Exploring Locum Tenens: The Pros and Cons for Medical Professionals

In a healthcare system that’s constantly shifting under the pressures of workforce shortages, changing reimbursement models, and rising physician burnout, more clinicians are rethinking what a sustainable medical career looks like. For many, locum tenens work has become an increasingly attractive option—a way to preserve clinical practice while regaining control over time, income, and lifestyle.

Locum tenens (Latin for “to hold the place”) allows physicians, advanced practice providers, and other clinicians to step into temporary roles at hospitals, clinics, and other facilities. It can be a powerful tool for career exploration, financial recovery after training, or preventing long-term burnout—but it isn’t the right choice for everyone.

This guide breaks down the good and the bad of locum tenens work with a focus on residents nearing graduation, fellows, and early-career physicians evaluating the post-residency job market. You’ll find detailed pros, cons, and practical strategies to help you decide whether this path fits your goals in healthcare.

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What Is Locum Tenens Work in Today’s Healthcare Market?

Locum tenens work is more than just “temporary coverage.” It has become a structured, widely used component of modern medical employment and workforce planning.

Core Definition and Scope

In healthcare, locum tenens refers to clinicians who provide temporary clinical services to fill gaps such as:

• Coverage for vacations, parental leave, or sabbaticals
• Open positions while facilities recruit permanent staff
• Seasonal or unpredictable increases in patient volume
• Coverage in rural or underserved communities

Assignments can range from:

• A single emergency department shift
• A week or two of call coverage
• Several months of full-time work at a hospital or clinic
• Long-term rolling contracts renewed every 3–6 months

Specialties commonly using locums include:

• Hospitalist medicine and internal medicine
• Emergency medicine and urgent care
• Anesthesiology and CRNAs
• Psychiatry and behavioral health
• Radiology
• General surgery and some surgical subspecialties
• Primary care (family medicine, pediatrics)

Key Characteristics of Locum Tenens Work

• Temporary Positions
  Assignments may be per diem, short-term, or multi-month, giving you the option to test different work settings without a long-term commitment.

• Flexible Scheduling and Work Flexibility
  You generally choose when you’re available, how many shifts or weeks you want to work, and which offers to accept or decline.

• Geographic Variety
  From urban academic centers to critical access hospitals, opportunities exist across the U.S. (and sometimes abroad), giving you the chance to experience different regions and patient populations.

• Agency or Direct Contracting
  Most clinicians work through locum tenens staffing agencies, but some negotiate directly with facilities, especially after gaining experience and contacts.

For residents and fellows approaching graduation, locum tenens can function as a bridge between training and permanent practice, offering a low-risk way to explore multiple practice models before signing a long-term contract.

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The Upside: Advantages of Locum Tenens for Modern Healthcare Careers

Locum tenens has grown in popularity for a reason. When used intentionally, it can dramatically improve work flexibility, financial security, and professional growth.

1. Flexibility and Career Control

Locum tenens may offer a level of scheduling control you have never experienced in training.

How this flexibility plays out in real life:

• You choose when to work—and when not to
  Want a true break after residency? You can schedule 2–3 months off and then line up a block of shifts when you’re ready.

• You can align your work with life events
  Moving for a partner’s job, raising young kids, caring for elderly parents, or pursuing research or entrepreneurial projects becomes more manageable when you aren’t tied to a rigid full-time contract.

• You can adjust your workload in response to burnout
  If you feel your resilience slipping, you can step back, decrease shifts, or take a month off between assignments—something very few permanent roles allow.

This autonomy is one of the most powerful tools for preventing and reversing physician burnout, especially in high-intensity specialties.

2. Diverse Clinical Experiences and Skill Building

Locum tenens providers often work in multiple settings across different regions, healthcare systems, and patient populations.

Benefits of this diversity include:

• Broader clinical exposure
  You may diagnose conditions more common in rural settings, manage varied pathology in different regions, or learn new procedural techniques favored at certain institutions.

• Systems and workflow insight
  Seeing how multiple hospitals structure rounding, triage, documentation, and team communication gives you a library of “best practices” to carry into any future permanent role—or your own private practice.

• Adaptability and resilience
  You become skilled at quickly learning new EHRs, navigating unfamiliar team dynamics, and managing patients in resource-limited environments. This agility is highly valued in leadership and administrative roles later in your career.

For early-career physicians uncertain about their long-term niche, these experiences can clarify whether you prefer:

• Academic vs. community practice
• Inpatient vs. outpatient vs. hybrid models
• Urban, suburban, or rural settings
• Large health systems vs. smaller independent practices

This information is invaluable before you commit to a multi-year employment agreement.

