Unlocking Locum Tenens Opportunities in Anesthesiology: A Guide

Locum tenens work has become an increasingly attractive option for anesthesiologists at all stages of their careers—from new residency graduates navigating the anesthesia match to late-career clinicians seeking flexibility. Whether you’re still in anesthesiology residency and planning your post-graduation path, or you’re an attending considering a change, understanding locum tenens opportunities in anesthesiology can open doors to financial, professional, and lifestyle advantages that traditional full-time roles may not offer.

Below is a comprehensive guide to how locum tenens works in anesthesiology, what to expect, how to get started, and how to strategically integrate locum work into your career plans.

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Understanding Locum Tenens in Anesthesiology

Locum tenens—Latin for “to hold the place of”—refers to temporary physician staffing. In anesthesiology, this means you work short- or medium-term assignments at hospitals, ambulatory surgery centers, or office-based anesthesia practices to cover staffing gaps.

Why Locum Tenens Is Common in Anesthesiology

Anesthesiology is particularly well-suited to locum tenens for several reasons:

• High and growing demand: Chronic anesthesiologist shortages, increasing surgical volumes, and aging populations create ongoing coverage needs.
• Shift-based structure: Operating room schedules, call coverage, and procedural blocks are easily divided into discrete chunks that lend themselves to temporary coverage.
• Predictable, billable services: Anesthesia services are clearly defined and billable, making it easier for facilities to justify locum tenens costs.
• Flexible deployment: Anesthesiologists can often transition quickly between institutions, as core clinical skills are broadly applicable.

For residents thinking ahead to the anesthesia match, this environment means that even if your first job out of residency isn’t your “dream job,” locum tenens can be a powerful tool to explore different practice settings without long-term commitments.

Typical Locum Tenens Settings for Anesthesiologists

You’ll find locum tenens anesthesiology opportunities in a variety of settings:

• Community hospitals
• Academic medical centers (particularly for coverage gaps)
• Rural critical access hospitals
• Ambulatory surgery centers (ASCs) – orthopedics, GI, ophthalmology, plastics, etc.
• Office-based anesthesia – dental, ophthalmology, pain procedures
• Specialty hospitals – cardiac centers, orthopedic centers, women’s hospitals

Each setting offers different case mixes, staffing models (solo, care team, CRNA supervision), and call expectations. Understanding how these fit your skills and preferences is key to choosing the right locum assignments.

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Benefits and Tradeoffs of Locum Work in Anesthesiology

Locum tenens anesthesiology can be professionally and financially rewarding, but it’s not for everyone. Weighing the pros and cons honestly will help you decide where it fits in your career trajectory.

Major Benefits of Locum Tenens in Anesthesiology

1. Higher earning potential

Locum anesthesiologists are typically compensated on an hourly, daily, or shift basis at competitive rates. Common advantages:

• Premium pay for shortage areas (rural, high-need hospitals)
• Overtime and call differentials that can significantly boost income
• Opportunities to negotiate rates as you build experience
• Ability to stack assignments during high-demand periods

Many locum tenens anesthesiologists report total annual earnings that surpass typical employed salaries, especially if they’re open to frequent travel and night/weekend work.

2. Exceptional flexibility and control

You decide:

• When you work (weeks on, weeks off; seasonal blocks; occasional weekends)
• Where you work (specific regions, states, or facility types)
• What kind of schedule you’ll accept (day shifts only, no OB, no peds, etc.)

This flexibility can be ideal for:

• Early-career anesthesiologists wanting travel and exploration
• Physicians balancing work with family, research, or advanced degrees
• Late-career anesthesiologists transitioning toward partial retirement

3. Exposure to diverse clinical environments

Locum work is a crash course in adaptability:

• Learn different anesthesia machines, EMRs, and protocols
• Work with diverse surgical teams and case mixes
• Experience both independent and care-team models
• Compare community vs academic vs rural practice styles

This exposure can significantly sharpen your clinical judgment, efficiency, and communication skills—and help you clarify what you want in a permanent position.

4. Strategic career and geographic testing

Locum assignments allow you to:

• “Test-drive” a region before relocating permanently
• Explore subspecialty-heavy environments (e.g., cardiac, neuro, OB-heavy)
• Try different practice models (private practice, hospital employed, academic-affiliated)
• Identify red flags in practice cultures before signing a long-term contract

This is especially useful if your anesthesia match placed you in an area you’re not sure you want to stay in long-term, or if your first permanent job isn’t ideal.

