 All right, today I'm going to break down how I make more money as a cardiology fellow, how I did this early in my training, how much I made, and how much I expect to make this year doing something called moon lighting. Let's break it down. Hey friends, welcome back to channel. In case you're new here, my name is Lux. I'm an internal medicine board certified physician and currently a first year cardiology fellow here at the MD journey. We make content to help people like you succeed on your medical journey, but doing it with less stress. So in today's episode, I'm going to break down exactly what moon lighting is, what your roles and hours would look like. Most importantly, how much money you can expect to make per shift. And then at the very end, I'll break down how much money I made as a resident, as well as how much money I expect to make now as a cardiology fellow, it's probably more than you expect. So let's get into it. First, let's talk about exactly what moon lighting is. Moon lighting is basically taking extra shifts in your area of practice using your experiences, but usually outside of your current job description or even your current employer. So it's basically taking extra shifts, being whatever kind of doctor you're already trained to be. So for example, I'm a board certified internal medicine doctors. As you'll see when I do moon lighting, I could just work as an internal medicine doctor, even though currently my day job is training to be a cardiologist independently in two years. And to give you a few examples of moon lighting that I've done as well, examples that I've seen, let's go ahead and start talking about moon lighting that I did back when I was a resident in internal medicine. And to give you guys a better idea, here are a few examples. Back when I was a resident, so I did a three year internal medicine residency and that basically was all taken place during the COVID pandemic. So they would look to trainees or residents like me who have finished medical school. So I had my MD, but if you had your DO, you're technically a doctor. You just at that point need some supervision while you're doing stuff, but they may say, Hey, Lux, we have a Saturday evening shift where we need help admitting patients from the emergency room. We only have two doctors that work there. We usually need four doctors for the volume that we normally see. We have two open slots. Can you take one of them and work from 7pm to 7am admitting patients with somebody supervising your admins? So that would be a very common example of moon lighting shifts that I would do where I would just come to the hospital and admit patients as they came and how a supervising physician, if I would just talk about my plan since I wasn't officially a licensed board certified physician like I am now. But on the flip side, sometimes the hospital will say, Hey, we actually don't need any help with admitting patients from the emergency room. We just need somebody to help cross cover all the patients where all the doctors are gone for the day. So you can imagine if you have 10 doctors in a day time taking care of everybody, there needs to be somebody there at night time to be able to take care of any emergencies or be able to answer questions for nurses. And so they may say, Hey, here are a list of 30 patients. If the nurses call you about these 30 patients, then you have to be able to help whether it's take care of an emergency, answer basic questions from their chart, whatever it may be. But otherwise, that's all you're there for. If you're not called for anything, you just kind of hang out. So that's called cross cover. So we've talked about moonlighting admissions shifts. We've talked about moonlighting cross cover shifts. And sometimes you have shifts that are a little bit of a combination. You may cross cover some patients as well admit some patients. But those are very typical examples back when I was a resident of things that I did, especially during the COVID pandemic, where the necessity for residents and trainees to take these shifts was really high. Towards the later part of this video, I'll talk about exactly how much I made on those shifts. So again, stay tuned. So those were examples of moonlighting experiences as a resident. And now I'm going to talk about more that you can even do as a fellow. Now a quick overview for the lingo, if you're not familiar, resident is basically somebody who's finished medical school and is going through their three or seven year training to be that kind of doctors. I spent three years to do internal medicine residency. And now I'm doing subspecialty even further to just be a cardiologist. So three year fellowship, but usually between your residency and your fellowship, you get board certified in your broad field. So I got board certified in internal medicine. I can work and as an independent medicine doctor, which I actually have done as a year as a hospitalist, if you guys are interested, I'll go ahead and link that video up here or as well in the description. But as you can imagine, because a fellow has more certifications, they have more opportunities to work both independently as well as oversee other trainees. When I was a resident working in the ICU, often sometimes there wouldn't always be a supervising attending in-house in case we had an emergency, but there would be a moonlighting fellow that'd be usually in cardiology, a pulmonary who had their medicine licensed. It could just oversee us making decisions. So we had no indication to bother them because we kind of knew what we were doing overnight. The fellow made a decent amount of cash, which we'll go to in a second and really not do anything. They would just kind of sleep and be available in case you needed them. But they would still get paid on the flip side again, because you have your license, you can practice