3. Financial Benefits and Strategic Income Planning

For many clinicians, especially recent graduates with significant student debt, the financial advantages of locum tenens are a major draw.

Common financial upsides:

• Competitive or higher hourly/daily rates
  Locum pay often meets or exceeds equivalent permanent roles because you’re solving an urgent staffing need.

• Supplemental benefits through agencies
  Many agencies include:

  • Travel reimbursement (flights, mileage)
  • Lodging (hotel or corporate housing)
  • Rental car or transportation stipends
  • Malpractice insurance (often with tail coverage)

• Ability to rapidly pay down debt or build savings
  Some physicians take 1–3 years of high-intensity locums work to:

  • Eliminate or significantly reduce student loans
  • Build a down payment for a home
  • Create a financial cushion before transitioning to a lower-paying but preferred permanent role (e.g., academic medicine or part-time practice)

• Opportunity for tax planning (if truly independent contractor)
  Depending on how you’re classified and how you structure your work (W-2 vs. 1099, LLC or S-corp where appropriate, etc.), there may be legitimate business expense deductions (travel, licensing fees, CME, equipment). This should always be guided by a tax professional familiar with physician locums.

4. Networking and Career Exploration Without Commitment

Locum tenens placements allow you to “test-drive” different workplaces and connect with diverse colleagues without locking yourself into long-term contracts.

Advantages for career development:

• Broadened professional network across multiple health systems, which can lead to:

  • Future job offers (many facilities recruit high-performing locums as permanent staff)
  • Consulting or medical directorship opportunities
  • Research or quality-improvement collaborations

• Insight into organizational culture
  You can experience first-hand how different institutions:

  • Treat clinicians and staff
  • Handle patient safety and quality
  • Manage staffing and workload
  • Address burnout and well-being

  This is far more informative than what you can gather from an interview day alone.

• Stronger negotiating position
  When you’ve worked in multiple settings and know your value, you are in a better position to negotiate compensation, schedule, and nonclinical support in any future permanent role.

5. Built-In Breaks and Burnout Mitigation

Physician burnout is a major driver of career dissatisfaction and departure from clinical medicine. Locum tenens can directly address several root causes of physician burnout:

• Control over schedule, patient load, and vacation
  You can design your calendar to include real recovery time, not just token PTO that you’re pressured not to use.

• Reduced nonclinical burdens
  Many locums positions focus primarily on clinical work, freeing you from:

  • Committee meetings
  • Long-term QI projects
  • Office politics
  • Administrative responsibilities that often drain energy in permanent roles

• Psychological reset
  Leaving a toxic or unsustainable job and working as a locum can provide the distance needed to reassess your values, career goals, and lifestyle priorities.

For some physicians, locum tenens becomes their long-term model; for others, it’s a strategic pause and reset before choosing a more sustainable permanent environment.

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The Downside: Challenges and Risks of Locum Tenens Work

Despite its appeal, locum tenens is not a universal solution. The same features that create flexibility and opportunity can also introduce uncertainty and stress.

1. Lack of Job Security and Income Predictability

The temporary nature of locums means you do not have guaranteed future work unless you specifically line it up.

Potential downsides:

• Gaps between assignments
  Even if you’d like to work continuously, credentialing delays, seasonal volume shifts, or changes in facility needs can lead to periods without income.

• Financial planning complexity
  Without a regular paycheck or benefits, you must:

  • Budget for variable income
  • Maintain a larger emergency fund
  • Pay your own health insurance in many cases
  • Plan for taxes proactively (especially if you receive 1099 income)

• Emotional stress
  Uncertainty about the next contract—Will it be extended? Will the facility change vendors? Will the need taper off?—can cause anxiety, especially if you have major financial obligations.

Mitigation strategies:

• Maintain at least 3–6 months of living expenses in cash reserves.
• Work with multiple agencies and cultivate direct relationships with facilities.
• Start the search and credentialing process for your “next” assignment well before the current one ends.

2. Inconsistent or Limited Benefits

In contrast to many permanent full-time roles, locum tenens positions may provide minimal traditional employment benefits.

Common gaps:

• Health insurance – Often your responsibility to purchase individually or through a spouse/partner.
• Retirement plans – No employer-sponsored 401(k) or pension; you must set up your own IRA, SEP-IRA, or solo 401(k) if eligible.
• Paid vacation or sick leave – Time off is usually unpaid.
• Disability and life insurance – Typically not included.

