Discover the Benefits and Challenges of Locum Tenens Careers

Life as a Locum: Embracing the Pros and Challenges of Temporary Assignments

Locum tenens work has evolved from a niche solution for staffing gaps into a mainstream career strategy for many medical professionals. As healthcare systems grapple with workforce shortages, burnout, and changing patient demographics, temporary assignments have become a powerful way for clinicians to practice medicine on their own terms.

For residents nearing graduation, early-career physicians, advanced practice providers, and allied health professionals, understanding the realities of locum tenens is crucial when mapping out long-term healthcare careers. This guide explores not only the benefits and challenges, but also practical strategies to thrive as a locum while protecting your work-life balance, finances, and professional growth.

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Understanding Locum Tenens and Today’s Healthcare Landscape

What Does “Locum Tenens” Really Mean?

“Locum tenens” is Latin for “to hold the place.” In healthcare, it refers to licensed practitioners who temporarily fill clinical roles when a facility:

• Has a staffing shortage
• Is recruiting for a permanent hire
• Needs coverage for vacations, parental leave, sabbaticals, or illness
• Is expanding services or opening a new unit

Assignments can range from weekend call coverage to multi-month contracts and may be local, regional, or across the country. Positions exist in:

• Academic medical centers
• Community hospitals
• Critical access and rural hospitals
• Outpatient clinics and urgent care centers
• Telemedicine services
• Behavioral health and rehabilitation facilities

Locum tenens has become a key part of the modern healthcare workforce—supporting continuity of care while giving medical professionals more agency over where and how they work.

Who Typically Chooses Locum Tenens Work?

Locum tenens attracts a wide range of clinicians at different career stages:

• Physicians (MD/DO across all specialties: hospitalists, anesthesiologists, EM, psychiatry, surgery, OB/GYN, primary care, etc.)
• Nurse Practitioners (NPs) and Physician Assistants (PAs)
• Registered Nurses (RNs), CRNAs, and other advanced nursing roles
• Allied Health Professionals (PT, OT, SLP, respiratory therapists, imaging techs, pharmacists)
• Mental Health Providers (psychiatrists, psychologists, LCSWs, counselors)

Common situations where clinicians turn to locum tenens:

• Just after residency or fellowship – to explore different practice settings before signing a permanent contract
• Between jobs – to bridge gaps or relocate without income interruption
• Mid-career – to regain control over schedule, prevent burnout, or accommodate family needs
• Pre-retirement – to taper clinical workload while staying clinically active
• Side work – to supplement income alongside a part-time or academic role

Locum work is not “one size fits all.” It can be a full-time career or a strategic, time-limited phase within a broader professional journey.

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The Advantages of Locum Tenens Careers

For many clinicians, the attraction of locum work is rooted in flexibility, autonomy, and the chance to practice medicine without some of the burdens of traditional employment.

1. Flexibility and Work-Life Balance on Your Terms

One of the strongest selling points of locum tenens is the control it gives you over your schedule and lifestyle.

With locums, you can:

• Decide when you work (e.g., blocks of 7-on/7-off, a few weekends per month, or back-to-back multi-month contracts)
• Choose where you work (urban vs rural, coastal vs inland, close to family vs adventurous new locations)
• Shape how much you work (full time, part time, or intermittent)
• Build intentional time off between assignments for travel, research, board prep, or family

For example:

• A hospitalist might work 3–4 intensive months of back-to-back assignments, then take 4–6 weeks completely off.
• A new graduate may accept shorter contracts to sample community practice, academic settings, and telemedicine before committing to a permanent job.

This degree of autonomy supports a more deliberate work-life balance, especially in contrast to rigid schedules in some employed positions. For medical professionals facing burnout or family demands, this flexibility can be transformative.

2. Diverse Clinical Experience and Rapid Skill Development

Locum tenens assignments expose you to a wide variety of practice environments, patient populations, and systems of care. This can greatly accelerate professional growth.