independently. So just how I worked as a hospitalist, admitting patients and triaging them. I can take extra shifts with my old employer or any similar employer, which I currently do. And we'll talk about that in a second, basically doing what I did as a hospitalist, which is showing up, admitting patients, taking care of the patients who are already on the list, discharging them and so forth and getting paid a certain amount for that. So now that we talked about exactly what mood lighting is and the various roles that you can take on, let's talk about the time commitment of what these shifts look like or have looked like for me. So back when I was a resident, most of the shifts that we would take for mood lighting would be anywhere from 10 to 12 hours. You would work from 7 to 7 p.m., 7 to 5, or you would work a night shift where you would work from 7 to 7. Those would be the longer shifts. Sometimes, depending on how flexible the person who is giving you the shifts were, you could say, hey, I want to work a half shift. I may work 7 p.m. to 1 a.m. and then have a decent night sleep before I go do my clinical duty for the next day, or I may work a half of an afternoon, enjoy the rest of the evening as well as the nighttime before I go back to my normal rotations. But most of the shifts that I ended up doing were 10 hours or 12 hours. Now, currently, as a cardiology fellow, a lot of my mood lighting is actually spent working for my former employer when I was a hospitalist just picking up extra shifts when they need them. And so for those shifts, usually I'll wake up at 7 o'clock, get ready, go to the hospital, go through my list of patients, which could be anywhere from 15 to 18 patients. Always be ready for admissions. You may get anywhere from 2 to 3 within a 3 or 4-hour window. And so you basically have taken care of, like, 20 to 21 patients in the matter between 7 and 3. Usually, I would say that I would not be taking any more admissions after 3, so you give them a big chunk of time where they could give you patients and you take care of old ones. And then from 3 to 7, I was available from home in case there was an emergency that had to go back to the hospital or do some triaging or whatever it may be, but I was not open to admission. So I was technically working from 7 to 7, but 7 to 3 would be my admission window where I'd have to actually be physically in the hospital. And then 3 to 7, I would have to be nearby and available for the nurses and other doctors if they had any questions. And then probably my favorite part about these shifts is that you are the decision maker. There's nobody above you in terms of supervision. You are the head honcho, the decision maker, the tending. And so it's really nice in terms of efficiency and just being able to take care of patients quicker. So now let's break down the most burning question, which is how much do you make on these shifts? Now in general, to give a good range, I've seen shifts being offered anywhere from $1,000 to 1,500 per shift. Anywhere from the 10 to 12 hour shifts that would be kind of the range. Again, it would depend on the role that you would be taking on during those times slots. So if I was working in the COVID ICU back as a resident, I would get paid on the higher end of that because these were sicker patients. You needed to be in-house. You would have to admit sicker patients. So because of the workload usually being higher, the pay was higher too. Versus things that were more cross-covered. So if I was working a night where I didn't have to admit and I just took care of patients in the hospital that were already there, usually there's a chance that there's not much that goes on. You may answer a page here and there, but you could possibly even get some sleep. And so those shifts may be closer to the $1,000 mark. And so a lot of times when I would be taking these shifts, I would look for that number of 1,200 for a 12 hour shift and usually would take a night shift because that meant that if it was a chill night, I had some admissions, cross-cover wasn't too bad. I could possibly get some sleep, wake up the next day and have a day off or go to my clinical responsibility, whatever kind of part of my structure there was and still get paid a decent amount while getting that experience as an early training, being an independent provider. Now currently as a fellow, knowing that that was my threshold as a resident and knowing that I have more experience, I usually use that 12 to $1,300 mark as kind of my initial cutoff. And depending on the shifts or how necessary it is for somebody to fill them, some of these companies will offer bonuses to encourage more people to take shifts where they are really severely down in terms of providers that have available. So personally, I would look for those shifts to have those bonuses because it makes sense if I'm gonna show up to go work, even if I have to work hard, I'd rather make more money versus not being so busy but still being present in the hospital. Now that we talked about numbers and roles, let me just go ahead and break down how much I've made through moonlighting both in residency and now in fellowship. So in residency, about halfway through my second year, I was officially approved by my program to be able to moonlight. And this is also where the opportunities were starting to increase because COVID numbers were going up midway through my residency. And so I probably took anywhere from 20 to 30 moonlighting shifts in a span of a year, year and a half. Each of those shifts, again, making anywhere from $1,000 to $1,200, some of them were half shifts. I estimate during that year and a half that I made between $24 to $30,000, not including taxes of course. And as a reference point, my salary for those three years were about 15 to 60,000. So I'm making essentially half of my