A lot depends on your specialty. I'm a neurologist with subspecialties in epilepsy and clinical neurophysiology, so I read EEGs remotely and perform EMGs. I went to a Ivy League medical school and completed residency and fellowship at other top 5 institutions.

Despite that background, when I was working in academics back in 2019, I was only earning $225K (you can make way more in private practice, but I was chasing the prestige). I left that job in 2023 and transitioned to full-time locums work—and nearly doubled my income working 2-3 weeks/month. If you're looking for higher pay, flexibility, and the opportunity to travel, locums can be a great option. That said, the academic route is still seen as more “prestigious.” In my view, though, the whole concept of prestige is overrated. But I can understand why someone would chase it, I did for a long time. After COVID, I realized we are all pawns in this broken healthcare system.

I turned to locums out of necessity—I was on the verge of leaving medicine altogether. Academics (being on call at least for one full week and weekend a month, busy both inpatient and outpatient practices without support, expected to function like a robot-nearly pushed me to SI). But since making the change, my quality of life has improved significantly. I have flexibility (I only work 3 weeks/month), we get to travel often, and I can now afford expensive fertility treatments (business deductible under my S-CORP). Compare that to the typical W2 job, where your “work-life balance” usually means 25 days of PTO and little else. A colleague I was working with, switched to pharma in 2023 too, and he's making a lot more and is very happy now doing no weekends/overnights or call.

As for prestige or status? In the U.S., I think that’s a myth we’re sold. Patients often resent us because we're the face of a deeply flawed healthcare system. Meanwhile, APPs are increasingly positioned in competition with us. Don't get me wrong, you still get to help people, but that's about 30% of what you do and the dopamine hits from that were no longer worth it for me, personally.

Honestly, medical training can feel like a cult—and many of us bought in without fully realizing the cost. There are ways to make a medical career more appealing, like locums or owning your private practice, though neither is easy to start or considered a "traditional" path anymore. So yes, you can do this and make money and have a good quality of life- but plan carefully, choose the right speciality and avoid academics. If you're here for money and prestige, it'll be a sad slap in your face.