5. Burnout mitigation and autonomy

Many anesthesiologists pursue locum work to regain autonomy:

• Less involvement in hospital politics and long committee meetings
• Clear, transactional relationships: you’re there to provide coverage, not manage long-term department issues
• Easier to say no to toxic environments—your contract has a defined end date

Tradeoffs and Challenges to Consider

1. Income variability and lack of traditional benefits

Locum work typically means 1099 independent contractor status:

• No employer-sponsored health insurance or retirement plan
• Unpaid time off (vacations, illness, gaps between assignments)
• Variable income month-to-month depending on assignments and hours

You’ll need to plan proactively with:

• A solid emergency fund
• Personal retirement strategies (e.g., solo 401(k), SEP IRA)
• Individual or marketplace health insurance

2. Administrative and logistic complexity

As a locum tenens physician, you’ll juggle:

• Multiple state medical licenses and DEA registrations
• Facility credentialing and privileging processes
• Travel logistics: flights, housing, rental cars (sometimes handled by agencies, sometimes not)
• Malpractice coverage documentation across assignments

Agencies often help with these tasks, but you still bear the responsibility of oversight and organization.

3. Professional isolation and limited continuity

You may experience:

• Less sense of belonging with the local anesthesia group
• Limited involvement in long-term QI, teaching, or leadership roles
• Minimal continuity with surgeons or surgical service lines

Some anesthesiologists miss the deeper collegial relationships and institutional ownership that come with a stable team and permanent role.

4. Steep learning curve at each new site

Every assignment requires rapid acclimatization:

• EMR and documentation workflows
• Local policies on regional blocks, blood products, ERAS pathways
• PACU protocols, pre-op holding norms, and surgeon preferences

This can be intellectually stimulating, but also stressful if support is limited or orientation is rushed.

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How to Get Started: From Residency to Locum Tenens Practice

If you’re approaching the end of anesthesiology residency or already in practice and considering a change, a structured approach will make your transition into locum work smoother.

Step 1: Clarify Your Goals

Before reaching out to agencies or facilities, identify your priorities:

• Income targets: How much do you need (and want) to earn annually?
• Lifestyle needs: How many weeks off do you want? How much travel is acceptable?
• Clinical boundaries: Comfortable with OB? Peds? Cardiac? Regional-heavy practices?
• Geography: Are there states or regions you strongly prefer or want to avoid?
• Timeline: Are you planning locum work as a bridge (e.g., after the anesthesia match while you look for a permanent job) or as a long-term career structure?

Write these down; they’ll inform every subsequent decision and help you negotiate effectively.

Step 2: Understand Agency vs Direct Contracting

Most anesthesiologists begin with locum tenens agencies, which:

• Match you to available opportunities
• Assist with licensing, credentialing, and travel arrangements
• Provide malpractice coverage for their assignments
• Handle billing and payment (you receive a contracted rate)

Over time, some anesthesiologists also develop direct relationships with hospitals or groups, contracting without a third-party agency. This can increase your hourly rate but requires more administrative work and potentially arranging your own malpractice coverage.

For starting out, using a reputable agency is usually simpler and safer.

Step 3: Optimize Licensing and Credentialing

To be competitive for a wide range of travel physician jobs in anesthesiology, consider:

• Target states strategically: Start with states where:
  • You have personal ties or want to live
  • Licensing is relatively fast and straightforward
  • Demand for anesthesiologists is high (often rural or underserved regions)
• Consider the IMLC (Interstate Medical Licensure Compact) if you’re in a compact state; this can accelerate multi-state licensing.
• Keep a meticulously organized folder (digital and/or physical) with:
  • Updated CV
  • Medical school and residency certificates
  • Board certification or eligibility documentation
  • State licenses and DEA registrations
  • Immunization records (including TB, Hep B, COVID, etc.)
  • Procedure logs and case logs from anesthesiology residency or recent jobs

Starting this organization in residency makes the transition far easier when you begin locum work.

Step 4: Prepare Financially and Legally

As a locum tenens physician (1099 contractor), you’ll need:

• Tax planning:
  • Quarterly estimated tax payments
  • Tracking deductible expenses (travel not reimbursed, licensing fees, CME, equipment)
  • Potential incorporation (LLC or S-corp) after discussion with an accountant
• Benefits planning:
  • Individual health insurance and disability insurance
  • Retirement accounts (solo 401(k), SEP IRA, or traditional IRA)
• Legal review:
  • Have an attorney experienced in physician contracts review any master service agreements and assignment contracts, at least early on.

