Since the end of 2023, I have been involved in the CRNA locum world. I am beginning to understand the potential of locum work to absolutely explode investing potential and net worth.

I previously wrote a blog post titled CRNAs: Financially Independent within 10 Years. To show mathematically how this could be achieved, I used the following criteria:

Average Earning CRNA
Average CRNA Debt ($150,000)
Average Cost of Living
Average Annual Return

The numbers work. A CRNA living a middle-class lifestyle can achieve FI in 10 years. Refute as you will, the numbers work.

Let’s make similar, but new assumptions for locum CRNAs. I’ll use a range of setups for a locum CRNA working full-time hours.

Low End:

Low is relative, but a sunshine tax location may offer $175 per hour. At 40 hours per week, that’s $7,000 weekly. Assuming 46 weeks of work, we are looking at $322,000 annually. Not bad for no call, nights, or weekends. Probably a good job in a reasonable area.

Middle Ground:

Something like $220 per hour. At 40 hours per week, that’s $8,800. Add a bit of call or overtime to make $9,500 per week for 46 weeks. A total of $437,000 annually. Very doable across much of the country with minimal call, weekends, or overtime.

Upper End:

This section is for income-driven CRNAs. The combination of a solid base rate, call, and weekends translates to an average of $13,500 per week. Assuming 46 weeks, that’s $621,000 annually. High, but incomes go higher than this.

There is a wide range of income for full-time locums. We all participate for our own reasons. Money is just the byproduct.

Taxation:

Here is the tough part…every self-employed CRNA runs their operation differently. Some minimize expenses, pay a higher effective tax rate, and pocket more money. Others live in the IRS gray areas maximizing expenses, pay the lowest tax rate possible, and don’t have as many dollars pass through.

Some gigs pay an all inclusive rate while others cover travel and lodging.

Some S-Corp owners take low salaries to save on FICA taxes. Others opt for higher salaries to increase Social Security contributions and Solo401(k) contributions.

The self-employed crowd has access to Solo401(k)s which often come in the traditional and Roth varieties. Pre vs post tax contributions greatly influence effective tax rate. Loading up the traditional accounts with a lower income job could result in a 15-18% effective tax rate, far lower than the average earning W-2 CRNA.

Earn $600,000+ and your deductions are now a significantly smaller portion of gross income. And you no longer meet requirements for qualified business income (QBI) deductions. An effective tax rate could easily be 30%.

This aspect truly needs to be individualized, but for the sake of simplicity, I’m going to assume 30% of gross income goes towards expenses and taxation. The other 70% goes in your pocket.

A full-time locum on the lower end NETs $225,000 annually. The upper end is almost double that amount at $435,000 (and beyond).

Expenses:

Now that we know what the “income” end of the equation looks like, let’s look at the “expenses” side. I’m referring to personal expenses and cost of living, not business expenses.

This table shows the Bureau of Labor Statistics data from September 2023. They probably have a 2024 version, but it won’t be drastically different. An average family of 4 in the United States lives on $80,000 annually. A single individual is closer to $50,000 annually.

As a full-time locum, much of your housing, transportation, food, and insurance premiums would be covered by the business. It would be part of the 30% of deducted income, so COL would be lower than what you see in the table.

A locum may or may not have a house or apartment used as a home base. A residence and domicile. A location used as a tax home.

The TFC family no longer owns a house and is on the road quite frequently. We have a low-cost dwelling to call home. It’s where we receive mail, vote, and register our vehicles. For all intents and purposes, it’s our residence and domicile.

Hospital stipends pay most of our housing and milage while on assignment. If not part of a stipend, it’s nice to have expenses covered by the business using pretax dollars. The business net income decreases, but so do our personal expenses. It’s a matter of which bank account pays the bills.

All this to say, our housing and transportation costs are far less than the national average.

The 4% Rule

Financial independence stems from the Trinity study and the recommended annual portfolio withdrawal rate after earned income ceases — 4%. Find your FI number by multiplying cost of living * 25.

COL * 25 = FI#

$80,000 * 25 = $2M

$50,000 * 25 = $1.25M

A family living on $80,000 annually could reasonably retire on $2M of investable assets. These FI numbers are in 2025 dollars. If retirement is in the future, account for inflation. The FI number increases 3% annually to reasonably account for inflation.

Without digressing too far, we are responsible for most insurance coverages and a fraction of housing, vehicles, and meals. After accounting for stipends, we realistically live on $35,000-40,000 annually (and that includes vacations). More work, more stipend.

However, it would be unrealistic for us to use a $40,000 COL to calculate our FI number because that wouldn’t be our expected COL during retirement. I approximate our FI number to be $2.2M to $2.5M.

Assumptions:

Single CRNA
$150,000 Debt
National Average COL
Invests All Cashflow
8% Annual Return
Fixed Income and COL

Low-End Locum Larry’s monthly numbers would show $4,166 of expenses and $18,783 of net income. This creates $14,617 of monthly cashflow.

High-End Locum Henry would see the same $4,166 of expenses and a respectable $36,225 net income. This creates $32,059 of monthly cashflow.

$150,000 of student loans vanish in 6-12 months as a locum.

Student Debt Vanishing in 6-12 Months as a Locum CRNA

Wealth Building:

This is where things get crazy. Due to the short time frame, I used a flat COL and income. More than likely, any COL increases would be negated by pay increases; therefore, both remain static for simplicity.

This table shows a side-by-side of Low-End Larry and High-End Henry. Most full-time locums find themselves on this earning spectrum. The columns on the right show their FI numbers adjusted for inflation.

The green cells are when FI is achieved. Low-End Larry strolls in just shy of 8 years. High-End Henry smashes his student debt and rockets to FI in just 4 years. The gold cell shows High-End Henry meeting FI for the average family of 4 on 1 income in JUST 6 YEARS!

Most any CRNA starting locum work in their early 30s has the earning potential to be financially independent by age 40. Locum work in today’s market is lucrative. Not exactly suitable for most new grads. But it doesn’t take years to prepare for locum work either.

Application:

If you have a few years to locum, great. It will be the financial boost you didn’t know you needed. It’s a great way to build a nest egg to minimize the importance of compensation for subsequent jobs. For a CRNA in their 30s, achieve Coast FIRE by having $1M invested. This allows the freedom to lower savings rate because this portfolio will continue to grow over the next couple decades.

If working as a permanent CRNA, consider locum contracts on weekends or PTO weeks. This is micro locuming which may even sound fun. A couple $5,000 weekends or $10,000 weeks throughout the year make a huge difference. Casual locum work pays for hobbies and guilt-free vacations.

There are W-2 jobs that allow for similar levels of income, so don’t use that as an excuse.

A higher income can support a higher COL. Just be mindful of savings rate. There are plenty of $1M earners who spend $1M. Don’t join them.

Heed this Warning:

Do not blindly envy High-Earning Henry. I’m speaking from experience when I tell you running on the high end is demanding. That kind of CRNA income manifests with call and weekends, both of which become tiresome quickly. Jobs that pay well usually have a substantial drawback either in practice or location. Making 99th percentile dollars is amazing for a short while, but don’t count on this percentile of CRNA income for a career.

Locum work is sustainable for us because we travel as a family. If we didn’t, it wouldn’t happen. The plan isn’t to be a cross-country locum indefinitely. Kids starting school marks the end of the unrestrained contracts.

At some point, the money won’t matter, so the inconveniences will become extra inconvenient. For now, we enjoy the perks of traveling, the extra income, and experiencing different parts of the country alongside those inconveniences.

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Thanks for reading!

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