Moonlighting Issues: Visa, Hours, State, License

Moonlighting, as most of you already know, refers to a physician working extra hours over and above his primary job responsibility. It's a real cool way to learn and earn some dough - averaging 65 to 75 $ per hour ! It's called Moonlighting since these are usually done in the evening night hours.

Having said that, let us also add that there are two main types of Moonlighting : In-House or Internal Moonlighting (i.e. in the same facility that you are working as a resident or fellow) and the Real ,External Moonlighting (i.e. working at an outside facility)

Lets go over some restrictions, rules and issues applicable to IMGs, FMGs and American Medical Grads on Moonlight:

1. Visa Issues:

J1-visa holders are NOT permitted to Moonlight :-( . Read the ECFMG statement on this Here. [Rules are rules - You gotta play by them YET, on public forums, you are bound to find J1 Residents / Fellows mentioning that they broke the law at their own risk ....Money always lures.. ;-)]

On the other hand, H1B visa holders are allowed to Moonlight, provided they are not breaking the other rules mentioned below.

2. State Rules:

You are allowed to moonlight if you have have an Unrestricted State License to do so in that specific state. Yes you guessed it right, even though this country is called United States, each State has it's own rules on almost everything ..LOL . While some states like Maryland allow you to Moonlight even after two years into Residency, while other states (e.g. Georgia) can be more strict , allowing IMGs to Moonlight only 2-3 years after residency.

3. Residency Program Rules:

And then, ofcourse, there is always the need for permission from the program director - you don't want to lose your position in your quest for some extra $ right ? Again, you are bound to find folks breaking the rule and bringing home extra $ behind the director's back ;-)

4. RRC Resident/Fellow Work-Hours Rules:

Lastly, note that the Residency Review Council (RRC) has passed regulations that residents are NOT allowed to work more than 80 hours a week, for most specialties . While this may seem like a blessing to some over-burdened residents, the downside is the 80 hour Rule INCLUDES Internal Moonlighting hours and restricts money making - did I hear you say "Damn !!" ;-)

Thus, isn't moonlighting one of the reasons why a physician shortage is good for us ...

Another thing, if you are negotiating with a facility about Moonlighting, make sure you ask about malpractice coverage - not all hospitals will cover you for malpractice. But then again, places that don't cover malpractice typically also pay higher...

Forget the money part, most residents who have moonlighted with agree - moonlighting makes you professionally mature and a proactive learner as you throw yourself into an environment with no attendings to guide you !

[More coming soon...]