5 Get the Most Bang for Your Buck

All moonlighting residents should take an active role in maximizing the educational benefit of the moonlighting experience. Here are some suggestions:

• Actively seek feedback from patients, nurses, colleagues, and physician leadership. Your colleagues can provide valuable suggestions for improvement. Use this opportunity to identify your weaknesses and focus on improving those areas.
• Many groups provide patient care information, such as productivity, patient satisfaction, and compliance with guidelines and benchmarks, to providers. If you don’t receive this information, ask for it.
• Perform frequent patient follow-ups, via chart review or phone, to “calibrate” your clinical judgment (eg, how many of your admitted chest pain patients rule in for acute coronary syndrome or if the patient you sent home with vague abdominal pain returns with acute appendicitis).
• Ask for help if you’re unsure. Remember that patient care should always come first, and asking for help is not an admission of weakness or ignorance.
• Log all major procedures (eg, intubations, chest tubes, central lines, procedural sedation). Although they do not count toward residency requirements, they can be used for future credentialing.
• Do not forget to maintain a healthy work-life balance. Your primary job is to finish residency, not to moonlight.

Dr. Silman is assistant clinical professor of emergency medicine, assistant residency director, and director of medical student education in the department of emergency medicine at the University of California, San Francisco.

Dr. Chen is associate program director and associate professor of clinical emergency medicine in the department of emergency medicine at the University of California, San Francisco.