Radiology residents moonlighting in ED

[radsbound]

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Is it possible for a radiology resident to moonlight in the ED and manage patients medically just like other ER residents/attendings? Thanx

 

[tigershark]

Yes, but why would you want to?

You can moonlight as a radiologist doing prelim reads and make much more money.

 

[radsbound]

Thanx for the reply. Oh, I meant right after internship when I will only have medical management knowledge. I am assuming that for me to be able to do prelim reads I would need to have some radiology residency experience under my belt. Since you mentioned, what year (R1, R2...) can people start reading prelim films while moonlighting. I appreciate the input.

 

[f_w]

Look for a gig where you can 'baby-sit' an MRI of CT scanner. In order for a free-standing imaging facility to be allowed to administer IV contrast safely, a 'supervising physician' has to be on site (also, in order to charge medicare for studies done 'with contrast' a supervising physician has to be on site). This person has to be trained in the recognition and treatment of contrast reactions, generally something a 1st year rads resident should be able to.
Typically, you will just sit there in a back office and play poker on the internet, no image interpretation required. Still, the going rate in our area was the same as what the IM residents got for taking care of critically ill patients in the community hospital CCU.

 

[Docxter]

Look for a gig where you can 'baby-sit' an MRI of CT scanner. In order for a free-standing imaging facility to be allowed to administer IV contrast safely, a 'supervising physician' has to be on site (also, in order to charge medicare for studies done 'with contrast' a supervising physician has to be on site). This person has to be trained in the recognition and treatment of contrast reactions, generally something a 1st year rads resident should be able to.
Typically, you will just sit there in a back office and play poker on the internet, no image interpretation required. Still, the going rate in our area was the same as what the IM residents got for taking care of critically ill patients in the community hospital CCU.

A guy in our residency moonlighted in a community hospital ICU throughout his training. It certainly paid much much more than CT/MR contrast monitoring.

 

[tigershark]

Thanx for the reply. Oh, I meant right after internship when I will only have medical management knowledge. I am assuming that for me to be able to do prelim reads I would need to have some radiology residency experience under my belt. Since you mentioned, what year (R1, R2...) can people start reading prelim films while moonlighting. I appreciate the input.

Once you pass your writtens (R2-R3 for most) and are technically board eligible you can start doing prelim reads for private groups providing coverage for nights/weekends, many of the residents in my region make six figures this way. One guy who went nuts with it made over 200k his R4 year, most make between 60k-150k on top of their regular pay.

Starting your R1 year you can do the babysitting thing which pays just as much as most others make moonlighting in the ER.

This greatly varies from region to region.

I noticed on the interview trail that the residents at most of the "elite" east/west coast programs lived like paupers in small apartments while the residents in my home state were living very comfortably and owned houses, new cars etc., so much of it depends on where you are.

 

[radsbound]

Thanx folks, you are a helpful bunch. Its great to have guidnace for us budding radiologists. Just out of curiosity, how is the Chicago market for 'babysitting' gigs and prelim reads gigs. I am an M3, and I will have a 300k+ in loans by the time I gradute..........so any extra money would be helpful to pay some of my loans.

 

[f_w]

Don't know how the market for babysitting gigs is in chicago. These jobs go by word of mouth, it is not like the rads groups put up an ad for this. Usually, the seniors will hand down these jobs once they start doing real moonlighting jobs.

300k in loans sounds bad. But keep one thing in mind. Unless the radiology job market collapses, you won't have much of a problem to pay this off 4 years from now, even if it has grown to about 360k with the accrued interest by then.

Radiology residency, while it is not as time intensive as lets say surgery, does require you to be mentally present. You will have to read, read, read. If you spend your nights covering some ICU or ER, it can have a negative impact on your daytime performance. Your goal should be to become the best radiologist you can be. Consider NOT moonlighing during your first and second year. Once you are a third year (and contrary to popular belief you are not 'board eligible' at that point), there are opportunities for you to moonlight for very good money. Often these are rural hospitals with only one radiologist that need coverage for days that the rads is off. Once you have access to this type of real moonlighting, making a dent into your loans would be an option.

You might want to consider to make some payments on your student loan interest while you are in residency (but not on the principal). While you are still a resident, you can deduct your loan interest. Once you are out in an attending job, you can't deduct the interest because you are past the 109k threshold the goverment in their infinite wisdom came up with.

 

[superdevil]

...many of the residents in my region make six figures this way. One guy who went nuts with it made over 200k his R4 year, most make between 60k-150k on top of their regular pay.

