Jamie JohnsonBy Jamie Johnson, WCI Contributor

Residency comes with many challenges, and you can expect to work long hours while earning a fraction of what licensed physicians make. In 2021, the average resident earned $64,000. In comparison, the average physician earns $352,000 annually. Plus, the average medical student graduates with $250,990 in student loan debt. This leads many residents to consider medical moonlighting as a way to bring in extra income.

But what is medical moonlighting, and how do you know if it’s a good option for you?


What Is Moonlighting in Medical Residency?

Medical moonlighting involves working an additional job as a physician outside of your residency program. It’s common in specialties where the demand for services outweighs the number of available physicians.


Moonlighting Jobs for Doctors

Here are some examples of medical moonlighting jobs available to doctors, according to the American Academy of Family Physicians (AAFP).

Inpatient shifts:

  • Admitting physician
  • Cardiac surgical unit
  • Dialysis unit
  • Emergency room
  • General medical floor
  • Intensive care unit
  • Psychiatry unit
  • Rehabilitation unit
  • Telemetry floor

Outpatient shifts:

  • Ambulatory care center
  • Healthcare clinic
  • Medical staff at entertainment events
  • Private practice
  • Radiology center
  • Team physician at sporting events
  • Urgent care center


How Much Money Can You Make Moonlighting in Residency?

How much you earn moonlighting will depend on the type of work you end up doing. You might find work within your specialty or do something more general, like working in urgent care. The average pay range is $100-$200 per hour, depending on the location and job duties.

More information here:

Financial Considerations for Moonlighting as an Independent Contractor


Pros and Cons of Moonlighting as a Resident



  • Financial benefits: Moonlighting can significantly improve your financial situation, especially for residents with lower pay and a lot of student loan debt. You can use the money to save for retirement, pay down your student loans, or just have more financial breathing room.
  • Additional experience: Moonlighting gives you the opportunity to see different types of patients and to do different kinds of work.
  • Gives you more options: If something happens with your current job, you already have your foot in the door somewhere else. This can help reduce your stress, especially if your current work situation is tenuous.



  • Potential problems: Medical moonlighting as a resident can be controversial because you’re not a fully trained physician yet. The less training you have, the more likely you are to make a mistake or have an issue on the job. Plus, your residency program may dislike the idea of you moonlighting instead of working more hours for the program.
  • You’ll have less time available: The majority of residents work 60 hours or more per week, which doesn’t leave you with a lot of free time. You’ll need to decide if the financial benefits outweigh everything you’ll be giving up by working more.


Financial Considerations for Moonlighting

Before you start medical moonlighting, you need to make sure your new employer will pick up the cost of malpractice insurance. Malpractice insurance is expensive, so if you have to buy your own, the moonlighting job probably isn’t going to be worth your time.

You should also consider the potential tax burden of the additional income and whether it makes financial sense for you. Ultimately, there’s only so much you can do to reduce your taxes. You can write off any work expenses and find out if you qualify for business mileage deductions. For most physicians, the biggest tax break will come from contributing to a retirement plan. If you’re moonlighting, you can open an individual 401(k).

medical moonlighting

Depending on whether you’ve maxed out your 401(k) contributions at your main job, you could put additional money into a solo 401(k). If you’ve already maxed out your 401(k) contributions, you still could contribute 20% of what you’re earning at your moonlighting gig.

More information here:

Multiple 401(k) Rules – What to Do with Multiple 401(k) Accounts


How Do You Start Moonlighting?

The type of moonlighting gigs you’ll find will vary depending on your specialty. For example, there are generally a lot of opportunities available in emergency medicine whereas it may be harder to find jobs in other specialties. If you’re having a hard time finding moonlight jobs, the first step is to talk to your peers and colleagues to find out if they know of opportunities or what other people have done in the past. They may even be interested in having you step in and cover some of their moonlighting shifts.

Next, you can call up locum companies and find out what’s available. Those companies will take a cut of your earnings, but they should provide services in exchange. You could also arrange for some sort of internal moonlighting job with your current employer.

More information here:

From Fourth Year to the Real World: Transitioning from Med School to Residency


How Do You Know If You're Ready to Moonlight?

Before you begin moonlighting, you want to make sure you’re ready to take this step. Money is a great motivator, but it shouldn’t be the only reason you choose to moonlight. You have people’s lives in your hands, so you don’t want to take this step prematurely.

Start by making sure your current employer is going to be OK with you moonlighting and that there’s nothing in your contract prohibiting it. You should also monitor your working hours to ensure you’re following the Accreditation Council for Graduate Medical Education's (ACGME) 80-hour workweek policy. Any internal or external moonlighting you do will be considered part of that 80-hour workweek.

Assuming your supervisor thinks you’re ready and there’s nothing in your contract prohibiting you from moonlighting, you’re free to move forward. From there, you can start exploring your options and looking for a moonlighting gig that you think you’ll enjoy, that pays well, and that continues to give you more experience.


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