Some agencies offer limited benefits for W-2 employees, but this varies widely. Always ask detailed questions about:

• Employment status (W-2 vs. 1099)
• Health insurance options
• Retirement contributions (if any)
• Malpractice coverage (occurrence vs. claims-made, tail coverage)

You’ll need to intentionally build your own benefits infrastructure, which may require working with a financial planner experienced in physician-specific issues.

3. Constant Adaptation to New Systems and Cultures

Each new facility may require a crash course in:

• EHR systems (Epic, Cerner, Meditech, or smaller local platforms)
• Order sets, clinical pathways, and documentation requirements
• Call structures and escalation protocols
• Referral patterns and resource availability
• Team communication norms and interpersonal dynamics

This can be energizing, but it can also be exhausting.

Challenges include:

• Slower workflow initially as you learn a new EHR
• Risk of errors if onboarding is rushed or incomplete
• Frustration if expectations are unclear or support is limited
• Variable nursing and ancillary staff support

To protect both yourself and your patients:

• Insist on adequate orientation time, even if brief.
• Ask for quick-reference guides to common orders and protocols.
• Clarify ahead of time: average daily census, support staff, call expectations, and procedures you’re expected to perform independently.

4. Potential for Professional Isolation

Locum tenens providers often describe a sense of “never fully belonging” to any team.

Potential downsides:

• Limited long-term mentorship
  You may not have the same continuity with colleagues, department chiefs, or academic mentors.

• Less involvement in institutional culture
  You’re often not included in staff retreats, committees, or major strategic decisions. For some, this is a relief; for others, it can feel marginalizing.

• Fewer deep, lasting colleague relationships
  While you may form strong bonds on long-term assignments, constant movement can make it harder to build a robust local support network.

Ways to counter isolation:

• Maintain strong connections with residency/fellowship peers and mentors.
• Join professional societies and engage in regional/national communities.
• Consider telehealth or part-time local roles to build continuity somewhere, even while doing locums.

5. Credentialing, Licensing, and Administrative Burden

Before you can start an assignment, you must be properly licensed and credentialed—processes that can be slow and frustrating.

Common hurdles:

• State medical licenses
  Applying for new state licenses can take months. The Interstate Medical Licensure Compact can help if you qualify.

• Hospital privileging and payer enrollment
  Even with an existing license, each facility has its own credentialing timeline and documentation requirements.

• Paperwork overload
  You’ll be repeatedly asked for:

  • Board certification status
  • Malpractice history
  • Immunization records
  • Reference letters
  • CME records

Agencies often help with this, but it still demands your time and organization. For residents completing training, starting the licensing process early—ideally in PGY-2 or PGY-3 for longer residencies—can smooth your transition to locums.

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Real-World Case Study: Locum Tenens Success and Trade-Offs

Consider Dr. Sara Thompson, a general surgeon who left a demanding full-time job at a tertiary referral center after experiencing significant burnout. She wanted to continue practicing surgery but needed a different model of work.

How Locum Tenens Helped

• Regained control over schedule
  Dr. Thompson chose assignments in 2–3 week blocks with breaks in between, something her prior job could never accommodate.

• Explored new practice settings
  She operated in both rural community hospitals and mid-sized regional centers, discovering she enjoyed close-knit surgical teams and community-based practice far more than academic politics.

• Improved financial stability
  With competitive locums rates, plus travel and housing covered, she was able to:

  • Pay off remaining student loans faster
  • Build a substantial emergency fund
  • Take an extended 6-week trip abroad without worrying about job security

The Challenges She Faced

• Frequent transitions and learning curves
  Each new hospital came with different OR workflows, perioperative pathways, and documentation protocols. Adjusting quickly was mentally taxing.

• Uncertainty between contracts
  When one assignment unexpectedly ended early due to a permanent hire, she felt acute anxiety while her next credentialing process dragged on.

• Limited long-term relationships
  While she enjoyed working with new colleagues, she missed the sense of long-term team membership and mentorship she had during residency.

Ultimately, Dr. Thompson found that locum tenens was a powerful mid-career reset. After two years of locums work, she accepted a permanent community hospital position in a region she had discovered and loved through an earlier assignment—negotiating a far better schedule and support structure than she would have without her locums experience.

Her story illustrates the dual nature of locum tenens: flexibility and freedom balanced against uncertainty and constant change.

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Is Locum Tenens Right for You? Key Questions to Ask

Before you commit to locum tenens as your primary work model, take an honest inventory of your goals, needs, and tolerance for risk.

Ask yourself:

1. What are my top priorities right now?

   • Maximum income?
   • Geographic freedom?
   • Time for family or side projects?
   • Escape from burnout?
   • Clinical variety and exploration?