...the residents in my home state were living very comfortably and owned houses, new cars etc., so much of it depends on where you are.

holy ****. if you don't mind me asking, where are you? i will also have lots of loans when i graduate (around 190-210k), so i'm definitely listening...

 

[Docmike2006]

Some residency programs have "built in" moonlighting opportunities, you can babysit contrast injections for 50-75 bucks an hour. That adds up if you do it for 3 hours a couple of times a week.

Some hospitals, instead of paying for nighthawk services, hire R3s and R4s to do prelim reads. This usually pays around $100 an hour - this can amount to some pretty serious cash if you do a few 12-hour shifts per month. These aren't advertised widely, so talk to people.

 

[f_w]

Some hospitals, instead of paying for nighthawk services, hire R3s and R4s to do prelim reads. This usually pays around $100 an hour - this can amount to some pretty serious cash if you do a few 12-hour shifts per month. These aren't advertised widely, so talk to people.

One thing to keep in mind with radiology moonlighting is your future ability to obtain malpractice coverage at reasonable prices. I have gone through the process of obtaining malpractice coverage recently and they are very interested in your moonlighting activities. Extensive moonlighting, particularly activities that represent independent practice (e.g. providing final interpretations while doing locums in a rural hospital) can drive up the initial premium you (or typically your first employer) have to pay considerably.

 

[Docmike2006]

One thing to keep in mind with radiology moonlighting is your future ability to obtain malpractice coverage at reasonable prices. I have gone through the process of obtaining malpractice coverage recently and they are very interested in your moonlighting activities. Extensive moonlighting, particularly activities that represent independent practice (e.g. providing final interpretations while doing locums in a rural hospital) can drive up the initial premium you (or typically your first employer) have to pay considerably.

Interesting - I was not aware of that... Does the cost only go up if you were sued as a moonlighter or does that not play a role? What is the attributable increase? Do you know what their rationale may be for increasing the premiums?

 

[f_w]

Does the cost only go up if you were sued as a moonlighter or does that not play a role? What is the attributable increase? Do you know what their rationale may be for increasing the premiums?

It is the nature of 'claims made' malpractice insurance (today the most prevalent form of malpractice coverage). Your insurance only covers you if you carry the policy when the suit is filed. It usually takes about one year between 'committing a tort' and the suit being filed. So, if you come out of residency, for year #1 the chance of your carrier having to pay something on your behalf is practically zero. Over the next 8 years that likelihood goes up to the 'normal' risk level for a physician of your specialty. As a result, during year 1 of your practice, you will get a heavy discount on your malpractice premium, somewhere in the range of 81%. It goes up by 10% over the ensuing years until you are at the full 'claims made' premium.

Now, if you did a lot of independent moonlighting, you sot of got a 'head start' in your malpractice history. And unless your moonlighting activities where covered by a 'occurence' policy (very rare today), you are not considered 'naive' in your risk exposure. In other words, there is a chance that you can get sued over stuff done as a moonlighter and your malpractice carrier has to pay for it. So, they might not allow you to start at the usual first year rate but rather assess you at the 3rd year increment.

So, whatever you do to moonlight, obtain 'certificates of insurance' for anything you do. The verbal assurance of the practice administrator 'oh yes, you are covered under our locums policy' is not worth a lot if you are working to get full coverage for yourself later on.

 

[Docmike2006]

It is the nature of 'claims made' malpractice insurance (today the most prevalent form of malpractice coverage). Your insurance only covers you if you carry the policy when the suit is filed. It usually takes about one year between 'committing a tort' and the suit being filed. So, if you come out of residency, for year #1 the chance of your carrier having to pay something on your behalf is practically zero. Over the next 8 years that likelihood goes up to the 'normal' risk level for a physician of your specialty. As a result, during year 1 of your practice, you will get a heavy discount on your malpractice premium, somewhere in the range of 81%. It goes up by 10% over the ensuing years until you are at the full 'claims made' premium.

Now, if you did a lot of independent moonlighting, you sot of got a 'head start' in your malpractice history. And unless your moonlighting activities where covered by a 'occurence' policy (very rare today), you are not considered 'naive' in your risk exposure. In other words, there is a chance that you can get sued over stuff done as a moonlighter and your malpractice carrier has to pay for it. So, they might not allow you to start at the usual first year rate but rather assess you at the 3rd year increment.

So, whatever you do to moonlight, obtain 'certificates of insurance' for anything you do. The verbal assurance of the practice administrator 'oh yes, you are covered under our locums policy' is not worth a lot if you are working to get full coverage for yourself later on.

Thank you. This info is useful.