Unlocking Locum Tenens: Top Benefits & Drawbacks for Medical Careers

In today’s evolving healthcare market, many medical professionals are rethinking traditional, long-term employment models. Rising burnout, administrative burden, and shifting reimbursement models have pushed physicians, advanced practice providers, and other clinicians to look for more flexible work options after residency or fellowship.

One of the most prominent alternatives is locum tenens—temporary clinical work in which you “hold the place” of another clinician or help a facility cover gaps in staffing. For many, it offers an appealing mix of autonomy, income potential, and variety. For others, the trade-offs in job security, benefits, and continuity can be significant.

This enhanced guide will walk you through the key advantages and potential drawbacks of locum tenens, especially for those transitioning from training to practice. You’ll find practical examples, real-world considerations, and actionable tips to help you decide whether this path fits your long-term healthcare career goals.

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Understanding Locum Tenens in Modern Healthcare

Before weighing pros and cons, it helps to understand how locum tenens fits into the broader healthcare ecosystem.

What “Locum Tenens” Really Means in Practice

Literally translated from Latin, locum tenens means “to hold the place of.” In modern healthcare, that translates into:

• Short- or medium-term assignments (days to months, sometimes a year or more)
• Working in hospitals, clinics, urgent cares, telemedicine platforms, or specialty practices
• Filling coverage gaps due to:
  • Vacations or parental leave
  • Medical or personal leave
  • Unfilled permanent positions
  • Seasonal or unexpected patient surges
  • Expansion of services before permanent staff are hired

Assignments are typically arranged through locum tenens staffing agencies, though some clinicians negotiate directly with health systems. Most roles are 1099 independent contractor positions in the U.S., which affects taxes, benefits, and financial planning.

Who Uses Locum Tenens?

Locum tenens is increasingly common across many specialties and career stages:

• New residency or fellowship graduates exploring regions and practice settings before signing a long-term contract
• Mid-career physicians or NPs/PAs seeking to reduce burnout or transition out of a demanding role
• Late-career clinicians easing into semi-retirement while maintaining clinical skills and income
• International medical graduates (IMGs) with appropriate visas and licensure seeking U.S. experience (where allowed)
• Nurse practitioners, physician assistants, CRNAs, and other advanced practice providers looking for flexible work and higher hourly rates

Understanding where you are in your career trajectory is essential in deciding if locums aligns with your long-term plan in medicine.

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Key Advantages of Locum Tenens for Medical Professionals

For many clinicians, the upsides of locum tenens are compelling—especially in the first several years post-training, or during a career transition.

1. High Degree of Flexibility and Control Over Your Schedule

One of the strongest advantages of locum tenens is the ability to design your work life more intentionally.

How this flexibility plays out:

• Control over when you work
  • Choose months that you want to be fully booked and months where you scale back
  • Build in time for board exam preparation, conferences, research projects, or extended travel
• Choice of where you work
  • Try different states, regions, or practice settings before committing
  • Work near family for a period, then accept assignments in a new city
• Ability to say no
  • Decline assignments that don’t fit your clinical comfort zone, schedule, or compensation expectations

Example:
A hospitalist just out of residency might work a 7-on/7-off locums schedule in a city close to family for six months, then take a three-month break to travel and interview for permanent positions—without being locked into a long-term employment contract.

Actionable tip:
Before starting locums, define your non-negotiables:

• Minimum time off per year
• Acceptable shift patterns (e.g., nights vs days, weekends)
• Maximum travel distance from your home base

Communicate these clearly to your recruiter or directly to facilities.

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2. Diverse Clinical Experiences and Accelerated Skills Development

Locum tenens can function like an extended, real-world fellowship in adaptability.

Benefits for clinical growth:

• Exposure to varied practice styles
  • Community hospitals vs academic centers
  • Private practices vs large health systems
  • Rural clinics vs urban tertiary care centers
• Broader case mix
  • Different local disease patterns and patient demographics
  • Varied resource availability (e.g., limited subspecialty backup in rural areas)
• System-level learning
  • Seeing different EHRs, workflows, and care models
  • Observing how high-functioning teams collaborate and communicate

Real-world example:
A cardiologist rotating through locum tenens roles in both a rural critical access hospital and a metropolitan academic center gains perspective on:

• Managing complex cardiac disease with limited local imaging vs. full subspecialty support
• Differences in patient education needs across socioeconomic backgrounds
• How referral patterns and follow-up care differ based on regional resources

Over time, this kind of exposure can make you more versatile, adaptable, and marketable—skills that benefit both locum tenens and permanent healthcare careers.

Actionable tip:
Keep a professional log or portfolio:

• Interesting or challenging cases (de-identified)
• New protocols or best practices you encounter
• Skills or procedures you gain confidence in

This can be helpful for future job applications, credentialing, and even board recertification documentation.

