What specialties can you enter that could work 1 week on 2 weeks off and still clear 200k? By "could" I also mean reasonably find or create a job that fits this schedule..
Hospitalist, nocturnist, intensivist, anesthesiology, emergency, consultation psychiatry, diagnostic radiology (note the inpatient nature of most of these) may be among your best bets for intermittent clinical work that pays OK. (“Laborist” is a much newer concept than my training, but it sounds about right.)
I do locum tenens psychiatry. With a bit of persistence I can make around $24k/wk (for 7-on/7-off, 12-hour shifts with copious call). $230-250/hr is not terribly hard to find, but there’s a huge income difference between 8 hr/day M-F and 7 days of 12-hour shifts. I mostly live at my house in the tropics in México and fly to assignments in the US.
No, you can’t just work your ass off doing that 52 wk/yr and make $1.2 million/yr for numerous reasons, including your ability to survive the schedule, but half that is eminently doable.
To make this rate, several assumptions are usually safe (basing this also on having hired a bunch of locums over the years):
- The contract will be for a limited time, since hiring an employee will be lots cheaper. The more lucrative, the shorter the contract. Thus, you’ll always have to be planning ahead for the next gig.
- They’ll work you like a rented mule to get their money’s worth. Employees knock off early, you stay late.
- This sort of rate might be available for a 14/14 schedule, but if they have enough people to staff 1/3 they probably don’t have to pay a super-high rate. I’ve done 14/14 but I’m usually plenty crispy at the end of a single week.
- You’re likely to be the one working holidays and typical vacation times.
- Somehow it always seems that these contracts are far from home no matter where you live, so you’ll be living in mid-market hotels. You’ll also usually spend at least a half-day traveling each way (14/14 reduces this and is cheaper for the employer as well).
- This would be a tough schedule if you have kids in school, a partner with a job, or a partner who doesn’t want to share a little hotel room all the time.
- The more isolated and boring a location, the more they have to pay, so there may not be a lot to do outside of work.
- For a single person, this can be an excellent way to ensure you stay that way.
On the plus side, you’re not paying for those flights or hotels and you might be able eat free/cheap (usually unhealthful) meals at work. Copious frequent flier miles = free status upgrades (I haven’t flown in the main cabin in years) and award flights.
I know people who only work one week per month or 3 months per year, but they accept a significant amount of uncertainty about their work schedule.
Take some free advice from someone who’s been paid a lot to work with many miserable, burnt-out, or impaired doctors: do not choose a specialty based on how you think it’ll pay! For one thing, this changes constantly. Sure, if you truly enjoy rotations (including the schedule) in 2 things equally, then why not let money be a factor? However, not everyone gets to be an astronaut, and not every student is a competitive applicant for every specialty. The kind of “lifestyle specialties” that often seem to offer great flexibility tend to attract people who are so competitive it might be hard to fit into a group if you’re not. They may also involve patient populations who need a lot of follow-up.
