While all residents and fellows are excited to start their careers as physicians, many of them also deal with large amounts of debt. According to a 2019 survey conducted by Weatherby Healthcare, 32% of physicians who were carrying medical school debt owed more than $250,000 and nearly half (49%) owed more than $200,000.
Physicians early in their careers employ various strategies to pay off medical school debt – from living as frugally as possible to participating in the Public Service Loan Forgiveness Program – but one effective option is often overlooked: working locum tenens.
Many physicians coming out of residency are finding locum tenens to be a great way to pay off medical school debt quickly while gaining experience in a variety of practice settings. Locums physicians typically earn more than their counterparts in permanent positions and have more control over how much they work, variables that can help speed up debt repayment.
When Dr. Gary Trewick finished his residency in 2016, he was facing over $500,000 in student loan debt. A hospitalist specializing in internal medicine, he has managed to pay off nearly all of his debt in just three years by working locum tenens.
His aggressive payment strategy is a result of advice he received from a neurosurgeon he worked with early in his career. “He told me, ‘Pay down your debt as soon as possible. That’s the best strategy.’ I went all in and I sacrificed just about everything,” he says.
Dr. Trewick says working locums assignments enabled him to pay down his debt so quickly. He works with multiple agencies to ensure he always has an assignment lined up for him, and he typically works about 20 days a month — a bit more than an average hospitalist. By maximizing the number of days he works, negotiating the highest pay rate possible, and accepting jobs in rural areas, he’s come very close to paying off his debt in just three years.
He concedes that doing what he’s done take a lot of determination, but he feels it was worth it. “Definitely pay off your loans as fast as possible,” he says. “Do locums. You may feel like you’re not ready, but if you can go with a full-time job, you can go with a locums job. There’s always enough work. If you’re doing it right, there will always be enough work.”
Living like a resident
Dr. Melissa Macaraeg, a pediatrician, finished her residency in 2018 and has been working a combination of per diem and locums assignments in her home state of New York. She discovered locum tenens during residency and decided it would be a great way to gain some experience while she applied to fellowship programs.
The combination of traveling and the freedom to work wherever she wanted was a big draw, especially after experiencing burnout during residency. “I was just exhausted. If I could earn more as a per diem and locums, then so be it. Paying off $200,000 is a lot of money but so is my mental health.”
To keep costs down, she adopted the advice of living like a resident and paying off as much of her debt as possible. “I keep the same budget, or almost the same budget, as I did in residency, and whatever is left over I use to go towards debt and loans,” she says.
Dr. Macaraeg took this advice a step further and moved back in with her parents, giving up her apartment in Brooklyn. “It doesn’t make sense for me to stay there with my traveling lifestyle,” she says. “With that and not having to pay rent or the exorbitant prices of getting on the subway, it worked out for me.”
When you have two doctors in the family, paying off medical school debt becomes an even bigger concern. Dr. Ashita Gehlot, an OB/GYN, and her husband Dr. Hevil Shah, a neonatologist, both completed medical school at the same time.
“Once medical school was over and both of us went into residency, then it became an eye opener,” says Dr. Gehlot. They quickly realized that it could take them 20 to 30 years to pay off their loans if they didn’t come up with a plan. For them, this meant living below their means.
Living comfortably but below your means for the first three to five years is what Dr. Gehlot recommends to those starting out in their careers. “I think we’ve figured out a good balance for us, but it’s not like we’re missing out on the really fun things in life.”
When her husband’s fellowship took them from Georgia to Ohio, Dr. Gehlot began working locums assignments. In addition to being able to practice both obstetrics and gynecology, she was thankful for the opportunity to begin aggressively paying off her student debt. She’s also been able to take on extra shifts, which equates to higher pay than if she’d stayed in private practice.
Pay off medical school debt faster
Paying off debt doesn’t have to be stressful if you have a plan. Whether you’re still making your way through residency or have already started as an attending physician, working locum tenens can help you earn more and pay down your debt at the same time. While some physicians enjoy working locum tenens full-time, even taking an extra shift or two in your hometown can add up over time.