Choosing between locum tenens and permanent employment can shape your schedule, income, benefits, and long-term career. Both options can offer a rewarding medical career, but they suit different priorities.
Locum tenens vs permanent jobs comes down to what you value most. You may want greater schedule control and clinical variety. Or you may prefer predictable income, employee benefits, and long-term relationships with patients and colleagues.
This comparison breaks down the key differences so you can choose the path that fits your professional and personal goals.
Locum Tenens vs. Permanent Jobs at a Glance
Locum tenens physicians work on temporary assignments that help healthcare facilities meet short-term or ongoing staffing needs. Assignment length can range from days to several months, and some positions can lead to longer arrangements.
Permanent physicians work in an ongoing role with a hospital, medical group, private practice, or other healthcare organization. These positions usually come with a set schedule, employee benefits, and a long-term employment agreement.
| Factor | Locum Tenens | Permanent Job |
| Schedule | More control over when you work | Usually set by the employer |
| Compensation | Often based on hourly or daily rates | Usually salary or guaranteed compensation |
| Benefits | Often varies by arrangement | Typically includes employee benefits |
| Work location | Can change between assignments | Usually one primary location |
| Clinical variety | High exposure to different settings | Greater continuity in one setting |
| Job stability | Assignment-based | Ongoing employment |
| Administrative support | Staffing agencies may handle many logistics | Employer usually manages onboarding |
| Career growth | Broadens experience across settings | Supports long-term leadership paths |
| Patient relationships | Usually shorter-term | More opportunities for continuity of care |
How Locum Tenens and Permanent Work Differ
The biggest difference is the level of control and commitment each model provides.
Locum tenens gives you more control over your schedule, location, and assignment length. You can accept work based on your availability and professional interests. This can work well if you want time between assignments or plan to travel.
Permanent employment offers greater predictability. You usually know where you will work, who your employer is, and what your schedule looks like. This structure can make long-term financial and family planning easier.
Your preferred work style matters here. If you enjoy adapting to new teams and healthcare systems, locum work can provide more variety. If you prefer a familiar environment and established routines, a permanent role may feel more comfortable.
If you are also comparing other flexible work arrangements, see how locum tenens vs. PRN vs. per diem differ in schedule, pay, and commitment.
Compensation, Benefits, and Overall Value
Pay often attracts physicians to locum tenens, but comparing only the hourly or daily rate can give you an incomplete picture.
Locum assignments may offer competitive rates and can include expenses such as travel, housing, and professional liability coverage. Your actual earning potential depends on factors such as specialty, location, experience, assignment requirements, and the number of shifts you accept.
Permanent positions generally provide a predictable salary or compensation structure. The total package can also include health insurance, retirement contributions, paid time off, CME benefits, and other employee benefits.
This makes locum tenens vs permanent compensation a total-value question. Compare the full package instead of looking at the advertised rate alone. If compensation is a major factor in your decision, learn more about the reasons behind higher locum pay .
You should also consider taxes, time between assignments, unpaid time off, retirement planning, and the value of employer-sponsored benefits. A higher locum rate does not automatically mean higher overall financial value for every physician.
Schedule Flexibility and Work-Life Balance
Schedule control is one of the clearest differences between the two career paths.
Locum physicians can often choose assignments around their availability. You may work for several weeks, take time away, and return when you want another assignment. Some physicians also use locum work to supplement a permanent position.
This flexibility is a major reason physicians choose locum work. In the 2024 Survey of Locum Tenens Physicians and Advanced Practice Professionals , 97% of surveyed physicians and advanced practice providers rated freedom and flexibility as a rewarding aspect of locum tenens.
Permanent jobs usually provide a more structured schedule. Your employer determines many aspects of your work hours, call schedule, PTO policies, and coverage responsibilities.
A permanent schedule can support family routines and long-term planning. Locum work can give you more freedom to arrange work around personal priorities.
Neither option guarantees better work-life balance. Your specialty, assignment, call requirements, commute, and workload all matter.
Career Growth and Clinical Experience
A permanent position can support long-term career development within one organization. You may pursue leadership roles, committee work, mentorship, research, teaching, or other professional opportunities.
Permanent employment is also common across the U.S. healthcare system. The American Medical Association’s Physician Practice Characteristics in 2024: Private Practices Account for Less Than Half of Physicians in Most Specialties found that 47% of physicians in 2024 either worked in hospital-owned practices or were directly employed or contracted by hospitals.
You also gain continuity. Working with the same team and patient population can help you build strong professional relationships and deepen your knowledge of a specific practice environment.
Locum tenens provides a different type of career development. Moving between facilities exposes you to different clinical workflows, patient populations, EHR systems, and practice settings.
That variety can help you build adaptability and broaden your professional experience. It can also help you identify the type of practice environment you want for your next long-term role.
For physicians between jobs, locum work can also help prevent an employment gap while providing additional clinical experience.
Licensing, Credentialing, and Administrative Work
Administrative responsibilities can influence your decision more than you might expect.
When you accept a locum assignment through a staffing agency, the agency may assist with licensing, credentialing, travel, housing, and malpractice coverage. The exact support depends on the agency and assignment.
Permanent employers also handle parts of the onboarding process, but requirements can vary by organization. You may need to manage relocation, licensing, credentialing, and other transition tasks when changing employers.
Ask who handles each responsibility before accepting a position. Clarify licensing requirements, credentialing timelines, malpractice coverage, travel arrangements, housing, and contract terms.
This can help you compare the actual workload behind each opportunity.
Radiologist Locum vs. Permanent: What Should You Consider?
The radiologist locum vs permanent decision often comes down to schedule control, workload, location, and professional goals.