You might rotate through:

• A high-acuity urban teaching hospital with residents and subspecialty support
• A solo coverage critical access hospital where you manage broader scopes of practice
• A community clinic serving under-resourced or immigrant populations
• A specialty surgical center with focused, high-volume procedures

These varied experiences help you:

• Sharpen diagnostic reasoning and procedural skills in different settings
• Adapt quickly to new EMRs, workflows, and team structures
• Learn regional practice patterns and resource availability
• Become more comfortable with uncertainty and change

For residents or early-career physicians uncertain about their ideal work environment, locums can function as a “test drive” across practice models—academic versus private, nonprofit versus corporate, rural versus urban—before committing long term.

3. Competitive Compensation and Financial Flexibility

Financially, locum tenens can be highly attractive, especially when used strategically.

Potential economic advantages:

• Higher hourly/shift rates than many employed positions, due to the temporary and often urgent nature of coverage needs
• Opportunities for overtime, nights, weekends, or holiday pay differentials
• Travel and housing support (stipends, direct booking, or reimbursement)
• Possible meal and incidental stipends depending on the contract and IRS guidelines

Many clinicians use locum tenens to:

• Rapidly pay down student loans or consumer debt
• Build a financial cushion or emergency fund
• Save for major goals (home purchase, children’s education, sabbatical)
• Test different regions’ cost of living before relocating permanently

Example:
A new graduate hospitalist might work 7-on/7-off locum shifts at a premium rate in a rural facility, then choose to pick up extra weeks at another site. Over a year, this can significantly exceed the income from a typical starting employed position, even after self-funding benefits.

4. Broad Networking and Career Exploration

Rotating through multiple institutions naturally expands your professional network far beyond what a single, long-term job typically offers.

As a locum, you can:

• Meet department chairs, medical directors, and staff across diverse systems
• Learn about institutional cultures and leadership styles firsthand
• Identify places where you might want to pursue a permanent role
• Obtain strong references from a variety of respected colleagues
• Discover academic or research opportunities through short-term collaborations

This network can be invaluable when:

• Relocating to a new city or state
• Applying for permanent roles or leadership positions
• Transitioning into subspecialty practice, telemedicine, or non-clinical roles

5. Increased Autonomy and Often Higher Job Satisfaction

Many medical professionals choose locum tenens to reclaim a sense of professional autonomy that can feel diminished in some employed settings.

Benefits that support satisfaction include:

• Less involvement in long-term hospital politics and bureaucracy
• Reduced responsibility for RVU tracking, committee work, and ongoing administrative tasks
• The option to walk away from environments that are unsafe, toxic, or misaligned with your values once the contract ends
• Ability to align work more closely with personal priorities—geography, schedule, type of practice, and patient population

When you can customize assignments around what matters most to you—whether that’s certain procedures, specific populations, or protected time off—job satisfaction often improves, and burnout risk may decrease.

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The Challenges and Trade-Offs of Locum Tenens Work

While the upsides are compelling, locum tenens is not without significant challenges. Understanding these realities—and planning proactively—can help you decide if this path fits your goals and temperament.

1. Lack of Guaranteed Job Security and Income Gaps

The same flexibility that makes locums appealing also introduces unpredictability.

Key considerations:

• Assignments may end earlier than expected due to staffing changes, census fluctuations, or new permanent hires.
• There may be gaps between contracts, especially if you’re tied to a specific region or narrow specialty.
• Cancellations or delays in credentialing can disrupt income timelines.

To manage this:

• Maintain an emergency fund (ideally 3–6 months of living expenses).
• Avoid overextending with fixed expenses (e.g., luxury housing, car leases) that depend on peak income months.
• Work with more than one locum agency or build direct relationships with facilities to diversify opportunities.
• Map out assignments 3–6 months ahead when possible, especially for in-demand seasons or locations.

Locum tenens can absolutely support a stable long-term career, but it requires more intentional financial planning than a traditional salaried job.