This groundwork protects you from surprises and maximizes the net benefit of your locum income.

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Locum Tenens Assignments: What to Expect Day-to-Day

Understanding the realities of daily locum work helps you decide if this path aligns with your preferences.

Typical Schedules and Call Structures

Locum tenens anesthesiology assignments range widely:

• Short-term: Weekend call, a week at a time, 2–4 week blocks
• Medium-term: 3–6 month assignments
• Long-term: 6–12 month (or recurring) contracts

Your schedule may involve:

• Daytime OR lists only
• A mix of OR and OB coverage
• 24-hour call or night shifts
• In-house vs home call (with guaranteed minimum hours or “beeper” status)

Clarify these details before accepting:

• Start and end times of “day” shifts
• Post-call expectations
• Average daily case volume
• Frequency and nature of emergent cases (trauma, ruptured AAA, unscheduled C-sections)

Clinical Scope and Case Mix

Facilities will expect you to handle the case mix described in the job posting, which may include:

• General surgery cases (bread and butter)
• Orthopedic, spine, neurosurgery, ENT
• Obstetrics (labor epidurals, C-sections)
• Pediatrics (healthy older children vs complex congenital)
• Cardiac anesthesia (if fellowship-trained and credentialed)
• Regional anesthesia portfolios (peripheral nerve blocks, neuraxial)

Be candid about your comfort and current skill level. Overstating your abilities is unsafe for patients and risky for your license. Facilities generally prefer a safe, appropriately selective anesthesiologist to someone “game for anything” without the skills to back it up.

Orientation and Support

Locum orientation can be as short as a few hours or as long as several days. Ideally, you’ll receive:

• EMR training and templates specific to anesthesia documentation
• Overview of anesthesia machines, drug dispensing, and airway equipment
• Protocols for:
  • Blood product ordering and transfusion thresholds
  • Regional blocks and anticoagulation
  • Difficult airway management and backup support
  • PACU discharge criteria and ICU transfers
• Contact lists for:
  • OR charge nurse
  • Anesthesia leadership
  • Pharmacy
  • Rapid Response/Code resources

If an assignment offers minimal orientation, factor that into your decision; some anesthesiologists accept this tradeoff at familiar types of facilities, but it’s not ideal for every clinician.

Professional Relationships and Team Dynamics

As a locum, you’ll often:

• Join an existing anesthesia group temporarily
• Work with CRNAs in supervision or collaborative models
• Interface with surgeons who have established preferences and routines

Successful locum anesthesiologists:

• Introduce themselves clearly and confidently
• Ask concise, targeted questions instead of assuming
• Respect local practice patterns while maintaining safe standards of care
• Document carefully, anticipating that they may not be on-site if questions arise later

Your professionalism and adaptability are your calling cards; strong performance often leads to recurring invitations or extended contracts.

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Strategic Use of Locum Work Throughout Your Career

Locum tenens isn’t only for full-time “travel physician jobs.” You can integrate locum work into almost any career stage.

During and Immediately After Anesthesiology Residency

You can’t practice independently as an attending until licensed and credentialed, but you can:

• Prepare during residency:
  • Track your case logs and procedures in an organized way
  • Network with faculty who have done locum work
  • Attend career panels that include locum tenens discussions
• Immediately post-residency:
  • Use short-term locum assignments as a bridge if:
    • You’re waiting for your primary job to start
    • You just missed an ideal anesthesia match opportunity and want time to re-apply
    • You’re uncertain about where you want to settle

This can be especially helpful if you need to pay down loans aggressively early on or want to experience different regions before committing.

Mid-Career: Flexibility and Skill Expansion

Mid-career anesthesiologists often leverage locums to:

• Supplement full-time income with occasional weekend or vacation coverage
• Explore different subspecialty environments (e.g., more cardiac, more regional anesthesia)
• Test out new geographic locations prior to a move
• Step away from an unsatisfying permanent job without a career gap

For example, an anesthesiologist frustrated with hospital politics might resign, spend 12–18 months primarily on locum work in varied settings, and then decide which style of permanent role (if any) they want next.