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3. Higher Compensation Potential and Strategic Financial Advantages

Locum tenens roles frequently come with competitive, and often higher, pay rates compared to many permanent positions, especially when you factor in flexibility and the ability to work extra assignments.

Why locum work can pay more:

• Facilities often offer premium rates to quickly fill coverage gaps
• Short-term nature means they may pay a higher hourly/daily rate instead of long-term benefits
• You can work additional shifts or multiple contracts if you choose

Illustrative ranges (rough ballpark; actual rates vary by region, specialty, and demand):

• A family nurse practitioner:
  • Permanent: ~$45–$70/hour
  • Locum tenens: ~$75–$150/hour in some markets
• A hospitalist physician:
  • Permanent: ~$230k–$300k/year
  • Locum tenens: Often $1500–$2500 per shift, sometimes higher in high-need areas

In addition, many locum contracts include partial or full coverage for:

• Travel and lodging
• Malpractice insurance (usually claims-made during assignment)

Strategic financial benefits:

• Ability to rapidly pay down educational debt with concentrated periods of high-earning work
• Potential to test-drive part-time work or early semi-retirement while maintaining income
• As a 1099 contractor, the option to:
  • Deduct legitimate business expenses (e.g., CME, some travel, professional fees)
  • Contribute to self-employed retirement plans (e.g., Solo 401(k) or SEP-IRA in the U.S.), potentially at higher levels than through some employer plans

Actionable tip:
Work with:

• A CPA or tax professional familiar with 1099 medical professionals
• A financial planner who understands locum tenens and irregular income

Their guidance can significantly impact how effectively you leverage locums income toward long-term job security and financial independence.

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4. Expanded Professional Network and Career Opportunities

Every new assignment introduces you to new colleagues, administrators, and communities.

Networking advantages:

• Future job leads:
  Strong performance on a locum assignment often leads to:
  • Invitations to return
  • Offers for permanent positions
  • Referrals to opportunities at affiliated sites
• Mentors and collaborators:
  You may meet faculty, researchers, or service line directors who can:
  • Mentor your career decisions
  • Collaborate on QI or research projects
  • Provide strong references for future roles
• Reputation building:
  Being known as a reliable, competent locum provider can spread across systems and regions, leading to inbound opportunities rather than constant searching.

Actionable tip:
Treat each assignment as both a clinical job and a long-term networking opportunity:

• Ask for feedback mid-assignment and at the end
• Request LinkedIn connections or professional references from supervisors
• Maintain a concise CV that you update with each new site and credentialing experience

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5. Reduced Long-Term Administrative and Leadership Burden

Many medical professionals are leaving traditional roles due to escalating non-clinical responsibilities. Locum tenens can partially insulate you from these demands.

Common differences compared to permanent employment:

• Less involvement in:
  • Long-term QI committee work
  • Practice management decisions
  • Performance review cycles
  • Longitudinal leadership duties
• Some assignments have expectations (e.g., attending meetings), but you’re less likely to be drawn into multi-year obligations or politics.

Evidence in practice:
Many locum tenens physicians report:

• More time spent in direct patient care
• Fewer late-night EHR “inbox” sessions
• Less emotional stress from workplace politics or long-term administrative battles

For clinicians who love the practice of medicine but want distance from the business of medicine, locums can be a compelling alternative.

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6. A “Test Drive” for Future Permanent Employment

Locum tenens can be an excellent way to audition clinics, hospitals, or regions before making a long-term commitment.

Benefits of using locums as a trial period:

• Assess:
  • Workload and staffing levels
  • Clinical support and call schedules
  • Culture and communication style of leadership
  • Community fit for you and your family
• Avoid discovering deal-breaking issues after signing a multi-year contract

Scenario:
A general surgeon is considering relocating to a mid-sized city. By accepting a 3–6 month locum assignment at that hospital, they can:

• Evaluate OR efficiency, anesthesia support, and case mix
• Speak candidly with permanent staff about burnout and turnover
• Explore the local community, schools, and cost of living

If the fit is good, the locum role can be converted into a permanent job with eyes wide open. If not, you can move on without a painful contract exit.

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Potential Drawbacks and Risks of Locum Tenens Work

While locum tenens offers many advantages, it is not ideal for everyone. It’s important to understand the challenges and build strategies to address them.

1. Inconsistent Work and Income Fluctuations

The same flexibility that many clinicians value can create uncertainty.

Risks to anticipate:

• Assignment cancellations or early terminations
• Seasonal variability in demand
• Gaps between contracts due to credentialing delays or personal scheduling constraints

This can make monthly income less predictable than a salaried job, which may be stressful if you have large fixed expenses.

