Moonlighting is when a licensed physician who is in residency or on a fellowship also provides clinical services outside of this work, usually for remuneration. The work might involve night and weekend coverage for community hospital emergency departments, intensive adult and pediatric care, palliative services or chronic care institutions, or other areas where additional help is needed.
As a resident physician or fellow, you receive a salary based on two things: your postgraduate year and the province you’re working in. How much you earn moonlighting will depend on how much you work and where you work, but you would typically be paid as any other staff would.
There is debate about the value of moonlighting during residency or fellowship. Here are some of the pros and cons to consider.
Pros of moonlighting
- supplement earnings and pay down medical training debt or start saving
- gain more clinical experience and responsibility
- gain exposure to communities outside the usual training sites
Cons of moonlighting
- difficulty achieving work-life balance
- lack of time to focus on residency or fellowship training
- tax liability because moonlighting income is not taxed at source
After balancing the pros and cons, if you decide moonlighting make sense for you, here’s what you’ll need to do next.
Next steps: Administrative and financial
- Check your eligibility. Not all programs allow for moonlighting if the existing call schedules are already heavy. If moonlighting is allowed, find out all the eligibility requirements, such as successfully completing the MCCQE Parts I and II and completing a minimum number of months of postgraduate training. If you want to work in emergency departments, for instance, you must have completed training in advanced trauma life support and advanced cardiac life support.
- Apply for registration. Registration for moonlighting goes by different terms across the country. It could be referred to as restricted registration, limited licensure or physician extenders. You must apply for registration and get approval from your program and postgraduate deans.
- Update your CMPA code. The Canadian Medical Protective Association provides professional liability insurance, giving you access to legal representation if you’re sued for medical malpractice or face other legal issues and complaints. The annual CMPA fee for residents and fellows is the same whether you’re moonlighting or not. Residents and fellows who aren’t moonlighting are classified under “Type of work” (TOW) as code 12 (note that extra resident shifts are not considered moonlighting). Residents and fellows who are moonlighting use TOW code 14 (this is for occasional moonlighting such as for two consecutive weeks or less). Be sure to update your code online.
- Plan for taxes. With the secondary income, you’ll likely move to a higher tax bracket. As a resident physician, you’re paid a salary with income tax automatically deducted from each paycheque. The money you make moonlighting is similar to earning self-employed income. You don’t pay tax upfront, and you can deduct various expenses from your moonlighting income. You’ll need to track your income to ensure everything is properly recorded on your tax return. Work with your MD Advisor* and accountant to figure out how much money you should set aside for taxes.
- Be strategic about your extra income. It’s easy for extra money to disappear. Have an idea of how much you will earn from moonlighting, and set aside an amount to pay down any debt or contribute to a tax-free savings account (TFSA). You can also contribute to your registered retirement savings plan (RRSP) to get the tax deduction or take advantage of the Home Buyers’ Plan.
You’ll be taking on a lot if you decide to moonlight, but the extra work could also bring professional and financial rewards. An MD Advisor can help you get the information and financial advice you need to make the right choice.
* MD Advisor refers to an MD Management Limited Financial Consultant or Investment Advisor (in Quebec), or an MD Private Investment Counsel Portfolio Manager.
The above information should not be construed as offering specific financial, investment, foreign or domestic taxation, legal, accounting or similar professional advice nor is it intended to replace the advice of independent tax, accounting or legal professionals.