Locum Tenens vs Employed Calculator

Locum tenens work offers flexibility, high daily rates and a chance to try different places before settling down. It also means no benefits, self-employment taxes and gaps between assignments. This calculator compares what you'd really keep from locums with a traditional employed job — and tells you the daily rate you'd need to match your current position.

What this calculator does

For the employed side, enter your salary and the yearly value of your benefits: health insurance, retirement contributions, CME, malpractice and disability. For locums, enter your daily rate, days worked per year, expenses you'd pay yourself, health insurance you'd buy and what you'd contribute to a solo 401(k). Add your filing status and state tax rate. The calculator shows:

• which option is worth more each year,
• the difference,
• each option's value after taxes, and
• the daily locums rate that would make them equal.

The formula in plain English

Employed value = salary − federal tax − Social Security and Medicare − state tax + benefits.

Locums value = (daily rate × days − expenses − health insurance − retirement contribution) − federal tax − self-employment tax − state tax, plus the retirement contribution, since it's still your money.

Locums income is treated as 1099 self-employment income. The calculator applies self-employment tax, deducts half of it, includes the self-employed health insurance deduction and retirement deduction, and applies the QBI deduction where your income qualifies. Federal tax uses 2026 brackets.

Breakeven daily rate is found by testing rates until both options are equal.

A worked example

Dr. Ramirez, a hospitalist, earns $300,000 with about $40,000 in benefits. A locums agency offers $2,000 a day for about 170 days a year. She'd pay about $8,000 in expenses, $10,000 for health insurance and contribute $40,000 to a solo 401(k). She's single in a state with a 5% income tax.

• Employed: about $240,200 a year in take-home pay plus benefits.
• Locums at $2,000 a day: about $223,300 in take-home pay plus retirement savings.
• The employed job is ahead by about $16,800.
• Breakeven daily rate: about $2,210.

At $2,400 a day, locums would come out about $18,300 ahead — while working 170 days instead of a full schedule. For many people, that time is the real attraction.

Why it matters at each career stage

If you're: Resident / fellow

Locums right after training can be a way to explore cities and practice settings before committing. Make sure you have your own disability coverage, since you won't have a group plan.

If you're: Employed

If you're burning out, locums can offer control over your schedule. Compare not just pay but days worked: the breakeven rate tells you what you need to keep your income while working less.

If you're: Practice owner

Some owners do locums after selling a practice or as they wind down. The same math applies; your expense assumptions may differ.

Before you switch

Price your benefits honestly. Health insurance for a family, disability insurance and retirement match can be worth $30,000 to $60,000 a year.

Plan for gaps. Assignments don't always line up, and credentialing for a new facility can take 60 to 90 days. Budget for unpaid weeks and keep a larger emergency fund — six months of expenses is a sensible target.

Expect more paperwork. Multiple state licenses, credentialing and multi-state tax returns take time and money.

Protect yourself. Confirm malpractice and tail coverage terms in writing for every assignment.

For a broader contractor comparison, see W-2 vs 1099. Plan your quarterly payments with the quarterly estimated tax calculator, and read our W-2 vs 1099 guide.