I read your debate about resident moonlighting with much interest.1 I think it is interesting that this debate has effectively excluded the residents’ point of view, even though residents are the ones most affected by it.
After completing my family medicine residency in Ontario (where moonlighting is prohibited), I moved to Alberta to complete a third year of training in emergency medicine. Alberta allows resident moonlighting, so I worked as a physician extender in a local community intensive care unit once every 3 weeks.
From an educational standpoint, I had a clear advantage in terms of comfort with critical care procedures and management of critically ill patients. To put it into context, more than 60% of the critical care procedures I performed during my year of emergency medicine training (central lines, chest tubes, intubations, and so on) were done while moonlighting. When I was eventually hired, my work as a physician extender was a big selling feature on my resume.
From a financial point of view, working 1 shift every 3 weeks allowed my wife to stay home with our 3 young children. By investing 1 day out of 21, my wife was able to stay home and provide loving care and guidance to our kids 7 days a week.
My moonlighting income doubled my resident salary; I also saved money on child care and transportation for my kids. Many of my resident costs (books, office supplies, continuing medical education, home office, vehicle, etc) became tax-deductible expenses that I could claim against my moonlighting income. This would not have been possible against my resident income.
Many things are incompatible with residents’ well-being, such as astronomical levels of debt and guilt about leaving their children to be cared for by minimum wage caregivers. In my situation, moonlighting vastly improved my personal and professional life.
Perhaps those educators who believe moonlighting harms residents would be willing to prove their commitment to the well-being of residents by paying off a portion of residents’ debt, equal to forgone moonlighting income. Or perhaps they would be willing to care for our children while our spouses go out to earn needed second incomes.
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