Moonlighting FAQ

Paperwork

There is a lot of paperwork associated with moonlighting, especially if you apply to multiple places or go through a recruiter. Below is a list of the documentation you might need to submit to apply / get credentialed at an institution. It is suggested that you scan and save these documents.

  • BLS, ACLS, ATLS, PALS
  • DEA, State controlled substance license
  • State Medical License
  • Med School Diploma (shrunken to 8.5 x 11)
  • Undergraduate School Diploma
  • NPI letter
  • Drivers License and Social Security Card
  • Letter of approval from Residency Director
  • Health immunizations and titers
  • 3 Letters of Reference

What to ask

  • What kind of coverage (single, double, MLP)
  • What specialties take call at the hospital?
  • What kind of follow up is available?
  • Do you have responsibilities outside of the ED?
  • Are you responsible for running codes on the floor and ICU?
  • Are you responsible for Labor and Delivery?
  • How is documentation done (T-sheet, EMR, Dictation)?
  • What are the main hospitals patients are transferred to? (STEMI, ICH, psych, trauma, obstetrics)
  • How are no shows handled?
  • What kind of lab tests are send outs? (Lipase, lactic acid, etc.)
  • What kind of imaging is available at night? Ultrasound? CT tech in house? Nighthawk?
  • How many floor/ICU beds are available?
  • Is there a surgeon on call at night?

What to take with you?

  • Stethoscope
  • Bougie
  • LMA
  • Food
  • References (digital, hard copies)
  • Anything else you know you can’t do a shift without (pillow, toiletries)
  • List of Emergency Numbers (ED administrator on-call, “emergency” attending cell numbers in case you get in trouble)

What to do on your first shift

  • Find out where your crash cart is
  • Check your airway kit
  • Meet the nurses and try to size up their abilities.
  • Let the staff know what they can pre-order for you.
  • Find out what’s for lunch/dinner/breakfast

The Contract

  • Claims-made: You’ll need tail coverage. Who pays for it?
  • Occurrence-made: Good, no tail involved
  • Noncompete clauses are a no-no
  • Is there a minimum number of shifts you need to work per month?

Financial issues of moonlighting

  • Your taxes just got more complicated
  • Independent contractor
  • Set aside about 1/3 of your paycheck each month
  • Deductions:
    • Mileage
    • Food while moonlighting
    • ACS, DEA licenses
    • Medical equipment
    • Conferences (portion not paid for by your residency)
    • Home office?
    • Check with your accountant
  • Estimated taxes
    • Unnecessary 1st year as an independent contractor
    • But in your second year, quarterly payments : 4/15, 6/15, 9/15, 1/15
    • Penalties for paying too little
    • Federal estimates can be based on your previous year’s income which will likely be lower
    • State estimates need to be paid as well

Related Content

Feb 04, 2021

Defending COVID-19's Latest Victims

As the U.S. struggles to flatten the ever-rising curve of COVID-19, the virus has revealed a new weakness in the health care system. Despite putting their own health at risk to treat victims of the pandemic, emergency physicians are becoming unemployed.

Jan 05, 2018

EM Job Search Resources

Jan 01, 2018

Getting Ready for the Rest of Your Life