Reality example:
An emergency physician finds abundant locums shifts in the summer, but in winter the local hospitals hire more permanent staff and cut back on higher-cost locum coverage. Unless the physician has other contracts lined up or savings in place, income may drop unpredictably.

Mitigation strategies:

• Maintain a 3–6 month emergency fund (or more, depending on your risk tolerance)
• Consider having:
  • Multiple active state licenses
  • Relationships with more than one locum agency
• Track your typical annual work patterns and “smooth” your spending accordingly

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2. Limited Traditional Job Security and Benefits

Locum tenens is, by definition, temporary. This can be freeing, but it also means:

• No guaranteed long-term employment at any single site
• Many roles are 1099 contractor positions without:
  • Employer-sponsored health insurance
  • Employer retirement contributions
  • Paid time off, parental leave, or disability coverage

For clinicians with families or major financial obligations, this trade-off can be significant.

Mitigation strategies:

• Purchase individual health insurance, disability insurance, and life insurance outside of an employer
• Build your own “benefits package” by:
  • Opening self-employed retirement accounts
  • Budgeting for your own CME and licensing costs
  • Planning ahead for unpaid vacation and parental leave
• Consider a hybrid model:
  • A part-time employed role with benefits
  • Plus locums work to supplement income and flexibility

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3. Frequent Adjustment Periods and Steep Learning Curves

Every new facility comes with its own:

• EHR system
• Order sets and protocols
• Team dynamics
• Call structures
• Local unwritten rules

As a locum tenens provider, you’re expected to become functional quickly, often after just a brief orientation.

Example:
A physician moving from a small community hospital to a busy trauma center may need to adjust rapidly to:

• Different triage processes
• Higher acuity
• Different thresholds for transfer vs in-house management

For some clinicians, this frequent adaptation is energizing. For others, it can be exhausting.

Mitigation strategies:

• Develop a standardized “new site checklist”:
  • EHR shortcuts and favorites
  • Key contact numbers and escalation pathways
  • Local formulary or formulary restrictions
• Practice asking clear, concise questions during orientation:
  • “What are the top three pitfalls for new providers here?”
  • “Who do I call first for urgent consults or unexpected situations?”

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4. Ongoing Licensing, Credentialing, and Paperwork Demands

While locum tenens may reduce some practice management burden, it often increases licensing and credentialing work.

Challenges:

• Maintaining multiple state medical or nursing licenses
• Completing hospital credentialing packets repeatedly
• Tracking:
  • CME
  • Immunizations
  • Certifications (BLS, ACLS, PALS, board certification, etc.)

Delays in any of these can postpone your start date and impact income.

Mitigation strategies:

• Keep a digital “credentialing packet” ready:
  • Updated CV in standard format
  • Copies of licenses, certificates, diplomas, board certifications
  • Immunization records and TB/fit test records
• Use a secure cloud folder and keep everything organized by category
• Renew licenses early and set calendar reminders months in advance

Many locum agencies will support this process, but ultimately, you are responsible for staying up to date.

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5. Limited Long-Term Patient Relationships and Continuity of Care

If continuity and deep, long-term patient relationships are central to your professional identity, locum work may feel less satisfying.

Challenges:

• In outpatient or primary care settings, you may:
  • See patients only once or a few times
  • Hand off chronic disease management to the permanent team
• Less opportunity to:
  • Follow cases over time
  • Witness the long-term impact of your interventions

Some specialties (e.g., EM, hospitalist medicine, anesthesia) naturally involve less long-term continuity, so the impact may be smaller. But for primary care, pediatrics, or certain specialties, this aspect is important to consider.

Mitigation strategies:

• Choose longer-term locum assignments (6–12 months) where possible
• Prioritize sites where you can function as part of a multi-visit care team
• Consider a mixed model:
  • Maintain a small panel of long-term patients in one setting
  • While doing periodic locums for variety and supplemental income

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6. Constant Learning of New Systems and Protocols

Every facility has its own way of doing things: from clinical order sets to documentation workflows.

Implications:

• Initial efficiency may be lower at each new site
• Risk of error if local practices differ significantly from your usual approach
• Cognitive fatigue from repeated changes in routine

Mitigation strategies:

• Arrive with a mindset of structured curiosity:
  • “How do we typically manage X here?”
  • “Are there local guidelines for Y?”
• Use templates and personal checklists to standardize your own practice as much as possible within local norms
• Give yourself grace for a brief ramp-up period at each site, and communicate clearly with staff as you learn their systems

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Making an Informed Decision: Is Locum Tenens Right for You?

Locum tenens is neither inherently better nor worse than permanent employment; it is simply a different tool for designing your medical career. The key is aligning that tool with your priorities.