Locum radiologists can work across different hospitals, imaging centers, and geographic markets. This can provide exposure to different systems and allow greater control over assignments.
A permanent radiology position can provide a consistent practice environment, established colleagues, predictable benefits, and opportunities to develop long-term relationships within one organization.
Radiologists should compare more than the hourly rate. Review call expectations, shift length, modality mix, remote or onsite requirements, credentialing needs, and the full compensation package.
Orthopedic Surgeon Locum vs. Permanent: Which Fits Better?
The orthopedic surgeon locum vs permanent choice requires a close look at surgical volume, call coverage, facility resources, and scheduling.
Locum assignments can give orthopedic surgeons opportunities to work in different hospitals and practice environments. They can also provide flexibility for physicians who want to control when they accept assignments.
A permanent orthopedic role can provide greater continuity with patients, surgical teams, referral networks, and hospital leadership. It may also provide a clearer path toward leadership or partnership opportunities, depending on the employer.
Before choosing, compare case mix, expected volume, call duties, support staff, operating room access, compensation, and benefits.
Who May Prefer Locum Tenens?
Locum work may fit physicians who:
- Want greater control over their schedules.
- Prefer short-term commitments.
- Want to travel or work in different locations.
- Want to experience different practice settings.
- Need flexibility during a career transition.
- Want to supplement income with additional assignments.
- Plan to reduce their workload later in their career.
- Want to evaluate a facility before making a long-term commitment.
Locum work can also provide a practical way to try a new location or practice environment before accepting a permanent offer.
Considering this career path? See our guide on Why Choose Locum Tenens?
Who May Prefer a Permanent Job?
A permanent position may fit physicians who:
- Want predictable income and benefits.
- Prefer a consistent work location.
- Value long-term patient relationships.
- Want to become part of an established medical team.
- Seek leadership or organizational advancement.
- Prefer a structured schedule.
- Want long-term roots in a community.
- Prefer employer-sponsored benefits and retirement programs.
Permanent employment can provide a stronger sense of continuity for physicians who want to build their career within one healthcare organization.
Can You Combine Locum and Permanent Work?
You do not always have to choose one path.
Some physicians maintain permanent employment and accept locum assignments during available time. Others move between permanent and locum work at different stages of their careers.
A hybrid approach can provide a steady primary income while creating opportunities for additional clinical work and flexibility. Your employment agreement may limit outside work, so review your contract before accepting another position.
Locum work can also serve as a bridge between permanent roles. An assignment may help you maintain clinical activity while you search for a long-term position.
How to Choose Between Locum Tenens and Permanent Employment
Start by identifying your top three priorities.
If flexibility ranks first, compare assignment schedules, time off, locations, and call requirements. If financial stability matters most, compare guaranteed compensation, benefits, retirement contributions, and potential gaps between assignments.
If career growth drives your decision, review leadership opportunities, mentorship, specialty exposure, and professional development. If patient continuity matters most, consider how long you want to work with the same patient population and care team.
Also review the contract carefully. Look at compensation, termination terms, malpractice coverage, licensing responsibilities, travel, housing, scheduling, and any restrictions on outside work.
The right choice should support your current career goals. You can always reassess as your priorities change.
Locum Tenens vs. Permanent Jobs: Which Is Right for You?
There is no single answer for every physician.
Choose locum tenens if you value flexibility, variety, geographic freedom, and greater control over when you work.
Choose a permanent job if you value stability, predictable benefits, continuity of care, and long-term career development within one organization.
Your specialty and career stage also matter. A new attending may value the chance to experience different practice settings. A mid-career physician may prioritize schedule control. A late-career physician may want fewer long-term commitments while continuing to practice.
Take time to compare the complete offer, not one benefit or pay rate. The best career path is the one that fits your professional goals, financial needs, lifestyle, and preferred way of working.
FAQs
How Much More Can Locum Tenens Physicians Earn Than Permanent Staff?
Locum tenens physicians can sometimes earn higher hourly rates than permanent staff. However, permanent roles may include benefits, PTO, and other compensation that affect the overall value.
Can a Locum Tenens Assignment Turn Into a Permanent Job?
Yes. Some assignments can lead to permanent positions when both the physician and facility want to continue the relationship. This gives both sides a chance to work together first.
Do I Need a Medical License in Every State Where I Work?
Generally, yes. You need an active license in each state where you practice. Some states offer faster licensing options, and staffing agencies may help with the process.
Which Medical Specialties Have High Locum Tenens Demand?
Emergency medicine, hospital medicine, radiology, anesthesiology, and psychiatry often have strong demand. Demand can be especially high in rural and underserved areas.
Can Physicians Negotiate Locum Tenens Pay and Contract Terms?
Yes. Rates and contract terms can often be negotiated based on specialty, location, experience, and demand. Review the full agreement before accepting an assignment.
How Do Locum Tenens Physicians Keep Up With CME Requirements?
CME requirements depend on the state and your licensing rules. Physicians can often complete CME through online courses, conferences, and other approved programs while working locum assignments.
What Should I Look for in a Locum Tenens Staffing Agency?
Look for strong physician support, clear contracts, malpractice coverage, and reliable communication. It also helps to review the agency’s reputation and experience with healthcare facilities.
Are Locum Tenens Jobs Difficult to Find?
Staffing agencies can help physicians find assignments that match their specialty, schedule, and location. Availability can vary based on demand and the physician’s qualifications.
How Much Experience Do You Need for Locum Tenens Work?
Experience requirements vary by assignment and facility. Some positions may require specific clinical experience, board certification, or other credentials based on the role.
