Unlocking Locum Tenens Opportunities in Cardiothoracic Surgery: A Guide

Choosing a career in cardiothoracic surgery already places you in one of the most demanding and specialized fields in medicine. Layer on the unique flexibility of locum tenens work, and you have a career model that can be both highly rewarding and strategically powerful—if you understand how to navigate it.

This guide walks you through locum tenens opportunities in cardiothoracic surgery, with a particular focus on how this intersects with residency, fellowship, early career decisions, and long-term professional planning.

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Understanding Locum Tenens in Cardiothoracic Surgery

Locum tenens (Latin for “to hold the place of”) refers to temporary physician assignments where you step in to provide care when a hospital or practice needs additional coverage. In cardiothoracic surgery, these needs are often high-stakes: coverage gaps in heart surgery services can directly affect patient access to life-saving care.

Why Hospitals Use Locum Cardiothoracic Surgeons

Hospitals and health systems may seek a locum tenens physician in cardiothoracic surgery for reasons such as:

• A surgeon leaving unexpectedly (retirement, relocation, illness, or resignation)
• Maternity or medical leaves within a small surgical group
• Seasonal fluctuations in surgical volume (e.g., winter heart failure and cardiac disease spikes)
• Bridging coverage while recruiting a permanent surgeon
• Expanding services or opening a new cardiac surgery program
• Covering regional call rotations in lower-volume centers

Because cardiothoracic surgery is a high-acuity, low-volume specialty in many hospitals, losing even one surgeon can destabilize a program. Locum tenens physicians help maintain continuity: keeping ORs open, supporting ICU teams, and ensuring emergent cases are managed.

Types of Cardiothoracic Locum Assignments

Assignments can vary widely:

• Short-term coverage (a few days to 2 weeks)

  • Typically call-heavy roles or urgent coverage for vacations/meetings
  • Often focused on emergency or urgent cases, less elective volume

• Medium-term coverage (1–3 months)

  • Common when a surgeon is on extended leave or during recruitment
  • Blend of elective cases, call, and clinic

• Long-term coverage (3–12+ months)

  • Used when a program is building a new service or awaiting permanent hires
  • You may function almost like core faculty, involved in program development and training

Assignments may be:

• In large academic centers – Complex cases, advanced technologies (ECMO, transplant, LVAD), teaching responsibilities
• In community hospitals – Bread-and-butter adult cardiac and thoracic surgery, high independence
• In hybrid settings – Regional referral centers where you handle both high acuity and volume

For residents and fellows planning their careers, understanding this spectrum helps you decide where locum work might fit into your professional trajectory.

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How Locum Tenens Fits into Cardiothoracic Surgery Training and Early Career

While you cannot work independently as a cardiothoracic locum tenens physician until your training is complete and you’re fully licensed and credentialed, planning ahead during residency or fellowship can position you well.

During Residency and Fellowship

Cardiothoracic surgery residency or fellowship is intense; heart surgery training leaves little time for outside clinical work. Still, you can lay groundwork for future locum opportunities:

• Clarify your scope of future practice

  • Adult cardiac only?
  • Adult + general thoracic?
  • Pediatric congenital?
  • Transplant and mechanical circulatory support?

• Emphasize case breadth and autonomy

  • Programs that offer strong exposure to CABG, valve surgery, aortic work, and thoracic malignancy prepare you better for community-based locum roles.
  • If you’re aiming for academic or advanced programs, seek exposure to transplant, ECMO, and minimally invasive techniques.

• Learn how different systems function

  • Rotations at outside institutions or visiting resident rotations expose you to diverse OR workflows, ICU setups, EMR systems, and multidisciplinary team structures—valuable experiences for a travel physician job later.

• Build relationships

  • Mentors, program directors, and attending surgeons can become references for credentialing.
  • Former faculty may also contact you about locum coverage needs at their institutions.

While you cannot officially advertise yourself as a locum tenens surgeon yet, you can already be strategizing: what skills will be marketable, what settings you prefer, and how confident you will be practicing semi-independently soon after graduation.

Transitioning from Training to Locum Work

Many new cardiothoracic surgeons assume that the only logical next step is a traditional full-time faculty or private practice role. In reality, some early-career surgeons pursue locum tenens either as a bridge or as a deliberate long-term model.