Clarify Your Career Goals and Personal Priorities

Ask yourself:

• How important is geographic stability vs the desire to travel and explore?
• Do you value predictable income more than flexibility—or vice versa?
• How central are benefits and long-term job security to your current life stage?
• Do you thrive on variety and adaptation, or do you prefer a consistent team and system?
• Are you primarily trying to:
  • Pay down debt quickly?
  • Avoid burnout?
  • Test regions or specialties?
  • Transition toward semi-retirement?

Your answers can help you decide whether full-time locums, part-time locums plus a core job, or primarily permanent work makes the most sense.

Practical Steps to Get Started Safely

If you’re leaning toward trying locum tenens:

1. Do your homework on agencies and facilities

   • Ask colleagues for recommendations
   • Check online reviews and speak with multiple recruiters
   • Ask direct questions about:
     • Typical rates and negotiation flexibility
     • Malpractice coverage and tail (if any)
     • Travel and housing support

2. Start with one well-vetted assignment

   • Choose a site known to be supportive of new locum providers
   • Avoid overly remote or extremely high-acuity first assignments if you’re new to independent practice

3. Set financial safeguards

   • Build a buffer before you fully transition from salaried work
   • Clarify your tax strategy and business structure (sole proprietor, LLC, etc., where applicable) with a professional

4. Regularly reassess

   • After each assignment, reflect:
     • What worked well?
     • What didn’t?
     • Does locum work still align with my evolving goals?

Locum tenens can be a long-term career strategy or a bridge to your next chapter. The most successful clinicians use it intentionally.

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Frequently Asked Questions About Locum Tenens

1. What exactly is locum tenens and who typically uses it?

Locum tenens is a form of temporary clinical work in which medical professionals fill short- or medium-term staffing gaps. Assignments can range from a few shifts to many months. Physicians, nurse practitioners, physician assistants, CRNAs, and other clinicians use locums at various career stages, including:

• Immediately post-residency or fellowship, to explore options
• Mid-career, to avoid burnout or after leaving a permanent role
• Late-career, to maintain income and clinical skills with more control over schedule

It’s especially common in specialties like hospital medicine, emergency medicine, psychiatry, anesthesia, radiology, and primary care.

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2. How does locum tenens pay compare to permanent positions overall?

On an hourly or per-shift basis, locum tenens often pays more than permanent employment, particularly in high-need areas or specialties. However:

• You usually won’t receive employer-sponsored benefits
• You must cover your own health insurance, retirement contributions, and paid time off
• Income may be more variable month-to-month

When comparing offers, consider the total compensation package, including:

• Base rate
• Call pay, overtime, and bonuses
• Travel and housing support
• Malpractice coverage
• Value of benefits you’re giving up (health insurance, retirement match, CME, etc.)

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3. What licensing and credentialing requirements should I be prepared for?

Locum tenens providers must:

• Hold a valid, unrestricted license in each state where they work
• Meet hospital or clinic credentialing requirements, which typically include:
  • Proof of education, training, and board certification/eligibility
  • References from recent supervisors
  • Up-to-date BLS/ACLS (and pediatric/advanced certifications as required)
  • Immunization and TB screening records

Processes can take weeks to months. Starting early, keeping meticulous records, and working with agencies that have strong credentialing teams can help minimize delays.

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4. Are locum tenens positions truly flexible, and can I do them part-time?

Yes. Flexibility is a core benefit of locum tenens. You can:

• Work full-time locums, moving between assignments
• Use locums part-time to supplement a primary position
• Take seasonal or intermittent assignments only at certain times of year

That said, the degree of flexibility depends on:

• Your specialty and local demand
• How many states you’re licensed in
• Your willingness to travel or accept nights/weekends

Clear communication with your recruiter and realistic expectations about availability are key to making part-time or highly flexible work patterns successful.

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5. How can I decide if locum tenens is a good fit for my long-term career?

Ask yourself:

• Do I value autonomy and variety enough to accept less traditional job security and benefits?
• Am I comfortable with travel, new environments, and repeated learning curves?
• Do I have (or can I build) the financial cushion needed to handle income variability?
• Does my specialty have strong locum demand in regions I’m willing to work?

A practical way to decide is to try a single, well-structured assignment while still employed or during a planned transition period. Afterward, reflect on how it impacted your stress levels, finances, and professional satisfaction. For many clinicians, even a short locum experience provides clarity about their preferred model for the next phase of their healthcare career.

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Locum tenens can be a powerful way to design a medical career that prioritizes flexibility, autonomy, and diversified experience. By understanding both the advantages and the potential drawbacks—and planning deliberately—you can use locums as a strategic tool to support your clinical growth, financial goals, and long-term professional fulfillment.