Moonlighting as a Doctor: How to Earn More While Managing Your Career

Physician moonlighting refers to taking on paid clinical work outside of a physician’s full-time role or training program. These additional shifts are typically completed during evenings, weekends, or scheduled time off, allowing physicians to earn extra income without leaving their primary position.

Moonlighting is distinct from locum tenens work, which usually involves temporary, full-time assignments at different facilities. Instead, moonlighting allows physicians to stay rooted in their current roles while exploring flexible opportunities on the side.

Some physicians turn to moonlighting to supplement their income or manage student loan debt. Others pursue it to build new clinical skills, explore different care environments, or prepare for future transitions in their career.

According to the 2021 Medical Economics Physician Report, about one in three physicians earned additional income outside of their primary role in 2020. The amount physicians earned through this work varied widely by specialty. In 2020 Pediatricians brought in the highest average secondary income at $62,000, followed by family medicine at $53,000, internal medicine at $46,000, and OB/GYNs at $38,000.

In terms of how physicians earn this extra income, moonlighting often extends beyond just clinical shifts. Among those with secondary income, 17% reported non-medical work such as consulting or public speaking as their primary side activity.

The top 10 sources of  additional income for physicians: 

Telehealth has made it easier than ever for physicians to moonlight from home. Many platforms offer flexible pay-per-visit arrangements across. Because telemedicine generally requires only a computer and a license in the patient’s state, it’s one of the most accessible moonlighting routes available.

2. Clinical Moonlighting

This is the most traditional form of moonlighting. It involves taking on extra clinical shifts outside of one’s full-time job, often during evenings, weekends, or scheduled time off. 

Common clinical moonlighting settings include:

3. Locum Tenens

Some physicians pick up short-term locum tenens assignments as a moonlighting option. While many locums roles are full-time, others are weekend-based or part-time, making them ideal for moonlighting. This 

route allows physicians to travel, earn premium pay, and explore new clinical settings without long-term commitment.

4. Consulting and Non-Clinical Work

Moonlighting doesn’t have to involve direct patient care. Physicians can also earn extra income through:

5. Academic and Research Opportunities

Many medical schools and teaching hospitals welcome practicing physicians to take on part-time teaching roles. These may include supervising clinical rotations, delivering lectures, or serving as adjunct faculty members.

In addition to teaching, physicians can contribute to medical research on a moonlighting basis. This could involve assisting with clinical trials, collaborating on research teams, or contributing to grant-funded studies. Some physicians also engage in academic writing, peer review, or continuing medical education (CME) content development. 

1. Know Your Program’s Rules

Start by reviewing your residency program’s policies on moonlighting. The ACGME rules cap combined training and work hours at 80 per week and place clear guardrails around patient safety and education. Not all residencies allow internal or external moonlighting, and many require formal approval. Avoid surprises by clarifying your program’s specific protocols and getting any necessary permissions in writing.

2. Prioritize Balance Over Burnout

While moonlighting can ease financial pressure, overcommitting is a quick route to fatigue and jeopardized performance. Aim to limit your moonlighting shifts — many career advisors recommend no more than two extra shifts per month to keep your stamina, learning, and wellbeing intact. Listen to your body and mind, and set personal boundaries that protect your primary role.

3. Protect Your Educational Goals

Remember, residency is a (mercifully) temporary chapter—a unique window to hone your clinical acumen, form lasting professional relationships, and build your reputation. Don’t let extra work compromise your core educational objectives or crowd out time for studying, research, or following up on complex cases.

4. Plan for the Future

The end of residency comes faster than you think. Use any available margin not just for side gigs, but also to research and network for your first attending job. Consider how each moonlighting opportunity fits into your longer-term aspirations, and weigh the value of immediate income against preparation for the next phase of your career.

5. Double-Check Licensure and Coverage

Before accepting any moonlighting position, confirm that you have the right licensure and malpractice coverage for the work you’ll be doing. Requirements often differ across states and clinical settings, so don’t assume your primary residency coverage will extend to outside work.

By staying proactive, setting healthy limits, and keeping your ultimate goals in view, you can leverage moonlighting for both financial breathing room and professional growth—without letting it become a stumbling block in your medical journey.