Late Career: Transitioning Toward Retirement

Locum work can smooth the transition out of full-time practice:

• Gradually reduce clinical hours without abrupt retirement
• Focus on lighter case mixes or daytime-only schedules
• Spend extended time near adult children or grandchildren in different states
• Maintain clinical relevance and income while enjoying more control over time

This phase demands particular attention to maintenance of certification and credentialing requirements, as well as physical and cognitive demands—be honest with yourself about what is sustainable and safe.

Combining Locums with Other Professional Goals

Locum tenens can be paired with:

• Academic roles (visiting or adjunct positions)
• Research or quality improvement projects
• Consulting or medico-legal review work
• Global health/overseas medical missions
• Non-clinical roles in pharma, medtech, or healthcare administration

The common thread: locum work gives you schedule flexibility and sometimes geographic mobility that can make these hybrid careers feasible.

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Special Considerations: Locums, the Anesthesia Match, and Long-Term Planning

Even though locum tenens work is typically a post-residency path, your understanding of it can influence decisions as early as medical school and residency applications.

During Medical School and the Anesthesia Match

As you plan for an anesthesiology residency through the anesthesia match:

• Factor in programs’ case volume and diversity; a strong foundation makes you more competitive for locum work later.
• Look for programs that:
  • Emphasize regional anesthesia, OB, and complex cases
  • Offer rotations in community and rural hospitals (mirroring likely locum environments)
  • Have faculty who can mentor you in non-traditional career paths, including locums and travel physician jobs

The better your training, the more confident you’ll feel accepting a wide range of locum assignments safely.

Evaluating Permanent Jobs with Locum Work in Mind

When considering your first permanent job:

• Ask about policies on moonlighting and external locum work.
• Understand any non-compete or geographic restriction clauses that might limit your ability to work nearby as a locum tenens physician.
• Consider whether the group’s scheduling model will allow you to block out weeks for locum assignments, if you plan a hybrid structure.

Even if you don’t intend to start locums immediately, maintaining options increases your long-term career resilience.

Locum Tenens vs Permanent Practice: A Long-Term Perspective

Over a 10–20 year horizon, anesthesiologists commonly shift between:

• Full-time permanent roles
• Full-time locum tenens work
• Hybrid models (permanent job + locum assignments on the side)
• Short sabbaticals supported by prior high-earning locum periods

The key is intentional planning—financial, professional, and personal. Locum work is not merely a stopgap; it can be a strategic tool to design the anesthesiology career you actually want.

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FAQs: Locum Tenens in Anesthesiology

1. When is the best time to start doing locum tenens work as an anesthesiologist?
Most clinicians start after completing residency and obtaining at least one full, unrestricted state license. Some prefer to complete 1–2 years in a permanent role first, to build confidence and a strong reference base. Others jump directly into locum work after residency, especially if they’re comfortable clinically and value flexibility. The right time depends on your comfort level, financial situation, and career goals.

2. How does malpractice coverage work for locum anesthesiologists?
Most major locum tenens agencies provide malpractice coverage (often with tail coverage included) for your work under their contracts. If you contract directly with hospitals or groups, you’ll need to clarify whether they provide coverage, or whether you must purchase your own. Always confirm whether the policy is claims-made or occurrence-based, and what tail provisions exist; this is particularly important in procedural fields like anesthesiology.

3. Can I do locum work part-time while holding a full-time job?
Often yes, but it depends on your primary employer’s policies and your contract. Some hospital systems and groups explicitly allow outside work or moonlighting, while others restrict it. Carefully review your employment agreement for non-compete clauses, conflict-of-interest policies, and scheduling expectations. If permitted, weekend or vacation locum assignments can be a powerful way to boost income or explore other practice settings.

4. How competitive are locum tenens assignments in anesthesiology?
Demand remains high in many regions, particularly rural and underserved areas, making anesthesiology a favorable specialty for locum work. More desirable locations and schedules (e.g., coastal cities with no call) can be competitive, and agencies may prioritize anesthesiologists with strong references, board certification, and flexible availability. Maintaining up-to-date licenses, a clean credentialing record, and a reputation for reliability significantly improves your access to top assignments.

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Locum tenens opportunities in anesthesiology offer a powerful combination of flexibility, financial reward, and professional growth. Whether you’re fresh from the anesthesia match, mid-career and reassessing your priorities, or planning a phased retirement, understanding how to leverage locum work can help you design a career that aligns with your life—rather than the other way around.