For many physicians, the demands of a primary practice often leave little room for downtime, let alone a second job. Yet, moonlighting remains a pervasive practice in medicine. For some, it’s a means for financial survival during residency or fellowship; for others, it’s a strategic tool for skill retention and autonomy later in their career.
In the realm of pulmonary and critical care medicine, the weight of the ICU and the unpredictability of overnight calls create a specific kind of burnout risk. However, this same mix of skills makes pulmonologists highly versatile in the moonlighting market. Unlike some specialties where opportunities are limited to clinic hours, pulmonologists have access to a diverse array of income streams—from remote sleep study interpretation to high-acuity critical care shifts.
Find out how you can leverage your specialized training to secure moonlighting opportunities, offering a path to financial freedom that doesn’t necessarily require spending more nights in the hospital.
Who is eligible for moonlighting as a pulmonologist?
Eligibility for moonlighting varies widely among pulmonologists and depends on subspecialty training, board certification and clinical privileges. While many physicians complete combined pulmonary and critical care training, not all pulmonologists practice in the ICU or are trained in sleep medicine.
Typically, pulmonologists complete an internal medicine residency followed by fellowship training in one of the following tracks:
- Pulmonary disease (PD) only
- Pulmonary and critical care medicine (PCCM)
- Sleep medicine (as an additional fellowship or subspecialty certification)
Physicians who are board-certified in pulmonary disease alone, without critical care certification, are typically not eligible for high-acuity ICU moonlighting or intensivist coverage. However, they are well suited for lower-acuity moonlighting roles such as outpatient pulmonary clinic coverage, inpatient pulmonary consult services, bronchoscopy (depending on privileging) and remote diagnostic work (e.g., PFT or imaging review).
In contrast, pulmonologists with formal critical care training (PCCM) and appropriate hospital privileges may be eligible for ICU-based moonlighting, including nocturnist shifts or coverage at community hospitals.
Sleep medicine represents a separate pathway. Pulmonologists who have completed accredited sleep medicine training and hold board certification may moonlight in sleep clinics, interpret sleep studies or provide tele-sleep consultations. Pulmonary training alone does not qualify a physician for sleep medicine moonlighting without this additional credentialing.
Moonlighting during fellowship is also a common entry point. Many programs permit second- and third-year fellows to moonlight once they hold an unrestricted medical license and receive program director approval. These positions can be internal (such as additional ICU coverage within the home institution) or external (including lower-acuity nocturnist roles). Importantly, all moonlighting—internal or external—must comply with ACGME duty hour requirements, including the 80-hour weekly limit, and must not interfere with fellowship training objectives.
Why do pulmonologists seek moonlighting opportunities?
For pulmonologists, motivations for moonlighting typically include financial necessity, lifestyle management or desired professional satisfaction.
Intense call schedules and ICU burden
Pulmonary/critical care roles often entail frequent overnight calls, weekend ICU coverage and high-acuity decision-making, sometimes leading to burnout. Moonlighting can offer a solution by providing controlled work. A pulmonologist might choose a moonlighting gig that involves only daytime consults or remote work to escape the grind of 24-hour shifts. It allows them to earn predictable income without the longitudinal responsibility of being the primary attending of record for a bustling ICU service.
Monetizing specialized diagnostic expertise
Pulmonologists possess a skillset that translates well to the digital health space. The ability to interpret pulmonary function tests (PFTs), analyze advanced imaging, review bronchoscopy data, and conduct sleep studies allows for work that doesn’t require a physical presence.
Financial supplementation
Financial pressure remains a main motivator for moonlighting and physician side hustles in general. In a poll asking Sermo members for the main benefit of a side hustle, extra income was the most popular answer with 41% of votes. Polled members most commonly (40%) indicated that they aim to make $0–1,000 per year from side hustles.
“Financial health maybe is the biggest challenge for many professionals in any area,” a pulmonologist noted on Sermo. A hematologist seconded that notion: “Side hustles are necessary with the current state of world economy.” Moonlighting serves as a powerful accelerator for debt reduction, income diversification and reaching financial goals faster.
Career autonomy and RVU protection
Many moonlighting physicians still find enjoyment in their primary role. In a small-sample poll, 74% of Sermo members said they enjoy their primary role more than their moonlighting gig.
That said, relying solely on a primary employer can leave physicians vulnerable to shifting administrative targets. Supplemental income reduces reliance on Relative Value Unit (RVU) productivity targets and rigid institutional scheduling demands. It provides leverage—knowing you have other income streams makes it easier to negotiate better terms or walk away from a toxic primary work environment.
Where to find moonlighting opportunities as a pulmonologist
Gone are the days of relying solely on word-of-mouth in the doctor’s lounge. Today, a mix of digital platforms and traditional networking can help you find moonlighting opportunities.
