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Traditional offerings still abound, but advances in technology have also opened up new possibilities.

Fam Pract Manag. 2021;28(5):25-29

This content conforms to AAFP criteria for CME.

Author disclosures: no relevant financial affiliations.

Physicians have worked secondary jobs in medicine for decades. Known as “moonlighting” in years past,1 having a second (or third) job is now even more common — and easier — due to technology and the “gig economy.” In addition to earning extra money, the benefits include honing your skills and networking. Family physicians are uniquely positioned to pursue secondary jobs, given our breadth and depth of knowledge. This article is an overview of some of the most common opportunities for extra income, as well as what you should consider before pursuing them.


It may be tempting to jump right in when you see an opportunity that appeals to you, but there are several things to think about before taking on another job.

Understand external limitations. Many employed physicians (and residents) are subject to contracts or policies that may limit their outside work activities. For example, the Accreditation Council for Graduate Medical Education (ACGME) caps the number of hours a resident can work per week, and moonlighting jobs are included in its 80-hour weekly limit on duty hours. Review your contract and your institution's rules carefully, be transparent with your current employer, and consult with an attorney if you have questions.

Define your goals. Why are you taking on a second job, and what do you hope to achieve? Are you looking to earn a certain amount of money or pay off debt? Are you trying to maintain a skill set or learn new skills? Do you want to eventually make this second job your primary employment? There are many opportunities for family physicians, but they vary a lot in terms of pay, time commitment, and difficulty. Knowing your limits and outlining your goals will help you choose the right opportunity and save time chasing dead ends.

Review the costs. There may be both direct and indirect costs in pursuing an external opportunity. These could include cross-licensing in multiple states, acquiring additional malpractice coverage, setting up proper infrastructure, and skill-building time. Review the scope of your current employer's medical liability coverage, which is unlikely to cover an external opportunity. To gain additional coverage, consult with the credentialing team of the external organization for which you're looking to work. Purchasing coverage on your own, while an option, may be complicated or expensive, so it's often best to negotiate this as a term of your engagement.

Get organized. Collect any relevant documents, including medical licenses, Drug Enforcement Administration licenses, your medical school diploma, residency certificate, board certification, Basic Life Support/Advanced Cardiovascular Life Support certification, curriculum vitae, letters of recommendation, and proof of malpractice coverage.


  • Family physicians are uniquely suited for many secondary job opportunities due to their broad knowledge base and scope of practice.

  • Traditional gigs such as expert witness work and case reviews still abound, but technology has also opened up new opportunities in fields such as telehealth and health care startups.

  • Physicians should understand licensure, liability, and other issues before pursuing jobs outside their primary employment.

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