Yockey and Aussprung had to hold a permanent license, which involves completing the first year of residency and passing a “Step 3” licensing exam. With that, Yockey was permitted to stand in for emergency room physicians on weekend shifts, and Aussprung often manned the neonatal intensive care unit (NICU).

Not all moonlighting opportunities require a permanent license, however. As a second-year family practice resident at Boston University (BU), Michael Noonan, D.O., discovered he was eligible to moonlight at the residency facility where he was based as long as he was already doing rotations there. To work anywhere outside BU’s hospital system, however, he needed an unrestricted, or permanent, license.

Finding work
So Noonan began exploring moonlighting opportunities to make some extra cash, and discovered fairly quickly that he could pick up extra shifts in admissions at his hospital. From the middle of his second year of residency to the end of his third year, he admitted patients to the hospital and assisted in morning rounds.

He would work 12- to 14-hour shifts, generally 7 a.m. to 7 p.m. on Saturdays and Sundays, one to three times a month. In exchange, he earned $75 per hour, or about $2,700 for those three shifts, which, he points out, “was about what I  was making after taxes as a resident.” That additional cash “can be a huge differential for a person in residency,” he says.

Aussprung also started his search for moonlighting work internally and had no trouble finding it. His residency director routinely alerted the residents in his program to moonlighting opportunities—shifts that needed filling within the hospital—and he pursued it. He could make about $1,000 working a 24-hour weekend shift, and frequently did.

Yockey contacted headhunters in the Indianapolis area to find his moonlighting gig, who inquired about openings he might be qualified to fill. Most hospitals wanted a board-certified physician, he reports, which he wasn’t. But one headhunter had a hospital willing to accept a doctor without those credentials. He got the job.

Noonan reports that physician staffing groups frequently have part-time work appropriate for residents and are a popular place for residents to begin their search. Although he did not approach them about moonlighting opportunities, placement services such as these are a smart starting point.


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