Common scenarios:

• Bridge year between fellowship and a permanent job

  • Use a year of locum work to explore different regions and practices, while continuing to build your case log.
  • Helpful if your preferred permanent job market is tight (e.g., major academic centers) and you want income and operative volume in the meantime.

• Dual-track strategy

  • Work part-time locum assignments while also doing research, global surgery, or advanced training (e.g., aortic, transplant, or minimally invasive fellowships).
  • Requires careful planning to avoid burnout and maintain competence.

• Locum as a test-drive

  • Try different environments—large academic centers, hybrid community systems, rural hospitals—to refine what kind of permanent role fits you best.
  • Observe culture, case mix, call structure, ICU support, and institutional politics without long-term commitment.

For fellowship graduates in cardiothoracic surgery, locum tenens can be more than a “stopgap”; it can be a structured phase of career exploration.

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Pros and Cons of Locum Tenens in Cardiothoracic Surgery

Before you commit, you need a realistic understanding of benefits and trade-offs—particularly in such a procedurally complex specialty.

Advantages

1. Financial Flexibility and Often Higher Hourly Rates

Cardiothoracic surgery is a high-demand niche, and locum assignments frequently offer premium compensation:

• Competitive daily or weekly rates, often higher than the prorated salary of a permanent position
• Extra pay for call, especially if in-house or associated with emergent sternotomies
• Covered travel, lodging, and sometimes meal stipends
• Potential for rapid debt reduction after residency and fellowship

For a surgeon just finishing a long training path, this can be a powerful tool for financial stabilization.

2. Geographic and Professional Flexibility

Locum work enables you to:

• Experience different regions before settling permanently
• Take time off between assignments for rest, research, or family
• Avoid immediate long-term contracts that may be hard to exit

This flexibility is especially useful if your partner or family hasn’t yet decided on their long-term location, or if you want to blend clinical work with other projects (academic, entrepreneurial, or global health).

3. Rapid Skill Consolidation

Early in your career, doing a high volume of core operations—CABG, valve surgery, lung resections—under varying conditions can accelerate growth:

• Exposure to different surgical techniques and preferences
• Adaptation to multiple perfusion teams and anesthesiologists
• Managing post-op care in different ICU models (closed vs open, intensivist-led vs surgeon-led)

This diversity can make you a more resilient, versatile surgeon.

4. Lower Administrative Burden (Sometimes)

As a locum tenens physician, you typically:

• Are shielded from long-term committee work and hospital politics
• Aren’t expected to attend every meeting or assume heavy nonclinical administrative roles
• Can focus on clinical work, patient care, and OR productivity

This can be a welcome break after years of residency obligations and academic expectations.

Disadvantages and Risks

1. Credentialing and Licensing Complexity

Each new assignment may require:

• Full hospital credentialing and privileging
• Verification of case logs and references
• Malpractice coverage review
• State licensure if crossing state lines

This can be logistically intensive and sometimes slow. Advance planning and working with an experienced locum agency are essential.

2. Variable Support and Resources

As a cardiothoracic surgeon, your outcomes depend on:

• OR equipment (grafts, valves, staplers, perfusion pumps)
• Perfusion team quality
• Cardiac anesthesia support
• ICU nursing and advanced practitioner coverage
• Availability of interventional cardiology, EP, and radiology

In some community or rural hospitals, you may face limited resources. Knowing your boundaries—and being prepared to decline unsafe cases—is paramount.

3. Less Continuity and Relationship Building

• Limited longitudinal follow-up with patients and families
• Harder to mentor trainees consistently if you’re in and out of different institutions
• Less opportunity to build a sustainable research portfolio or program leadership role

For some surgeons, this feels like a sacrifice; for others, it’s an acceptable trade-off.

4. Professional Identity and Perception

Most surgeons trained in traditional models still view permanent positions as the “default.” As a locum tenens cardiothoracic surgeon, colleagues may:

• See you as a temporary “fix” rather than a core team member
• Be slower to involve you in complex or borderline surgical decisions
• Be cautious about assigning you long-term quality-improvement projects

Over time, strong clinical performance and professionalism usually override these biases, but it’s important to be aware of them.

