Locum Tenens vs. Permanent Positions: Which Is Right for Your Medical Career?

The decision between locum tenens work and a permanent position is one of the most consequential career choices a physician can make. Locum tenens — Latin for "to hold the place of" — involves temporary assignments at healthcare facilities that need coverage due to vacancies, leaves of absence, or seasonal demand spikes. Permanent positions offer long-term employment with a single organization. Both paths have significant advantages and trade-offs that depend on your career stage, financial situation, and lifestyle priorities.

Locum Tenens: The Case For

Locum physicians typically earn $150 to $300+ per hour, with some high-demand specialties like psychiatry and anesthesiology commanding $350+ per hour. Housing, travel, and malpractice insurance are usually covered by the staffing agency. The flexibility is unmatched — you choose where you work, when you work, and how much you work. Many locum physicians take extended breaks between assignments, travel the country, or use locum work to explore different practice settings before committing long-term. For physicians recovering from burnout, locums offer a way to practice medicine without the administrative burden and politics of permanent employment.

Locum Tenens: The Trade-Offs

The downsides are real. Locum physicians do not receive employer-sponsored benefits — no health insurance, no retirement match, no paid time off. You are responsible for your own taxes as a 1099 contractor (though forming an S-corporation can provide tax advantages). There is no continuity of care, which bothers some physicians deeply. Credentialing for each new facility takes time, and last-minute assignment cancellations can leave gaps in your schedule and income. Long-term career advancement is limited — locum work does not build toward partnership or leadership positions.

Permanent Positions: Stability and Growth

Permanent physician positions typically offer a guaranteed base salary, comprehensive benefits (health, dental, vision, disability, life insurance), employer-matched retirement contributions (often 5-10% of salary), CME allowances, malpractice coverage, and paid time off. You build relationships with patients, staff, and community. Career advancement into leadership, teaching, and research is possible. For physicians with families, the stability of a permanent position — consistent income, predictable schedule, community roots — is often the deciding factor.

How to Decide

• Early career — permanent positions are generally better for building clinical skills, establishing referral networks, and qualifying for loan repayment programs
• Mid-career — locum tenens can be an excellent way to explore new geographies or settings, earn extra income, or recover from burnout
• Pre-retirement — many physicians transition to locum work in their final working years, reducing their schedule while maintaining income without a long-term commitment
• Financial flexibility — if you have significant student debt and need consistent income for loan payments, a permanent position with loan repayment may be the better financial decision

Whether you are looking for locum or permanent opportunities, search providers and opportunities at app.avahealth.co.

Related reading: Locum Tenens: A Complete Guide for Healthcare Recruiters and Providers, How Much Do Locum Physicians Make? 2026 Compensation by Specialty, Emergency Medicine providers.