Additional Revenue Stream

Moonlighting provides a valuable income boost for physicians looking to pay down debt, save for major goals, or increase financial stability. With flexible options like urgent care, hospital shifts, and telemedicine, many doctors can earn extra income without disrupting their full-time roles.

Career Growth and Versatility
 
It also supports professional growth. Physicians may gain exposure to new settings, refine skills, or explore different practice models. For early-career doctors, it’s a way to test future career paths without long-term commitments. Some also find personal fulfillment in moonlighting, especially when working with underserved communities or stepping into roles that feel mission driven. It’s not just about income — it can deepen a physician’s impact and confidence.

Personal Fulfillment

Some also find personal fulfillment in moonlighting, especially when working with underserved communities or stepping into roles that feel mission driven. 

Fatigue is one of the biggest risks. Adding extra shifts to an already full schedule can lead to burnout and affect performance in a primary job. Over time, the physical and emotional toll can be significant. Moonlighting can also disrupt work-life balance. Weekend or evening hours may cut into personal time and family commitments, leading to long-term strain outside of work.

There’s a reason why residency programs and many employers enforce an 80-hour weekly limit on work and education—exceeding that cap can be hazardous to both physician and patient well-being. Taking on additional moonlighting shifts may push you past these safe boundaries, not only impacting your energy and focus at work, but also interfering with your personal relationships, hobbies, and even any ongoing research commitments.

To maintain a healthy balance, many experienced physicians advise setting strict boundaries, such as limiting moonlighting to one or two shifts per month and regularly assessing your own well-being. 

There are administrative hurdles too. Physicians may need separate malpractice coverage, additional state licenses, and approval from employers to moonlight legally. Without careful planning, these logistics can create complications or even contract violations. According to the 2023 Physician compensation report 33% of physicians answered no when asked if their employment allows them to moonlight. 

Beyond this, finding medical moonlighting jobs isn't always straightforward. Some hospitals require physicians to be board-certified or hold a permanent license, which can be a significant barrier for residents or those in training. Securing adequate malpractice coverage is another critical step. It is essential to know what constitutes solid insurance or to work with a staffing agency that provides reliable coverage for its physicians. All of these logistical details require attention to ensure a smooth and legitimate moonlighting experience.

1. Employment Contracts and Exclusivity Clauses

Many physicians are bound by employment contracts that restrict outside work. These may include exclusivity clauses, which prohibit any form of clinical or non-clinical work beyond your primary position. Even if moonlighting is allowed, contracts often require prior written approval or notification. Always review your agreement carefully and clarify any unclear terms with your employer or legal advisor before accepting a secondary role.

2. Licensing and Credentialing Requirements

Working in a new facility or across state lines requires proper licensure and credentialing. Each state has its own licensing rules, and failing to comply can lead to disciplinary action. In hospital or clinic settings, credentialing can take weeks or months, so it’s important to plan. You must also ensure you’re practicing within your scope and meeting all documentation and supervision standards required by the facility or governing board.

3. Patient Safety and Clinical Judgment

Ethically, patient care should never be compromised due to moonlighting. Physicians must be honest with themselves about their energy levels, availability, and capacity. Fatigue from working extra shifts can impair clinical judgment and lead to mistakes that affect both moonlighting and primary patients. If moonlighting begins to interfere with your ability to provide safe, high-quality care, it may be time to scale back.

4. Separation of Roles and Resources

Physicians must maintain strict boundaries between their main role and any side work. Using your full-time employer’s resources, such as patient lists, EHR systems, or administrative staff — for moonlighting is both unethical and likely a breach of policy. Keep all documentation, scheduling, and communication separate, and ensure both employers are aware of your external commitments.

For physicians, moonlighting can be a smart way to earn extra income, broaden clinical experience, or explore new paths without leaving a full-time role. With options ranging from clinical shifts to research and consulting, it offers flexibility and professional growth.

Things to Consider Before Deciding

Start by weighing the financial and professional benefits against the realities of added workload and the risk of burnout. Carefully review your primary employment contract and any relevant residency or hospital policies for potential restrictions. Assess your personal and professional bandwidth - do you have the energy, time, and support to take on additional responsibilities without compromising patient care or your well-being? Finally, think about how moonlighting fits within your long-term career trajectory. Taking on extra shifts can be rewarding, but only if it aligns with your broader goals and doesn’t stretch you too thin.