2. Constantly Adapting to New Workflows and Cultures

Every new facility brings new:

• Electronic medical records (Epic, Cerner, Meditech, local systems)
• Order sets, policies, and clinical protocols
• Communication norms (pager vs secure chat vs phone)
• Support structures (availability of specialists, tech, RN ratios)

This adaptation can feel exhausting, especially during back-to-back short assignments.

Strategies to ease the transition:

• Request orientation details in advance (EMR, typical census, call expectations, average daily volume).
• Ask for quick-reference guides or local protocols when you arrive.
• Keep a small personal notebook or digital file with your own checklists, common orders, and scripts for new settings.
• Identify a “go-to” colleague early—charge nurse, chief resident, or another locum—for quick questions.

Cultural adaptation is just as important as clinical adaptation. Understanding local expectations around documentation, team communication, and patient flow can make or break an assignment experience.

3. Limited or Self-Managed Benefits

Unlike many traditional permanent roles, locum tenens arrangements often provide:

• Minimal or no retirement match
• Limited or no paid time off (your unpaid days off fall between contracts)
• Variable health insurance options (sometimes through the agency, often self-funded)

This requires you to:

• Secure your own health insurance, often through:
  • A spouse/partner’s plan
  • Individual marketplace plans
  • Professional association plans
• Set up your own retirement accounts (e.g., IRA, solo 401(k), SEP-IRA if you’re an independent contractor)
• Budget for unpaid leave, including vacations, illness, and family events

Working with a financial advisor who understands 1099/contractor income and healthcare careers can be extremely helpful in structuring taxes, retirement, and insurance.

4. Social Isolation and Limited Sense of Belonging

Short-term assignments can lead to:

• Difficulty forming deep, long-term relationships with colleagues
• Feelings of being a “temporary outsider” in cohesive teams
• Social isolation between assignments, especially if you travel alone or work in remote areas

To counteract this:

• Intentionally connect with a few colleagues at each site—join shared meals, ask questions, show interest in the team.
• Maintain a strong personal support network outside work (friends, family, online professional communities).
• Consider repeat assignments at the same facility to build continuity and familiarity.
• Use telehealth or PRN roles closer to home between distant assignments so you also have a “home base” professionally.

Some medical professionals love the independence; others deeply miss being part of a long-term team. Knowing your own social needs is key.

5. Licensing, Credentialing, and Administrative Burden

Locum tenens work comes with substantial administrative tasks, particularly if you practice in multiple states or systems.

Common pain points:

• Navigating state medical licenses or compact licenses
• Hospital privileging and credentialing forms for each new site
• Background checks, immunization records, and repeated onboarding paperwork
• Travel logistics and reimbursement documentation

How to manage effectively:

• Keep a centralized digital folder with:
  • Updated CV
  • Licenses and certifications
  • Malpractice history
  • Immunization records and TB/hepatitis screenings
  • Reference contacts
• Use spreadsheets or apps to track license expiration dates and renewal deadlines.
• Work with agencies that offer dedicated credentialing specialists and handle as much paperwork as possible on your behalf.
• Start licensing/credentialing early—often 2–4 months before a planned start date.

The administrative load is real, but it becomes more manageable with systems and experience.

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Practical Tips for Succeeding as a Locum Tenens Professional

Clarify Your Goals Before You Start

Ask yourself:

• Am I doing locums as a short-term bridge or a long-term career model?
• What are my top priorities right now: income, geography, schedule, family, academic involvement?
• What types of facilities and patient populations do I most want to work with?
• What are my firm deal-breakers (e.g., unsafe nurse-patient ratios, solo night coverage without backup, specific EMRs)?

Having clear priorities helps you and your recruiter evaluate assignments realistically—and say “no” when something doesn’t fit.

