Vlad Dzhashi, MD
👉 Feeling pressure from HUGE student loans you have?
👉 Looking to start your career with the HIGHEST possible income?
👉 Want to finally experience life to its fullest after more than a decade of hard work?
If the answer is yes, stick around and read on for different ways to start making great money right off the bat. I am going to show you what it takes to make $400K a year as a freshly minted hospitalist.
Why $400K?
I know…it may sound random, but hear me out first:
The average hospitalist salary now is $285,365 based on the most recent Today’s Hospitalist survey.
With $400K/year, you will be looking at making more than the 95% of hospitalists…
And of course…even if you live in crazy expensive cities like New York, Los Angeles, Boston, Honolulu, etc., you’ll have a great lifestyle AND would be able to put aside a large chunk every year.
Not bad, huh?
So…without further ado, let’s jump right in!
Option #1: Full-time locum tenens or per-diem
- Estimated # of shifts to make $400K:
- - 17 shifts a month with $165/hr
- - 15 shifts a month with $185/hr
- - 14 shifts a month with $200/hr
Benefits: you pay for your own benefits.
Note: great for hospitalists who don’t mind being away from home for at least one week a month.
This is what I’ve done for years. I started as a full-time locum after two and a half years of a permanent job, and later on, I added per-diem shifts to the mix.
Even with the most basic $165/hr rate, you can totally achieve this; after all, anybody can work 2-3 extra shifts a month.
With this approach, the biggest challenge is that you may need to travel. So, if you absolutely have to stay within commutable distance from your home (family, small kids, etc.) and you are NOT in a big metro area that has lots of big hospital employers offering per-diem jobs, you will be better off looking at other options.
But…if you CAN travel for at least 7-10 days a month, this is totally doable. Plus, travel can be a lot of fun: you’ll explore exciting places and meet a lot of new people.
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- Jumpstart your Locums Career!
- Sign up for my coaching to access:
- Top Gigs
- Top Pay
- Unique resources
- No stress
Onward.
Option #2: Permanent nocturnist job + locum tenens/per-diem
- Estimated # of shifts to make $400K:
- 10-11 night shifts at your permanent job and 4-5 extra shifts ($165/hr).
Benefits: covered by the employer.
Note: the best option if you don’t mind working nights.
I am not talking about 7 on/7off nocturnist jobs here: this schedule is hard and most people burn out.
I am talking about 7 on/14 off jobs.
You may be surprised, but there are a lot of hospitalist programs that try hard to retain their night docs by offering a 17-19 weeks a year schedule with the same full-time pay.
With this schedule, you’ll have plenty of time off to take extra shifts: you can work extra at the same hospital as your permanent job, sign up for per-diem shifts locally or do locum tenens anywhere else in the country.
I think this is totally the best option for “night owls” since you can make great money and you’ve got more than enough time off left to enjoy life.
On top of that, your permanent nocturnist job will sponsor your benefits and health insurance which will save you some money too compared to full-time locums/per-diem.
Hate nights?
Let’s look at other options.
Option #3: Permanent critical access hospital job + locum tenens/per-diem
- Estimated # of shifts to make $400K:
- 10-12 twenty-four-hour shifts and 4-5 extra shifts ($165/hr).
Benefits: covered by the employer.
Note: great for hospitalists enjoying autonomy and willing to live in a small town.
A lot of critical access hospitals (i.e., small rural facilities) cannot justify having a “full-blown” nocturnist program. As a result, hospitalists work 24-hour shifts.
I’ve seen anywhere from 10 to 12 shifts a month to be counted as a full time.
Since you work in a smaller hospital and you are the ONLY hospitalist on, your job will look different from your typical gigs:
- The average patient census is lower and sometimes can be as low as 6-8 patients a day.
- But…it will fluctuate a lot and it’s not uncommon to see a sudden census jump of 50-100% (i.e., from 8-10 to 16-18 pts). This mostly happens during the busy winter season.
- You are responsible for all medical admits that come to the hospital, so you will round AND admit throughout your shifts.
- You are guaranteed to get paged at night either from RNs or from the ER to admit patients.
- Since you don’t have all the subspecialties available, you tend to have a lot of transfers to bigger hospitals, which may get tricky.
On the plus side, you’ve got much more autonomy in making decisions, and patients tend to be more grateful for what you do.
Onward.
Option #4: Part-time or Full-Time — plus moonlighting/per-diem or locum tenens
- Estimated # of shifts to make $400K:
- 14-15 shifts a month at the permanent job and 5 extra shifts ($165/hr)
Benefits: covered by the employer.
Note: part-time option is great for “cautious” docs willing to get benefits AND get exposed to the locum’s world.
This approach may be the most common one that I see hospitalists are doing. You’ve got your full-time job and you work on the side for an extra income.
The thing is, if your permanent job pays peanuts or gives you less money just ‘cause you are a new grad, you may end up working a lot of extra shifts to get to our “magic” number.
On the other hand, if you are NOT interested in traveling, checking different places, working locum tenens AND you find a job that pays $300K+ a year for fresh grads, be my guest!
Just make sure your permanent job can supply you with enough extra shifts in-house.
If not, it may be hard to find a locum gig on the side, as a lot of hospitals want you to commit to at least seven shifts a month. So you’ll end up either getting stuck with your base salary or you’ll get overstretched with working 20+ shifts a month.
That’s why I like the idea of signing up as a part-timer (7-10 shifts a month) and working locum tenens or per-diem in your time off.
You kill two birds with one stone: you have a stable job that covers your benefits AND you can easily find shifts on the side.
What it takes to make $500k your first year as a hospitalist?
Half a rock without a shock!?
What if half a million sounds better to you AND you are ready to churn out in a total “beast” mode?
Great, I’ve got a breakdown for you in the table below.
- Click the image to zoom
Word of caution:
I suspect a lot of you reading this article may be tempted to work a GAZILLION shifts per month as soon as you graduate. After all, you really want to build a solid financial base ASAP.
Just remember: your career is a marathon not a sprint…
So give yourself plenty of time to rest, don’t forget to learn something new every year, pick up a hobby or two and spend time with your friends and family.
Balance is the key!
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ER docs are making this working 12x 9 hour shifts a month….us hospitalists need to insist that we are worth more. We should be making as much as ER docs, anesthesia etc. I made 450+ for a few years quite literally killing myself while other specialties are making that much and way more working way less. If I could do it over, I would have gone anesthesia for sure. As a hospitalist I see 18-20 patients a day, and am treated like a nurse by admin. The ER abuses us with garbage admissions half of which they never even saw but are billing critical care time on and dumping on us…..all for about the same as a senior engineer makes with a bachelors….total garbage…