Moonlighting

Moonlighting is an opportunity granted to PGY-2s and above who have: 1) completed and logged their required procedures (PIV, venipuncture, ABG, pelvic exam) on New Innovations, 2) have scheduled or taken the USMLE Step 3 exam, and 3) who are in good standing with the residency (New Innovations duty hours, evaluations, etc up-to-date). Once you've satisfied the above, please reach out to your firm assistant (Nettie or Frenchy) to let them know your intention to moonlight and follow their instructions. Once granted permission, you will be given a letter from the program which is your ticket to moonlight! Unfortunately, residents who are here on particular work visas may not be legally allowed to moonlight; ask your firm assistants for more details if you fall under this category.

Moonlighting is a nice way to be able to get extra exposure or practice in a more autonomous environment while making a decent chunk of change! 

*PLEASE BE ADVISED* that moonlighting should never take the place of a required shift. Your job as a resident is required... this is extra! Furthermore, moonlighting hours do count towards the ACGME duty hour limit of 80 hours per week. You are not permitted to moonlight for any shifts that would place you in violation of this limit. Violation of either of these policies would result in the automatic suspension of moonlighting privileges. For questions, please contact your chief resident. 

Weiler General Medicine (PA) Service

Contact: Naima Abdus-Salaam, Alisa Gooulbourne-Scott, Rita Migliaccio, Martha Rodriguez

*Please email all coordinators for any moonlighting related correspondence

Shifts

Compensation

Responsibilities

  • Progress notes not required on weekend days

Reporting Instructions

Arrive to the 2nd floor PA office (walk past 2N toward the Surgical Center, door on the left, code 3102*). As you enter, be sure to fill out a shift log form (found on the desk to the left of the lockers). Opposite this desk will be posted the assignments for the day; find your name and speak to some of the PAs there to find out who had your patients overnight. Note that it will not be a 1:1 handoff; you may receive signout from multiple overnight providers and you may receive signout for more patients than you are assigned. Handoffs here do not include detailed patient information; rather, you will likely only hear about acute issues, "watchers," and to-dos. Once the hectic part of signout is over, one of the senior PAs may help you get organized and take the patients you weren't assigned off your hands. Sign in as your patients' responsible provider. Then, if you are on days, pre-round on your assigned patients. If you are on nights, find a space to work (2nd floor medicine office is one option) and read up on your patients (the PA service keeps the handoff tab well updated). Admissions are assigned on a rolling basis (one PA/moonlighter at a time). You will need your pager and cellphone.

Difficulty

Medium. Workload varies but most residents report being able to nap for a few hours

Moses General Medicine (PA) Service

Contact: Inna Gedzberg

Shifts

Compensation

Responsibilities

  • Progress notes not required on weekend days

Reporting Instructions

Report to Klau 6, turn right when leaving the elevators, and find the PA office. There, you will try to find the day charge PA and ask for your assignments as well as from whom you should be seeking signout. Note that it will not be a 1:1 handoff; you may receive signout from multiple overnight providers and you may receive signout for more patients than you are assigned. Handoffs here do not include detailed patient information; rather, you will likely only hear about acute issues, "watchers," and to-dos. Sign in as your patients' responsible provider. Then, if you are on days, pre-round on your assigned patients. If you are on nights, find a space to work (2nd floor medicine office is one option) and read up on your patients (the PA service keeps the handoff tab well updated). Admissions are assigned on a rolling basis (one PA/moonlighter at a time). You will need your pager and cellphone.

Difficulty

Medium. Slightly heavier workload than Weiler PA service, anecdotally 

Moses/Weiler Oncology Service

Location: Moses NW8, Weiler 11S

Contact: Delroy Coleman, Richard Elkind

Shifts

Compensation

Responsibilities

Coverage, new admissions/transfers

Reporting Instructions

Moses: Report to the NW8 conference room (sometimes the day's long-call resident will be on NW2 however); the code to the door is 1-3-5. Receive signout and sign-in as your patients' responsible provider. It is a good idea to find out from the day resident who the Onc fellow on overnight is. You can reach out to them letting them know you're moonlighting in case they need to contact you and you may request that they let you know if they approve of any admissions/transfers to the floor. You may also ask the unit secretary to page you if he/she hears of any new admissions. Otherwise, you will be forced to stalk the Onc list to see if an admission/transfer is paged. 

Weiler: Report to 11S and find the room on the high-side of the unit where the PA will be sitting. Receive signout and sign in as your patients' responsible provider. You may ask the unit secretary or charge nurse to alert you of any new admissions/transfers to the floor.

