Career Path Comparison
Academic vs. Private Practice vs. Locums. Compare estimated lifetime earnings.
Starting Salaries
Lifetime Gross Earnings Estimate
Includes lower growth, assumes stability.
Assumes partnership track & higher growth.
High start, but benefits/taxes eat into this.
(sends these numbers to Ask; we don't keep them)
Clinical Context & Calculation Details
How to Use This Calculator
Adjust the starting salaries for an Academic attending, Private Practice partner, and a Full-Time Locum Tenens physician, as well as your expected total career length.
The tool contrasts the estimated lifetime gross earnings across the three major career paths using typical income growth curves.
Why Doctors Need This
Choosing a practice setting is arguably the biggest financial decision of your career. An academic physician and a private practice partner may work the exact same number of hours, yet the private practice partner may earn $2M-$5M more over a 30-year career.
However, total compensation isn't just salary. Academic roles offer unparalleled benefits like PSLF tax-free loan forgiveness, while locums provide ultimate schedule freedom at the cost of zero benefits or ownership equity.
The Math Behind It
Lifetime Gross: Standard Future Value of an Annuity formula, compounding the starting salary annually by an estimated growth rate (2% Academic, 4% Private, 1% Locums).
Growth rates matter immensely over 30 years. A Private Practice doctor who buys into a surgery center or imaging facility will see their income compound much faster than an employed academic physician receiving standard 2% cost-of-living adjustments.
Pearls & Pitfalls
- Pearl: If you owe $300k+ in student loans, a lower-paying Academic job at a non-profit 501(c)(3) hospital might actually be the most financially lucrative path for the first 3-5 years due to Public Service Loan Forgiveness (PSLF).
- Pitfall: Overlooking the value of benefits. A $350k locums rate might sound better than a $280k academic salary, but the academic job includes health insurance, paid malpractice tail, 403(b) matching, and paid time off—often worth $60k+ per year.
- Pearl: You are not locked in! Many physicians start in Academics to get their loans forgiven, then jump to Private Practice in their late 30s to maximize their peak earning years.
Worked Example
The calculator's default inputs, over a 30-year career. Each total is the sum of yearly pay: start × ((1 + growth)^years − 1) ÷ growth.
| Step | Calculation | Result |
|---|---|---|
| Academic / employed | $220,000 growing 2% a year for 30 years | $8.92M |
| Private practice | $280,000 growing 4% a year | $15.70M |
| Locums (gross) | $350,000 growing 1% a year | $12.17M |
Private practice leads academic by $6.78M, mostly from the faster growth rate: by year 30, private pay is $873,222 against $390,686 academic. Locum totals are gross 1099 revenue, before self-employment tax, benefits and malpractice that an employer would otherwise pay.
Assumptions & Sources
- Fixed growth rates written into the calculator: 2% academic, 4% private practice and 1% locums, every year. Only the starting salaries and career length are inputs.
- Gross pay, not take-home: no taxes, benefits, retirement matches, partnership buy-ins or locum business costs, and no inflation adjustment.
- PSLF is shown as a rough note (about $250,000) and is not added to any total.
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About the Author
Joshua Dunigan, DO | Family Medicine Resident & Founder
I'm a family medicine resident physician in Des Moines, Iowa (class of 2027). I founded MedMoneyGuide to give physicians specialty-specific financial guidance, with sources you can check.