Many physicians jump at the chance to take a locum tenens assignment outside the continental United States, but you may not always realize how the cost of living compares in different countries around the world. Before you hop on a plane for your next adventure, check out our cost-of-living comparisons and tips for budgeting and packing.
Locum tenens cost of living in Guam
Guam, the U.S. island territory 1,600 miles east of Manila, Philippines, is known for its tropical beaches and warm climate (averaging between 70 and 90°F year-round). Because it is also home to a U.S. air force base and a U.S. naval air station, Guam has many amenities U.S. residents are used to, including big box stores, fast-food restaurants, and luxury retailers. The official currency is also U.S. dollars, so you don’t have to worry about an exchange rate.
Dr. Bryan Zorko, an emergency medicine physician from North Carolina, has worked locums in Guam for more than a year. He says the position initially appealed to him because he could practice there and still have the advantages of being on U.S. soil, including a testing location to take his boards for critical care licensing.
“Guam is a nice location. It’s a good place to work, the acuity is high, the people are nice, and there’s a lot of stuff to do on the island,” Dr. Zorko says. “When I first came, I thought, ‘It’s only like a four-hour flight to Tokyo. I can go to the Philippines, too.’ The pandemic has changed that, but it’s meant that I focus more on the local stuff, which I may not have done if I had the opportunity to go off the island as much.”
Dr. Zorko explains that because you’re living on an island, groceries are more expensive (nearly 39% higher than the average U.S. grocery store). He was also responsible for finding his own housing after two weeks in Guam (rent prices are also higher in Guam) and recommends staying in a hotel for a bit before finding a place to stay.
“I found an apartment that looked good and tried to negotiate everything online and then realized about halfway through that the person was scamming me. Go in person,” he says. “I rented a car for the first three months or so and then just bought a car because it was going to be cheaper for me. The cost associated with renting a car for a year just made me cry.”
Though he hasn’t traveled as much as he hoped, Dr. Zorko says he became scuba-certified to go deep-water diving near the island and has explored many hiking trails, small beaches, and caves. He’s also climbed Mount Lamlam, Guam’s highest peak, and has enjoyed the local foods as well. Dr. Zorko recommends other doctors who work in Guam invest in discovering the island while they’re there.
“You’re going to have more fun if you’re willing to try stuff rather than trying to recreate everything the same way it is at home for you,” he says. “I think with any kind of international travel or new assignment, you bloom where you’re planted.”
Locum tenens cost of living in Ireland
Many locum tenens physicians are interested in locums jobs in Ireland, often called the Emerald Isle for its expansive grasslands. The rich history and folklore also makes Ireland appealing. Licensing for U.S. doctors can take months to complete, making it a commitment if you are interested in positions in this country.
Pay for U.S. physicians is lower in Ireland (Global Medical Staffing experts say you should expect about 80-85% of U.S. pay), but the cost of living in Ireland is not significantly higher than in the United States. Grocery prices in Ireland are about 5% lower than the United States, but restaurant prices are about 15% higher.
It’s important to note that when you work in Ireland, the cost of housing and transportation is not covered. Facilities in Ireland also expect physicians to work there for at least 12 months.
“Facilities want someone who wants to commit and make some roots in Ireland, at least for a couple years,” explains Matthew Brown, senior director of Global Medical’s international team. “These opportunities are for a long-term locum.”
Locum tenens cost of living in New Zealand
An island nation known for its varied landscapes — including active volcanoes, fjords, green valleys, and sandy beaches — New Zealand is primarily made up of the North Island (where the capital, Wellington, is) and the South Island, along with many smaller islands.
While physician pay is lower, locum tenens physicians who take locums assignments in New Zealand enjoy paid airfare, paid housing (either by the facility or through stipend) and a paid car (though the physician must pay for gas). Because New Zealand is an island nation, groceries are about 3% higher than average U.S. prices, and restaurant prices are slightly higher as well.
“Farmers markets have fresh fruit and tend to be less expensive than grocery stores, but the cost is driven up for anything New Zealand has to import, similar to Hawaii,” says Hailee Hyatt, international placement specialist for Global Medical. “If you’re coming from New York or Chicago, the price difference is probably not going to feel drastic. If you’re coming from a smaller city, you’ll probably feel it a bit more.”
Heather Van Dyk Smith, who relocated to New Zealand for a couple of years with her husband, Dr. Bryan J. Smith, and their children, notes that some small household items in New Zealand cost a lot more than they do in the United States. “Mascara is $26 (NZD). Ibuprofen and band-aids are really expensive, and you won’t be able to find antibiotic ointment like Neosporin there,” she says. “Everything else was pretty reasonable or equivalent. You tend to buy less and just make do with what you have.”
Despite other costs, Heather explains that some services and fees are lower in New Zealand, like the socialized healthcare. “Once you have supplemental insurance coverage, they pretty much cover everything. The deductible for that type of supplemental insurance is $75 New Zealand dollars. They also do it by your age, so I think for a whole year for four of us it was $900. The cost of prescription drugs is very cheap, usually $5,” Heather recalls.
Heather says their family enjoyed living in New Zealand and says the culture there is more relaxing. “Things are a lot slower and less worrisome. I felt very safe there and very comfortable,” she says. “The health system was easy, and the schools were pretty laid-back. You can just do your work, enjoy your friends, have really good food, and get outside.”
Locum tenens cost of living in the U.S. Virgin Islands
The U.S. Virgin Islands, which include the three main islands of St. Croix, St. John, and St. Thomas, lie about 112 miles east of Puerto Rico. As with Guam, the U.S. Virgin Islands’ official currency is the U.S. dollar, and the official language is English — which simplifies life for locum tenens doctors who want to travel internationally.
The cost of living in the U.S. Virgin Islands is similar to Guam’s, with grocery prices about 34% higher than in the United States and restaurant prices about 31% higher. However, doctors who take locum tenens assignments in the U.S. Virgin Islands will enjoy paid housing, a paid car, and paid basic utilities.
Lindsey Schoenberg, a senior physician placement specialist for Global Medical, notes that while the cost of living is higher than average U.S. cities in the U.S. Virgin Islands, the benefits of the assignment outweigh it.
“I’ve never had a doctor say, ‘Gosh, if I’d known what the cost of living was here, I wouldn’t have done this,’” Lindsey explains. “It’s never been a negative impact to the point of them not outweighing the positives of the assignment or the positives of living in these countries.”
Deciding to work outside the U.S.
While the locum tenens cost of living in different countries varies, you can have a positive experience during your assignment with a bit of planning.
“Don’t get crazy,” Hailee expresses. “You can only travel with a certain amount of bags, so bring the essentials and don’t waste the space in your suitcase.”
Matthew notes that most doctors find that the cost of living in any of these countries or territories is not as much as they expect. “When you factor the pay and the benefits, including some of the lower costs and offset our clients offer, the cost of living evens out.”
Have questions about what to expect on an assignment in another country or U.S. territory? Give us a call at 1.866.858.6269.
Lindsay Wilcox is a healthcare writer and editor with more than 10 years of professional writing experience. When she’s not circling typos, she’s enjoying fish tacos and hanging out with her family.