Moonlighting in 2nd or 3rd year

[Hanson]

Hi,

Many residents on my interviewing trail told me that as an IMG they can only do it after they have done 3 years of residency. Can your program director give you permission to break this rule?

Thanks,
Hanson

[teratos]

Yes, you can. Depends on the state though. Moonlighting is usually reserved for those with an unrestricted license. Laws vary from state to state regarding the number of years in residency one must to do qualify for an unrestricted license, and there are usually differences in the laws regarding IMGs. For example, im Maryland you can get a license after 2 years of residency. After that it often depends on whether your program director is in favor of allowing you to moonlight. I know many people who moonlighted WITHOUT their program directors knowldge, so I know that is a possibility as well. Also, many places offer in-house moonlighting opportunities. My hospital pays $65/hour for us to cover the non-teaching medical service. Doing admissions and taking care of problems with patients. Busy, but the extra check is really nice. Lastly, the RRC has alimit of 80 hours/week a resident can work. They are supposed to be really gung-ho about it in July. Moonlighting is included in that 80 hours. Hope that helps a bit....sorry for rambling, it's early. G

[Hanson]

Dr. Teratos,

Thanks for the great info. Moonlighting is a great way to learn and earn. I have heard that mal practice insurance is very high. Did you have the same problem?

Thanks,
Hanson

[teratos]

It seems, in my area at least, that the institutions where you moonlight cover the malpractice. You'd have to look around, but I bet you can find the same deal. G

[ResearchingGuy]

I've read of a number of residencies that offer "in-house" moonlighting opportunities. In your experience Dr. Durst, do you have to have a full license and your own malpractice insurance or is a "training" license and insurance from your program all that is needed.

I know that's a broad question but you seemed to touch on that in your post.

Thanks!

Best of Luck!

[FLK]

By In house, I assume you are referring to moonlighting Within the framework of your residency......an example would be a paid night float. you function as a resident, but you get paid extra. Many places have this set up.
It is not even necessary to have an unrestricted state license....malpractice is covered by your program

Out of the framework of your residency is different. you need a full unrestricted license to practice medicine. you are on your own.

depending on the job, the hospital will pay you an hourly rate and they take care of the malpractice coverage......of course, you are payingfor it. it just comes off the hourly rate.
there is an increasing need for hospitalists, and this is once common scenario...covering an inpatient unit on nights and weekends.

other types of moonlighting can be working in a physician's office.
they either add you to their malpractice policy or you buy your own.

To give you my own example: I moonlight at two different hospitals ( in a hospitalist capacity )

One job, I am employed by the hospital, and paid an hourly rate. they take care of the malpractice coverage.

The other group is a PC, and I pay for my own malpractice coverage ( which is about 20,000$/yr)

Guess which one pays more?
:D

[Hanson]

One job, I am employed by the hospital, and paid an hourly rate. they take care of the malpractice coverage.

The other group is a PC, and I pay for my own malpractice coverage ( which is about 20,000$/yr)

Guess which one pays more?
:D

My guess is the PC pays more but since you have to pay for insurance they come out to be equal. :lol:

[FLK]

the hospitalist job pays 60 an hourt

he PC pays 120 an hour on top of what they take out for my malpractice ( they cut out the middle man! )

[teratos]

The moonlighting I do is "in house". We work in our own institution, and function as a night float, taking care of admissions and emergencies on the non-teaching service. All you need is your training license and the malpractice is taken care of. We make $65/hour, which is competitive with moonlighting jobs in the area that require an unrestricted license. I'm not sure what the deal is with malpractice at those places, so I can't honestly comment. I think you have to supply your own coverage. G

[ResearchingGuy]

Thanks for the info on moonlighting guys. I know its still a little ways down the road for me but you can never plan too far ahead (in my opinion).

-RG

[Kirst]

Good stuff!

I always thought that licensure in any state for practice required a completed residency training AND a certification from the specialty board. With a degree alone, I thought one won't be able to qualify for a job anywhere except by residency programs.

[Daniel]

i just checked the emory internal medicine website and they stated that IMGs in georgia cannot sit for step 3 until 33 months into the residency...AND that they cant get an unrestricted license to practice until 3 years AFTER step 3! wow. kind of strict if you ask me. quite a difference from the requirements of US med grads.

[teratos]

There is often a big difference there. Doesn't make much sense does it? Some places allow "in-house" moonlighting, and you don't need an unrestricted license. I'm not sure how common that is. Having a license sure opens up a lot of doors in terms of extra money. On the other hand, it may make step 3 easier to pass, especially if you are doing IM or FP. I took step 3 after 2.5 years of IM residency and smoked it without studying a single thing. The test covered what I do every day, and at a more elementary level. G

[Anne Butsch MD]

Remember there are lots of different kinds of moonlighting, and each has its own set of rules, which will also vary by institution and by state.

For instance, even first year FMGs can moonlight in our program, doing certain things such as disability physicals (pays about $200 per physical), psych admits (about $60 per physical) or doing sports physicals for various programs (about $100-200 per session which runs 2-4 hours).

Then there is in-house moonlighting, which also includes working the ER (about $60 per hour). That is available to anyone who has completed their internship year. A full license is not required and malpractice insurance is covered under the umbrella residency policy.

"Real moonlighting" which is often working off-site in ERs or walk-in clinics requires an unrestricted license and you must arrange for malpractice coverage (it's usually provided, but you're still responsible for making sure you're covered). A few states will grant an unrestricted license to FMGs after 1 year of residency, a fair number allow it after 2 years and even more require 3 years. The residency programs themselves also may have restrictions. Many prohibit moonlighting at all. Do your homework.

[FLK]

i just checked the emory internal medicine website and they stated that IMGs in georgia cannot sit for step 3 until 33 months into the residency...AND that they cant get an unrestricted license to practice until 3 years AFTER step 3! wow. kind of strict if you ask me. quite a difference from the requirements of US med grads.


wow you must really like Georgia to take such a huge pay cut!

check out locum tenens opportunities in other states.

when living in Texas, I used to fly to Michigan one weekend a month to do a 3 day stint in -house .....and make more money than I was paid for a month as a fellow

there are lots of options.
too bad AMSA and other interests screwed everybody with this 80 hr / week max crap!!!!!

[futurestudentmay03]

Mind sharing what you were doing your fellowship in, what hospital you were moonlighting, how much you were getting paid moonlighting, and where your completing your fellowship/residency and what medical school you attended. Thank You so much!

[FLK]

sorry for the delay.

fellowship was Baylor coll of med in Houston.

used to work ( moonlighting at a variety of community hospitals) in Detroit