Exploring Locum Tenens Opportunities: A Guide for Med-Peds Residents

Understanding Locum Tenens in Medicine-Pediatrics

Locum tenens work—temporary coverage provided by a physician at a hospital, clinic, or practice—has become a major career pathway across specialties. For Med-Peds physicians, locum tenens opportunities are uniquely appealing because they leverage the full breadth of dual training: caring for adults and children in diverse settings across the country.

In the context of a med peds residency and early-career planning, it’s smart to understand how locum work can fit into your trajectory, whether as a short gap-year strategy, a long-term career model, or something in between. This guide will walk you through what locum tenens is, where Med-Peds physicians fit in, how it interacts with the medicine pediatrics match, and the practical steps to get started.

What is locum tenens?

“Locum tenens” is Latin for “to hold the place of.” In modern practice, it means:

• A physician works temporarily at a site in need of coverage
• Assignments range from weekend call to multi-month contracts
• Work may be local, regional, or fully travel-based (travel physician jobs)
• Payment is usually on a daily or hourly rate, often via an agency

For Med-Peds physicians, this can include:

• Hospitalist shifts (adult, pediatric, or combined)
• Outpatient primary care clinic coverage
• Urgent care shifts
• Inpatient pediatric or adult medicine coverage depending on your comfort and privileges
• Rural and underserved coverage where dual-trained physicians are particularly valuable

Why Med-Peds is well-suited to locum tenens

Med-Peds physicians bring a rare blend of flexibility and breadth:

• Dual board eligibility/certification (Internal Medicine + Pediatrics)
• Experience across inpatient and outpatient settings
• Comfort with complex chronic disease management across the life span

This allows you to fill multiple roles at a single site—sometimes in adult-only, pediatric-only, or combined practice. For hospitals and clinics, hiring one Med-Peds locum can fill gaps that would otherwise require both an internist and a pediatrician, making you highly attractive in the locum market.

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Locum Tenens Across the Career Timeline: From Match to Mid-Career

Locum tenens doesn’t exist in isolation. It interacts with training choices, the medicine pediatrics match, and long-term career planning. Understanding timing and options is critical.

During medical school: Planning ahead

You can’t work locums as a medical student, but you can:

• Explore the specialty:
  • Do sub-internships in Med-Peds, adult hospitalist, and pediatric hospitalist services
  • Seek mentors who have done locums or travel physician work
• Ask targeted questions on interview days about post-residency flexibility, loan repayment, and career paths of recent graduates
• Clarify your goals: Are you drawn to variety, travel, and flexible scheduling? That’s a good fit for locum tenens later.

This planning phase can influence your med peds residency program list. Programs with strong inpatient training, broad procedural exposure, and diverse clinical sites will give you a stronger skill set for locum assignments.

During Med-Peds residency

Residents usually cannot moonlight as independent locum tenens physicians unless they meet local and state requirements (often full licensure and completion of a certain level of training). However, you can prepare strategically:

1. Maximize clinical versatility

   • Seek rotations in:
     • Adult hospital medicine
     • Pediatric hospital medicine
     • ICU (if available)
     • Newborn nursery and NICU exposure
     • Urgent care and ED shifts
   • Build comfort in both adult and pediatric acute care; this is highly marketable in locum work.

2. Develop autonomy and efficiency

   • Ask for graduated responsibility in admissions, cross-cover, and night float.
   • Consider electives that enhance efficiency—e.g., high-volume outpatient clinics or urgent care.

3. Ask faculty about their post-residency paths

   • Did any graduates pursue a year or more of locums?
   • What skill gaps did they identify early on?
   • How did locum work affect fellowship opportunities (if relevant)?

4. Licensure and credentialing prep

   • Aim to secure full, unrestricted licensure in at least one state by graduation.
   • Keep your logbooks, procedure logs, and evaluations organized; they’ll be requested later by locum agencies and hospitals.

Post-residency: Transitioning to locum tenens

After completing a Med-Peds residency and obtaining board eligibility:

• Year 1–2 post-residency:

  • Many graduates pursue locums immediately to explore different practice models, geographic regions, and schedules.
  • Others combine a core job (e.g., full-time hospitalist) with periodic locum work to supplement income or maintain pediatric or adult skills.

• Mid-career:

  • Some physicians shift to locum tenens to avoid administrative burdens, tailor their workload, or explore new states/communities.
  • Locum tenens can also serve as a transition phase when changing practice types (e.g., from clinic-based primary care to inpatient-focused roles).