Difficulty

Variable. Can be a quiet no-hitter with ability to sleep for most of the night or can be 4+ admissions. On average, most shifts are easy-to-medium workload

Moses Palliative Care Service

Contact: Nicole Ferrara

Shifts

Compensation

When completed with shift, email Luisa Lamber (LULAMBER@montefiore.org) for payroll reporting

Responsibilities

Coverage, new admissions/transfers

PA/Moonlighter responsibilities

Administrative Policy and Procedure

Reporting Instructions

Report to Moses NW7 and find the Palliative Care day team for signout. Log into department environment PROV MMC PALLIATIVE MEDICINE. Sign in as responsible provider for your patients. You may wish to ask the unit secretary or charge nurse to let you know if any new patients are paged to the floor. Responsible for beds 700-707A (12 beds). 

Progress note templates, use .PALCAREPRO

Difficulty

Variable. Coverage aspect can be quiet or if patient with active/changing pain needs, can be busy. On average, most shifts are easy-to-medium workload

Montefiore Wakefield Psychiatry

Contact: Rachel Noone, Andrei Nagorny

Shifts (can be tailored to availability, ask the schedulers for more details)

Compensation

Parking is validated. Resident meal cards (if you have any) are accepted at the Wakefield cafe and cafeteria

Responsibilities

No psychiatric assessments are required. The moonlighter will only evaluate any new intakes (typically 0 - 3 per day) and complete an H&P prior to attending rounds.

Admissions are medically cleared prior to admission to psychiatry and are not medically acute.

An attending from geriatrics will supervise the case and round on the new admissions with the resident in the late morning/early afternoon.

24/7 onsite attending psychiatrist coverage for any questions about the unit.

Reporting Instructions

Montefiore Wakefield department of psychiatry is located at 600 E 233rd St in the Bronx, floor 7S. Parking is available across the street from the hospital in the parking garage and can be validated by their administrative staff if you're covering a shift. There is also shuttle service available from Moses to Wakefield. The unit phone number is 718-920-9644; the on-call psychiatrist phone number is 646-574-7433. The unit is a locked unit. ID access can be set up ahead of time through their administrative office. 

Difficulty

Medium. Patients are not medically acute/active by necessity of being accepted to inpatient psychiatry. Expect to do 0-3 H&Ps/day

Weiler CCU

Contact: Daanish Chawala, Meaghan McGoldrick, Kazi Ullah

Sign up for shifts here. Read the instructions carefully before signing up!

Shifts

Compensation

Responsibilities

Duties would be similar to that of a PGY2/PGY3 in the Moses CCU, including management of admitted patients and any admissions overnight (expected 1-2 post-STEMI pts). Census of 5-10 patients. Most patients are post-STEMI or post procedure (TAVR, mitral clip) or cardiogenic shock. No balloon pumps or Impella support. Supported overnight by in-house first or second year Cardiology fellow (similar to Moses CCU)

Reporting Instructions

Report to Weiler CCU, located on the 4th floor (turn left out of the main visitor elevators) and receive handoff from the day PA (or overnight moonlighter if doing a Saturday AM shift).

Difficulty

Medium-hard. Would not expect to be able to nap overnight.

Moses ED

Contact: Dr. Caron Campbell at 646-531-8476

Shifts

Compensation

Responsibilities

1.       Assuming care of the patient.

2.       Reviewing the chart (especially updated notes by specialties ie. ID for antibiotic approvals that can be ordered standing, etc.)

3.       Assessing patients

4.       Placing orders: home meds, updating antibiotic approvals, providing pain management, repeating labs, obtaining consults that may be needed to expedite patient's care.

5.       Reviewing the admit order to see if patient’s current admit designation is still appropriate (ie tele/med vs Cards/tele vs medicine vs surgery, vs other) If not, update the admit order.

6.       Checking the admit to list to assign the appropriate admitting attending. This is especially important for the nursing home patients.

7.       Evaluating patients to see if they are "Hallway/dayroom eligible." The eligibility criteria will be posted by your workstation.

8.       Assessing patients for discharge if appropriate.

In the event a patient should become unstable or requires a higher level of care, discuss with the ED attending who will escalate care.

Have close communication with patient logistics dept (x6651) for bed availability surveillance.

Reporting Instructions

Report to Moses ED

Difficulty

Medium-hard. Would not expect to be able to nap