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How to Prepare for a Cardiothoracic Locum Tenens Career

Whether you are a current resident, fellow, or new attending, deliberate preparation makes locum work smoother and safer.

1. Solidify Your Clinical Foundation

Before you consider independent locum assignments in cardiothoracic surgery, you should:

• Have adequate case numbers in primary surgeon roles, documented clearly in your logs
• Be comfortable performing the key index operations independently:
  • CABG (on- and off-pump if you plan to accept such assignments)
  • Valve operations (AVR, MVR/repair, TV as appropriate)
  • Basic aortic surgery in the ascending aorta and root (if you plan to handle aortic call)
  • Lung resections (lobectomy, pneumonectomy) if you’ll cover thoracic
• Be able to manage typical post-op complications:
  • Low cardiac output, arrhythmias, bleeding, tamponade
  • Respiratory failure, ARDS, pulmonary embolism
  • Sepsis and multisystem organ dysfunction

When you accept locum roles, you are usually treated as a fully independent surgeon; there is rarely a “warm-up” period with heavy supervision.

2. Optimize Your Credentials and Documentation

Locum tenens work in cardiothoracic surgery requires airtight documentation. Create a personal credentialing portfolio that includes:

• Up-to-date CV with detailed training and employment history
• Current licenses and DEA registration
• Board certification (or board-eligibility documentation and exam plans)
• Fellowship/diploma documentation from heart surgery training
• Recent case logs, clearly categorized (adult cardiac, thoracic, congenital if applicable)
• Letters of reference from program directors and senior faculty
• Proof of ACLS, ATLS (if trauma thoracic), and other relevant certifications
• Documentation of any QI or outcomes projects, especially if they show strong results

Keep this portfolio in a secure digital format so you can respond quickly to requests from locum agencies and hospitals.

3. Understand Malpractice and Risk Management

Key questions to clarify for each assignment:

• Who provides malpractice insurance (hospital vs agency vs you)?
• Is it occurrence-based or claims-made coverage?
• If claims-made, who covers tail insurance after you leave?
• What are the policy limits for high-risk procedures (e.g., complex aortic surgery)?
• Are there any exclusions that apply specifically to cardiothoracic procedures?

Given the stakes of cardiothoracic operations, you should never accept an assignment without clear, written malpractice arrangements.

4. Develop a Locum-Focused Professional Skillset

Success as a locum tenens physician in a high-intensity specialty relies not just on clinical skills, but on adaptability:

• Rapid systems learning – Quickly understand new EMRs, order sets, critical lab/radiology pathways
• Communication – Introduce yourself effectively to ICU teams, anesthesiologists, OR staff, and cardiologists on day one
• Boundary-setting – Know your limits in terms of case complexity given available resources
• Cultural sensitivity – Respect local practice norms without compromising safety

Residents can start practicing these skills on away rotations, visiting electives, and during rotations at affiliated sites.

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Practical Logistics: Agencies, Contracts, and Day-to-Day Life

Understanding the mechanics of locum work is crucial, especially if you’ve spent your entire training in one academic center.

Working with Locum Tenens Agencies

Most cardiothoracic surgeons use agencies to find and negotiate locum roles. When choosing an agency:

• Ask about their experience specifically in cardiothoracic surgery
• Request examples of recent placements (settings, rates, length of assignments)
• Clarify what support they offer:
  • Licensing assistance
  • Travel, housing, and rental car coordination
  • Malpractice coverage

You are not obligated to work with just one agency; some surgeons work with several to maximize options, while others prefer a single trusted partner for simplicity.

Understanding Contracts and Compensation

Key elements to review in every contract:

• Daily or weekly rate
• Call compensation structure
  • In-house vs backup
  • Weeknights and weekends
• Expectation for case volume and types of procedures
• Cancellation policies
  • What happens if the hospital cancels last minute?
• Travel and housing details
  • Reimbursement vs direct booking
  • Limits on costs and options for upgrades
• Non-compete clauses
  • Do they limit your ability to later take a permanent job at that hospital or in that region?

Given the complexity and liability profile of cardiothoracic surgery, strongly consider having an attorney review your first few contracts.