2. How comfortable am I with uncertainty?

   • Can I handle variable income?
   • Will gaps between assignments cause unacceptable stress?

3. What is my financial baseline?

   • Do I have an emergency fund?
   • Can I self-fund health insurance and retirement contributions?
   • Do I understand my tax obligations as a potential independent contractor?

4. How much structure and community do I need?

   • Will rotating environments energize or drain me?
   • How important is being deeply embedded in one team or institution?

5. Where am I in my career trajectory?

   • Just finishing residency or fellowship? Locums can be a powerful way to explore.
   • Mid-career and burned out? Locums can be a reset tool.
   • Nearing retirement? Locums can help you taper your workload on your own terms.

There is no universally correct answer. For some, locum tenens becomes their preferred long-term model for sustainable healthcare careers. For others, it’s a stepping stone, bridge, or strategic pause before choosing a permanent path.

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FAQs: Locum Tenens for Residents, New Grads, and Early-Career Physicians

1. Is locum tenens work suitable for new physicians just finishing residency or fellowship?

Yes—with careful planning. Many new physicians use locum tenens to:

• Explore different practice settings before signing a long-term contract
• Relocate gradually without committing immediately
• Boost income quickly to pay down debt or build savings

If you’re a new graduate, pay special attention to:

• Getting your first state license early (and considering additional states strategically)
• Clarifying how much support and supervision you’ll have on site
• Avoiding assignments that expect you to function as the lone specialist without adequate backup

Pairing mentorship (from former attendings or senior locum physicians) with your first few assignments can make this transition smoother and safer.

2. How do I find and evaluate locum tenens positions?

Common pathways include:

• Locum tenens staffing agencies – The most frequent route; they match your skills and availability with facility needs.
• Hospital or group direct contracting – More likely once you have experience or connections in a region.
• Online job boards and professional networks – Many advertise locum opportunities.

When evaluating positions, ask about:

• Schedule (shifts, call requirements, expected census or volume)
• EHR and onboarding/orientation details
• Available support staff (NP/PA coverage, specialist consult availability, nursing ratios)
• Compensation structure (rate, overtime, bonuses, cancellation policies)
• Coverage for travel, lodging, and malpractice (including tail)

Talk to other locum physicians who have worked with the same agency or facility whenever possible.

3. Will I be considered an employee or an independent contractor as a locum tenens provider?

It depends on the arrangement:

• W-2 employee – Some agencies or hospitals classify locums as short-term employees and may offer limited benefits and withhold taxes.
• 1099 independent contractor – Very common; you are responsible for your own taxes, benefits, and some business expenses.

Clarify your status before signing a contract. If you are a 1099 contractor, strongly consider:

• Working with an accountant or tax advisor experienced with physicians
• Setting aside estimated tax payments quarterly
• Exploring retirement vehicles (e.g., solo 401(k), SEP-IRA) if eligible

4. Can I work locum tenens while maintaining a permanent position?

Yes, many clinicians do hybrid models, such as:

• Maintaining a 0.6–0.8 FTE permanent role and adding locums shifts elsewhere
• Working locums during vacation blocks (if your contract allows moonlighting)
• Using locums to supplement income while ramping up a new private practice

However, you must:

• Review your employment contract for moonlighting or non-compete clauses
• Ensure no conflicts of interest (e.g., working for direct competitors nearby)
• Protect yourself from schedule overload and burnout

5. How can I negotiate better terms and protect myself as a locum tenens provider?

Even as a locum, you have leverage, especially in high-demand specialties or hard-to-staff locations.

Consider negotiating:

• Higher hourly/daily rates based on your experience and market norms
• Travel upgrades (non-red-eye flights, rental car reimbursement, closer lodging)
• Clear cancellation policies (compensation if shifts or contracts are canceled late)
• Reasonable call coverage and census expectations
• Guaranteed minimum hours or shifts per month

To protect yourself:

• Read contracts carefully; consider having an attorney review them, especially early in your locum career.
• Clarify malpractice coverage type (occurrence vs. claims-made; who pays tail).
• Keep detailed records of your assignments, hours, and any concerning clinical or workplace issues.

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Locum tenens work sits at the intersection of flexibility, opportunity, and uncertainty in modern medicine. Understanding both the good and the bad—and planning accordingly—can help you harness its benefits while minimizing its risks. Whether you choose locums as a short-term bridge, a mid-career reset, or a long-term lifestyle, the key is intentional, informed decision-making aligned with your personal and professional goals.