Interaction with fellowship plans

If you plan to pursue fellowship (e.g., adult cardiology, pediatric ID, med-peds ID, hospital medicine fellowships), locum work can still fit:

• Gap years before fellowship:

  • Use locums while waiting for fellowship start dates or between match cycles.
  • Maintain clinical currency and generate income while you clarify long-term goals.

• After fellowship:

  • Subspecialists with Med-Peds backgrounds may do locums in either adult or pediatric subspecialties, depending on certification and local credentialing norms.
  • Consider how subspecialty call responsibilities may affect your flexibility for travel jobs.

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Types of Locum Tenens Roles for Med-Peds Physicians

Med-Peds physicians can pursue a wide variety of locum tenens assignments. The specific mix will depend on your comfort, board status, and the needs of the hiring organization.

1. Inpatient hospitalist roles

Adult hospitalist locums

• Admit and manage adult inpatients, often on general medicine services
• Typical settings: community hospitals, academic affiliates, rural critical-access hospitals
• Common responsibilities:
  • Admissions from ED
  • Daily rounding
  • Discharge planning, coordination with consultants
  • Occasionally ICU co-management or step-down units, depending on site

Pediatric hospitalist locums

• Care for hospitalized children on pediatric wards, sometimes newborn nursery
• May include:
  • Attendance at high-risk deliveries
  • Management of bronchiolitis, asthma, neonatal jaundice, dehydration
  • Consultation for ED or surgical patients

Combined Med-Peds hospitalist roles

Some smaller hospitals or health systems employ one physician for both adult and pediatric inpatients. A Med-Peds locum may:

• Cover both adult and pediatric wards
• Provide newborn nursery care
• Be the key inpatient generalist for the facility overnight or on weekends

This is where Med-Peds training shines. Demonstrating comfort and competence in both age groups gives you a major edge over single-boarding colleagues.

2. Outpatient and primary care clinic coverage

General internal medicine or pediatric clinics

• Covering PCP clinics when physicians are on vacation, parental leave, or between hires
• Duties:
  • Seeing scheduled and same-day appointments
  • Chronic disease management (HTN, DM, asthma, ADHD)
  • Preventive care and immunizations
  • Occasionally telemedicine

True Med-Peds clinics

• Some organizations run dedicated Med-Peds practices that care for multi-generational families.
• As a locum, you may see:
  • Transitional-age youth with complex conditions
  • Adults with congenital heart disease, CF, or other childhood-onset illnesses
  • Young families where you care for parents and children in the same visit block

3. Urgent care and ED-adjacent roles

Locum Med-Peds physicians are often welcomed in:

• Urgent care centers seeing both adults and children
• “Fast track” or minor acute ED pods
• After-hours walk-in clinics

These roles suit physicians who enjoy procedural work and rapid turnover: laceration repairs, splinting, simple abscess drainage, acute infections, and minor trauma.

4. Rural and underserved locum opportunities

Many rural and frontier regions rely on temporary coverage to maintain access to care. Med-Peds physicians are especially valuable because they:

• Can cover both adult and pediatric panels
• May serve as the only inpatient or on-call physician overnight
• Help smaller hospitals avoid transferring pediatric cases unnecessarily

Key considerations for rural locums:

• Comfort working with limited subspecialty backup
• Willingness to manage broader scopes of practice (e.g., more procedures)
• Understanding of local resources: telemedicine, transfer agreements, and transport systems

5. Telemedicine locums

Telehealth is increasingly available as locum work:

• Video visits for acute issues and chronic disease follow-up
• Pediatric urgent telehealth (e.g., rash, fever counseling)
• Adult urgent and primary care tele-visits

You’ll need to manage multi-state licensing carefully, but tele-locums can complement or replace travel, especially for those seeking more flexibility or family stability.

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Locum Tenens Logistics: Licensure, Agencies, and Contracts

Once you’re ready to explore locum tenens, the next step is managing the logistics. Understanding how licensure, agencies, pay structures, and contracts work will make you more effective and protect you legally and financially.

Medical licensure and board status

Licensure

• Start with at least one state license where you intend to work.
• Consider the Interstate Medical Licensure Compact (IMLC) if your primary license is in a compact state and you expect to take multi-state assignments.
• Locum agencies often assist with licensing, but you should still know timelines (often 3–6 months).

Board eligibility and certification

• Most sites prefer or require board-eligible or board-certified physicians in both Internal Medicine and Pediatrics for true Med-Peds roles.
• Some sites will credential you for adult or pediatric-only roles if you have at least one relevant certification and a track record of experience.