Choose Locum Agencies and Assignments Carefully

Consider:

• Agency reputation and track record in your specialty
• How transparent they are about rates, expectations, and call responsibilities
• Whether they provide occurrence-based malpractice coverage
• Support with licensing, credentialing, travel, and housing

Before accepting an assignment, ask:

• Typical patient volume and acuity
• Support staff and specialty backup
• Call requirements and in-house vs home-call expectations
• Orientation plan and EMR training
• How locums are integrated into communication (hand-offs, rounds, team meetings)

Protect Your Well-Being

Locum tenens can tempt high-intensity schedules with lucrative pay, but long-term sustainability matters.

Protect yourself by:

• Setting maximum weekly hours or shift counts
• Ensuring you get adequate sleep, especially for night or call-heavy roles
• Blocking true time off between long stretches
• Continuing regular exercise, healthy eating, and mental health support—even while traveling

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Frequently Asked Questions About Locum Tenens Careers

Q1: What qualifications do I need to become a locum tenens provider?

You need all the standard credentials required to practice independently in your profession, including:

• An active, unrestricted license in the state(s) where you’ll work
• Board eligibility or certification (for physicians, where applicable)
• Up-to-date DEA registration (if you prescribe controlled substances)
• Current BLS/ACLS/ATLS/PALS/NRP certifications as relevant to your specialty
• Completed training (MD/DO/NP/PA/CRNA/PT/OT, etc.) and any required residency or fellowship

Most facilities prefer some post-training experience, but many also welcome new graduates, especially in high-demand specialties. Strong references and a clear, honest CV are essential.

Q2: How do I find locum tenens opportunities that fit my goals?

You can find opportunities through:

• Locum agencies specializing in your discipline or region
• Job boards focused on healthcare careers and temporary assignments
• Direct outreach to hospitals or groups you are interested in

To find the right fit:

• Work with one or two trusted recruiters rather than spreading yourself too thin.
• Communicate your non-negotiables (location limits, schedule, clinical scope).
• Ask to connect with other locums who have worked at the same facility for candid feedback.

Q3: Do locum tenens positions provide housing and travel?

Many assignments do provide support, though specifics vary:

• Housing: direct booking of furnished apartments/hotels or a taxable housing stipend
• Travel: reimbursement for flights, mileage, rental cars, or other transport
• Licensing: sometimes reimbursement for new state licenses, especially if the facility has a critical need

Clarify in advance:

• Whether housing is private or shared
• Distance from housing to the facility
• What expenses are reimbursed and how (per diem vs receipts vs flat stipends)

Q4: What are typical working hours and schedules for locum tenens roles?

Schedules vary widely depending on specialty and setting:

• Hospitalists: 7-on/7-off blocks, 12-hour shifts
• Emergency medicine: 8–12-hour shifts, variable patterns
• Outpatient clinics: traditional weekday office hours
• Anesthesia, surgery, OB: mix of OR time and call, including nights/weekends in some roles
• Psychiatry, telemedicine, outpatient specialties: more predictable daytime schedules

You can negotiate:

• Maximum weekly hours
• Number of nights or weekends per month
• Length of assignment and expected extensions

One of the key advantages is the ability to align assignments with the work-life balance you prefer.

Q5: Is locum tenens a good long-term career choice, or only a temporary solution?

It can be either:

• For some, locums is a short-term bridge after training, between jobs, or before retirement.
• For others, it becomes a long-term career model allowing them to maintain autonomy, variety, and higher earning potential.

Successful long-term locum professionals:

• Treat their work like a small business, with careful financial, tax, and insurance planning.
• Build strong professional reputations so facilities invite them back.
• Learn to balance intensive work blocks with restorative downtime to prevent burnout.

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By thoughtfully weighing the advantages—flexibility, variety, financial upside, and autonomy—against the challenges—instability, administrative load, benefits gaps, and potential isolation—you can decide whether locum tenens aligns with your personal and professional goals.

For many medical professionals in the post-residency and job market phase, locum tenens offers a powerful way to design a career that supports both meaningful patient care and a sustainable, fulfilling life outside of medicine.