Day-to-Day Realities of Locum Cardiothoracic Work

Your typical pattern may include:

• Travel days – Arriving a day early, meeting with the chief of surgery, cardiology, anesthesia, and ICU leads
• Orientation – Quick introduction to the EMR, OR, ICU, and call coverage protocols
• Clinical days
  • OR cases in the morning/early afternoon
  • ICU rounds (mentoring APPs or residents, if present)
  • Clinic (for longer-term assignments)
• Call nights/weekends
  • Emergency CABG after failed PCI
  • Acute aortic syndromes (if the hospital handles them)
  • Post-op complications requiring re-exploration or ECMO

Because you often face a compressed onboarding, it’s important to:

• Ask early: What procedures do they expect you to cover?
• Clarify transport and transfer protocols for cases that exceed local capabilities.
• Identify your key contacts: chief of staff, OR manager, perfusion leader, ICU charge nurse.

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Strategic Use of Locum Tenens Over a Cardiothoracic Career

Locum tenens doesn’t have to be “all or nothing.” Many cardiothoracic surgeons integrate locum work at different career stages.

Early Career: Exploration and Experience

In your first 3–5 years out of training, locum work can help you:

• Explore different models (private practice, employed, academic)
• Assess where your operative preferences and lifestyle goals align
• Build your reputation and case volume while paying down debt

Some surgeons alternate between 3–6 month locum assignments and focused research or training blocks.

Mid-Career: Flexibility and Diversification

Later, after you have established yourself, locum work can be a:

• Way to cut back from a grueling full-time call schedule while staying clinically active
• Strategy to relocate gradually—testing new markets before committing
• Method to keep your skills current if you transition partly into leadership, administrative, or industry roles

You might keep a core part-time position at one institution, supplementing with targeted locum assignments a few times per year.

Late Career: Phased Retirement and Mentoring

For senior cardiothoracic surgeons, locum tenens can:

• Allow you to scale down your workload while remaining clinically engaged
• Provide valuable coverage for smaller programs that benefit greatly from experienced surgeons
• Offer opportunities for mentorship and informal teaching during assignments

At this stage, case selection and call expectations should be carefully negotiated to match your desired scope and stamina.

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FAQs about Locum Tenens in Cardiothoracic Surgery

1. Can a cardiothoracic surgery resident or fellow work locum tenens?

Not as an independent cardiothoracic locum surgeon. During training, your practice is supervised and covered under your institution’s malpractice policies. However, you can:

• Prepare your credentials and case logs
• Network with agencies and mentors
• Learn multiple EMRs and team structures via away rotations
• Plan for locum work immediately after graduation once fully licensed and board-eligible/board-certified

2. Is locum tenens a good long-term career model for cardiothoracic surgeons?

It can be, for some surgeons. Many use locum work as a bridge, but others build a long-term practice around it, valuing:

• High flexibility
• Geographic variety
• Focus on direct patient care, with less committee work

However, it may be less ideal if your goals center on continuous research, program building, or long-term academic promotion.

3. How competitive are cardiothoracic locum tenens positions?

Compared with some other specialties, cardiothoracic surgery is relatively niche and high-demand. Hospitals often struggle to recruit permanent surgeons, which increases demand for locum coverage. That said, competition is stronger for:

• Desirable urban locations
• Large academic centers with advanced programs
• Positions with excellent compensation and lifestyle balance

Strong training, clear case logs, good references, and a flexible geographic preference will make you highly marketable.

4. What should I prioritize when evaluating a locum assignment in cardiothoracic surgery?

Focus on:

• Safety and support: perfusion, anesthesia, ICU, and cardiology backup
• Clear expectations on case complexity and call
• Adequate malpractice coverage and tail provisions
• Reasonable compensation relative to workload and risk
• Fit with your current skills and comfort level

If any aspect of the environment feels unsafe or under-resourced for complex cardiac or thoracic surgery, it is appropriate—and professional—to decline the assignment.

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Locum tenens opportunities in cardiothoracic surgery offer a powerful blend of flexibility, financial reward, and clinical variety. For residents and fellows nearing the end of heart surgery training, understanding how locum work fits into your broader career strategy can open doors you might not have considered—whether as a temporary bridge, a long-term lifestyle, or a strategic supplement to a more traditional role.