Working with locum tenens agencies

Most physicians find assignments through locum agencies. Their role:

• Match you with job opportunities that fit your skills and preferences
• Facilitate credentialing, licensing support, and travel arrangements
• Negotiate pay rates and contract terms (to varying degrees)

Tips for working with agencies:

1. Choose 1–3 reputable agencies

   • Ask co-residents or attendings for recommendations.
   • Look for Med-Peds–specific experience if possible.

2. Be clear about your scope

   • Explicitly state which age groups and settings you are comfortable with.
   • Define boundaries (e.g., “No independent ICU coverage,” “Newborn resuscitation only with backup”).

3. Request transparency

   • Ask for the bill rate and your pay rate, if possible.
   • Clarify OT, call pay, and cancellation policies.

4. Avoid overcommitting

   • Don’t sign overlapping or conflicting commitments with multiple agencies.
   • Track your schedule carefully to maintain reliability and reputation.

Pay structures and expenses

Typical compensation

• Hourly or per-diem rates vary widely by region, demand, and setting. As a Med-Peds physician you may command higher rates when you cover both adult and pediatric services.
• Call pay: Additional compensation for in-house or beeper call.
• Holiday and night differentials: Some contracts pay extra for nights or major holidays.

Expenses often covered by agencies or hiring sites:

• Travel (flights, rental car, mileage reimbursement)
• Lodging (hotel, apartment, or stipend)
• Malpractice insurance (more on this below)
• Licensing and credentialing fees, in some cases

Malpractice insurance and tail coverage

For locum tenens, malpractice coverage is non-negotiable:

• Many agencies provide claims-made coverage with tail included for the duration of each assignment.
• Confirm whether tail coverage is included after the assignment ends; if not, you may be vulnerable to future claims.
• Keep detailed records of policy numbers, carriers, and coverage dates; fellowship programs or future employers may ask for this history.

Vetting assignments and reading contracts

Before accepting an assignment:

1. Clinical expectations

   • Patient volumes (inpatient census, clinic visits per day)
   • Call frequency and type (in-house vs. home call)
   • Procedural expectations (e.g., intubations, central lines, lumbar punctures)
   • Pediatric volumes and acuity (especially important for Med-Peds roles)

2. Support and resources

   • Availability of subspecialists (in-house vs. tele-consult vs. transfer)
   • Availability of pediatric-trained nursing staff and equipment
   • On-site respiratory therapy, anesthesia, radiology, and lab support

3. Contract terms

   • Start and end dates, termination clauses, and cancellation policies
   • Guaranteed minimum hours or shifts
   • Non-compete clauses (can they restrict you from working in the region later?)
   • Documentation requirements and EMR training time

If a contract feels vague—especially around scope of practice or malpractice—push for clarification in writing before you sign.

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Advantages, Challenges, and Strategic Use of Locum Work

Locum tenens can be an excellent tool, but it’s not ideal for everyone. Understanding the pros and cons—and how to align it with your goals—will help you make thoughtful decisions.

Advantages of Med-Peds locum tenens

1. Flexibility and control over schedule

• Choose when and where you work
• Build in extended breaks for travel, family time, or academic projects
• Take advantage of travel physician jobs in different regions and practice environments

2. Diverse clinical experience

• Work in academic medical centers, small rural hospitals, community clinics, and urban safety-net systems
• See varied pathology and practice styles, sharpening your adaptability
• Maintain both adult and pediatric skills if you curate your assignments intentionally

3. Potential for higher earnings

• Locum pay can be competitive, especially in high-demand regions or short-notice coverage
• Ability to stack shifts during high-earning periods (e.g., winter respiratory season)
• Some physicians use locum tenens to pay down loans more aggressively

4. Reduced administrative burden

• Less involvement in long-term practice politics, bureaucracy, and committee work
• Focus is primarily on clinical care and documentation for the assignment
• No long-term commitment to EHR optimization projects, QI committees, or clinic management (unless you choose them)

5. Career exploration

• Try different practice models before committing (e.g., inpatient-only vs. mixed, hospital-employed vs. private group)
• Discover which settings best fit your personality and long-term goals
• Gain insight into how different institutions support Med-Peds practice

Challenges and trade-offs

1. Lack of long-term continuity

• Limited continuity of care for individual patients
• Harder to build long-term therapeutic relationships, especially in primary care
• May feel less attached to any single institution or team

