Now that I got this locum tenens gig in the US I feel a lot more positive about my future chances of finding similar gigs. The income was good and the work has been relatively easy. This means that living in Spain and working in the US as a clinician is a feasible method of surviving abroad.
So this got me thinking about regular locums work in the US. As in, making it a regular gig to fly out to the US for some locum tenens work in order to provide me enough income to run my household in Spain.
Living in Spain and Working in the US
At this stage of my life, I’m gravitating towards living in Spain. I’ve lived there on and off since the end of 2017. But I’m not married to the idea of living in Spain, it’s just a lovely place at this stage in my life.
In Spain I’m enjoying a very relaxed lifestyle, a slow pace of life, and I’ve made good friends there.
In my city, Santiago de Compostela, you can live on a small income and don’t need a car to get around. The weather is similar to that of the Pacific Northwest and the air quality is incredible.
I love the greenery everywhere. The air is fresh every day and I like walking around the city, rain or shine.
Living in Barcelona or Madrid of course would be different. There is more air pollution and a ton of tourists. Still, those are beautiful cities with warm and mellow people.
I prefer this smaller city feel. Having lived in LA, SD, and Portland, I don’t gravitate towards big city living. And if I ever miss it, I will always have my Portland condo.
Socializing has been easy in SDC. There are many opportunities to get together with friends to have wine or take an art class, on the cheap.
The city has a good number of artists. From those who make custom fashion to painters and jewelry makers.
Housing is relatively cheap in Spain, too. In SDC I can rent a nice place for 400 euros per month. For 600 I would get something quite fancy in the more modern part of the city.
Working in the US
The advantage of working in the US is the high income. The money I earn in one day in a clinic here is enough to pay for 1 month of living expenses.
But it’s not all fuzzy kittens and baby butts, working in the US as a physician is scary as fuck. Look at the drama I’ve had to deal with in regards to the medical board.
There is always the fear of a lawsuit or some bad outcome. Something I don’t think physicians in Spain worry about as much.
A locum tenens gig for 2 months could earn me somewhere around $30,000. And I wouldn’t have to work 100-hour weeks, either.
Some locums groups will pay for the majority of travel expenses. But even without that. It’s possible to live on the cheap if you have time to plan ahead.
For physicians with relatively clean professional records and all the proper state licenses, living in Spain and working in the US through locums is incredibly simple.
I’ve managed to pay less than $1,000 for a round-trip ticket to the US from Spain.
I chose the wrong AirBnb for this current locums gig I’m working here in Los Angeles. For $2,000/month, I should have been able to find a place where I can prepare my own meals.
As other readers on this website have commented, locum tenens is very tax efficient. If you know what you’re doing you can write a lot of your expenses off against your income.
Even as a per diem physician I have paid only 15% in taxes over the past few years. It’s far more tax-efficient than being a physician employee.
I thought I would be heartbroken being away from Spain for this long. But it’s been wonderful. I have made great friends in Los Angeles and reconnected with old buddies.
2 months away while working in the US isn’t too bad but it requires some planning.
If you’re super productive you can also rent out your place in Spain on Airbnb while away.
Then again, flying back for locum tenens work isn’t the only option for earning money in Spain as a physician. I can be a digital nomad physician and earn my income remotely.
I can do telemedicine while abroad. I created a course for physicians who want to live abroad and earn US dollars as physicians from US companies.
The idea of spending all of that jet fuel to fly from one continent to another doesn’t exactly give me a chubby. Telemedicine seems like the more sustainable way of practicing my trade.
Finally, another great way to earn a solid income as a physician is to use my clinical knowledge as a healthcare consultant. It’s a great way to live in Spain and earn income from the US.
I created a course for that as well, teaching physicians how to find a topic of interest and how to recruit their first set of clients.
You can consult for a medical device company, a pharmaceutical company, or a healthcare startup. Your knowledge in your specialty is very valuable.
Working in the US, Remotely
Finally, there are other ways of earning a location independent income from the US while living in Spain. I think some creativity will go a long way.
Online teaching is another way, which I did when working for a local community college. No reason you can’t do that while away in Spain.
You can sell courses, as I do on this website. Or you can do individual consulting for physicians if you have a certain skill-set that you can market.