- Hospital internal postings: consider your own hospital or affiliated network. Department chiefs frequently need coverage for ICU nights, weekend pulmonary consults or holiday shifts.
- Locum tenens agencies: agencies specializing in pulmonary/critical care coverage handle the logistics of travel, housing and malpractice insurance. This is ideal if you like to work in short, concentrated blocks.
- Tele-ICU and remote diagnostics platforms: look to companies specifically hiring for tele-ICU physician roles or remote interpretation.
- Specialized job boards: sites like DocCafe and major medical association boards often have filters for temporary or per-diem work.
- Sermo: as a physician-first community, Sermo allows you to connect with peers who can share leads on unadvertised opportunities. It is a space for peer advice on contract negotiation and case discussion, ensuring you know the market rate before you sign on the dotted line.
Moonlighting opportunities for pulmonologists
In a community discussion, some Sermo members shared that they moonlight three to four times per month, while others said two to six times per month. If you are ready to get started yourself, here are six specific avenues tailored to the pulmonary skillset.
Pulmonology locum tenens
Locum tenens work is a classic form of moonlighting. Inpatient/hospital coverage involves taking on temporary blocks of shifts—typically a week at a time—to cover inpatient pulmonary or critical care needs in hospitals. It allows you to see different practice models and visit new cities.
If you’re seeking lower acuity, providing part-time coverage in outpatient clinics for an established practice or healthcare system is an excellent option. This might involve seeing asthma, COPD or nodule clinic patients, providing relief to an overburdened local practice.
Nocturnist/weekend critical care
Hospitals are often short-staffed on nights and weekends. You can take on a role as a dedicated nocturnist or cover weekend ICU shifts. Since these shifts are harder to fill, physicians often have greater leverage to negotiate higher hourly rates compared to standard daytime work. The average rate in the U.S. is $117 per hour, according to ZipRecruiter data.
Tele-pulmonology/tele-critical care (e-ICU)
Tele-ICU involves remote monitoring of ICU patients, providing support to bedside teams, handling escalations and covering admissions overnight. Tele-ICU physician pay averages $120,690 in the U.S., per ZipRecruiter, and the work allows you to manage critical patients from a home office.
Sleep medicine coverage
For those with the appropriate certification, sleep medicine is an option for flexible moonlighting. It can involve remote sleep study interpretation (polysomnography), CPAP compliance reviews and virtual consults. This work is highly asynchronous; you can read studies whenever you have a free hour, making it easy to fit around a busy clinical schedule.
Non-clinical side jobs for pulmonologists
Sometimes, the answer to burnout isn’t more clinical work. If the thought of another patient encounter feels overwhelming, non-clinical side gigs offer a refreshing alternative. You might explore medical writing, advising health-tech startups, pharmaceutical consulting or either of the following:
Medico-legal consultations
Your expertise is valuable in the courtroom. Physician medico-legal consulting involves reviewing cases related to occupational lung disease (like asbestosis or silicosis), ICU outcomes or ventilator management standards of care. Lawyers and insurance companies pay premium hourly rates for expert opinions and chart reviews. One family medicine doctor on Sermo combined this type of work with clinical moonlighting. “I moonlighted in emergency rooms every chance I got and did medicolegal work whenever it came to me, for extra income,” they shared.
Pulmonology education
Opportunities exist in exam preparation (writing board review questions), Continuing Medical Education (CME) delivery or fellowship-level instruction. While pulmonary function test reading is diagnostic, teaching others how to interpret them for board prep companies offers a form of educational moonlighting.
Sermo paid medical surveys as a means to reach your goals
If you aren’t ready to commit to a locum contract or a legal retainer, there is a simpler way to start earning: paid medical surveys.
On Sermo, you can monetize your clinical knowledge in minutes. By sharing your insights on new treatments, drug protocols and healthcare trends, you contribute to the advancement of medicine while earning supplemental income.
For many doctors, this constitutes a viable source of extra money to further their careers, with the most active members making thousands of dollars annually. Whether you are saving for a secondary degree or funding a certification, survey income offers an immediate boost. It fits into the micro-moments of your day—between patients or while waiting for a case to start—turning downtime into productive time.
Join the conversation (and start earning)
Moonlighting can be a strategy for professional longevity and financial independence. Whether you choose to pick up extra ICU shifts, interpret sleep studies from your home office or consult on legal cases, the opportunities for pulmonologists are vast.
When you’re new to moonlighting, peer support is invaluable. Join the Sermo community to discuss rates, share opportunities and get honest feedback on different moonlighting gigs. And while you are there, you can take advantage of paid medical surveys to start earning extra income from home.