residency pay in the span of maybe 20 to 30 shifts, which is like a month's worth of work. That's like pretty awesome. And in a second, I'm gonna talk about exactly where this money goes, personally for me, where I decided to put it, but in retrospect, a lot of that money into going into investment accounts as well as a big down payment savings for us to ultimately buy the house that we have right now. And then finally transitioning to how much money I've made via moonlighting as a fellow. So I am in my first year of fellowship and after about a month, three or four, I was given the thumbs up by my program to say, you can moonlight, you are a good fellow and you can manage your responsibilities. If you wanna take extra shifts without going against your clinical hours and timing, then go for it. And so I basically worked for my old company and have now taken about 10 shifts and right now is the making of this video. We're in March and I have more coming around the queue. So with the 1200 kind of base salary plus the bonuses, I'm estimating that I've already made about $15,000, a little bit plus or minus, and then have the rest of 2024 to go. So before I break down what I do with that money, I'm really curious in the comments section if you made it this far on this video, do you think that's a lot? Is that too little? Have you heard of places that make more or less? What do you guys think about those numbers and the whole idea of moonlighting? But now I wanna break down really quickly my plan as well as again how I dispersed the money and how my wife and I decided to financially be responsible with the extra income that I'm making. So first thing is that I don't wanna take too many shifts. The income is nice, but in reality, I have a daughter at home, I wanna hang out with my wife and being busy as a cardiology fellow is crazy enough where I come home often very tired. And so I wanna make sure that when I take these shifts, I don't do it in a way that's gonna be too much for myself and my family. So I intend to not take any more than two to three shifts a month. Again, numbers-wise that would put me at about three to $5,400 a month in terms of extra income which is more than enough. In addition, I plan on alternating weekends at moonlight. So if I moonlighted last weekend, I won't do it this weekend and buys versa. That way, I always have some opportunities for family time and just honestly some relaxation. So that's the structure in terms of how many shifts I plan on taking this year. But now let's talk about how we intend on that money being used, how it's been used for my past mid-lighting shifts. From my wife and I, we'd like to think of everything as a bucket so if we make $100, X amount goes here, X amount goes there and it's the same for our moonlighting income. So there's a percentage that goes into things like investment. So funding our Roth IRA, for example, there's a percentage that goes into just creating a buffer for our home expenses. So owning a home is not cheap for a variety of reasons and things always come up. There is a bucket that is meant for things like travel or trips that we want to go on future or having a fund, just being able to buy gifts for families and friends. So because we have these various buckets and the amount of percentages that we want to go towards things like investing or charity or family time or future trips, essentially every time a dollar comes in, we know where that money will go. And this is my personal experience and opinion you may disagree with me, but that also helps that bucket system, helps me avoid going into a shift and saying, oh, their shift can pay for a really fancy dinner or a car or vacation, et cetera. Instead, it goes into these various buckets where the money doesn't seem as large anymore because you may have from $1,000, 200 go here, 200 go there and that pull grows over time. But these moonlighting shifts and the pay that come with them can easily be associated with high expenditures if you're not careful. So because I look at everything as a bucket, it one makes me focused on understanding that all that money is not going towards some crazy expenditure, but two, it also raises my threshold to take these shifts. But in reality, moonlighting is not that difficult. As you've kind of seen throughout this episode, is that if you pick the right roles that comes with the best rate, you can find the best combination of efficiency where you're not having to work the hardest but you're still getting paid for your time. But because personally for me, if I'm taking a moonlighting shift, I'm taking an afternoon or a morning or an evening shift away from hanging out with my wife and my daughter. And that has to be worthy enough to say, this many shifts a month or a year are going to be worthy enough for our future goals or personal goals, wanting to go on trips. And if it's not, it's easier enough for me to say the money would be nice. But honestly, for that extra 1,000 or 1,500, I'm going to spend today with my family. And personally, that's how I look at it. So having that bucket system, again, allows me to avoid those high expenditures of saying, oh, I'm making $1,000 today, I can use that on X, Y and Z. It's much easier for me to not get caught up in that when I basically automatically goes elsewhere and I basically don't see it. But during both residency and fellowship, I have found that it's given me a ton of buffers as well as opportunities instead of doing things like buying a home or going on amazing trips with my wife and now with my daughter. But that guys summarizes my big overview on moonlighting. Hopefully you guys enjoyed these style of videos, these topic of videos. And if you did, go ahead, let me know in the comment section what you want me to cover in future videos. 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