2. Variable support structures

• Some sites are understaffed or poorly resourced—that’s often why they need locums
• Onboarding and orientation may be minimal; you must adapt quickly
• You may be asked to stretch your comfort zone (e.g., more independent overnight practice)

3. Financial and logistical complexity

• Income variability from month to month depending on work volume
• Need to manage taxes, retirement, and insurance as an independent contractor (if 1099)
• Travel fatigue, time away from home, and frequent onboarding processes

4. Perception and career trajectory

• Some academic or traditional employers may misunderstand locum tenens as “less stable,” though this is changing
• You may need to articulate how locum work has sharpened your skills and broadened your experience during interviews for permanent roles or fellowships.

Strategic use of locum work in a Med-Peds career

Locums doesn’t have to be all-or-nothing. Many Med-Peds physicians blend locum tenens with permanent roles over time:

• Bridge between residency and permanent job:

  • Use 6–12 months of locums to explore geographic preferences.
  • Evaluate potential employers by working with them temporarily.

• Side work while in a core job:

  • Maintain pediatric or adult skills not used in your main position.
  • Supplement income while retaining benefits and stability from a primary employer.

• Transition to part-time or pre-retirement work:

  • Scale down FTE, choosing a handful of locum assignments per year.
  • Maintain clinical engagement without full-time clinic or call duties.

When viewed as a flexible tool rather than a rigid pathway, locum tenens can support a wide array of Med-Peds career shapes.

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Practical Steps to Get Started as a Med-Peds Locum Tenens Physician

If you’re approaching the end of residency or contemplating a shift into locum work, here’s a stepwise approach.

Step 1: Clarify your clinical scope and goals

Ask yourself:

• Do I want to focus on:
  • Inpatient adult?
  • Inpatient pediatric?
  • Combined Med-Peds hospitalist?
  • Outpatient primary care?
  • Urgent care/ED?
• How important is it to maintain both adult and pediatric practice?
• Am I comfortable with rural settings and limited subspecialty backup?
• How much travel am I willing to do, and how often?

Write down your “must-haves” and “dealbreakers.” This list will guide conversations with recruiters and help you screen opportunities.

Step 2: Strengthen your CV and references

• Highlight both Internal Medicine and Pediatrics experience clearly.
• List any leadership roles, QI projects, and teaching experience; hospitals value these in locum physicians as well.
• Obtain strong references from supervising attendings or chiefs in both adult and pediatric settings.
• Be ready to discuss your case volumes and comfort with common hospitalist or outpatient conditions.

Step 3: Connect with locum agencies and recruiters

• Reach out to multiple agencies initially; compare responsiveness, transparency, and Med-Peds literacy.
• Ask each recruiter:
  • “How many Med-Peds positions have you placed in the last year?”
  • “Do you have combined Med-Peds opportunities or mainly adult or peds only?”
• Review sample contracts and opportunities before committing to a specific schedule.

Step 4: Plan your financial and legal structure

• Decide whether you’ll work as:
  • A W-2 employee of the agency (they handle withholdings, may offer some benefits), or
  • A 1099 independent contractor (more flexibility, but you manage taxes and benefits).
• Consider talking with:
  • A tax professional experienced with locum tenens or independent physicians
  • A financial advisor to set up retirement accounts and savings strategies

Step 5: Start with one or two pilot assignments

• Choose sites with good reputations and robust support for your first assignments.
• Debrief after each:
  • What did you like or dislike about the census, acuity, schedule, and team dynamics?
  • How did you feel about the balance between adult and pediatric practice?
• Use those lessons to refine your future assignment preferences.

Step 6: Build a sustainable schedule and routine

Once you’ve confirmed that locum tenens fits your life:

• Create an annual calendar of desired work blocks and off-blocks.
• Consider alternating “intense” work months with lighter months.
• Establish travel routines—pack lists, housing preferences, EMR learning strategies—to minimize stress and maximize efficiency.

Over time, many Med-Peds locum physicians develop a small circle of “favorite sites” that they return to regularly, combining familiarity and continuity with the benefits of temporary work.

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FAQ: Locum Tenens Opportunities in Medicine-Pediatrics

1. Can I do locum tenens work right after the medicine pediatrics match and residency graduation?
Yes, many Med-Peds physicians begin locum work immediately after residency. You’ll need:

• An active state medical license (or several)
• Board eligibility in Internal Medicine and Pediatrics
• Completed credentialing at the hiring hospitals/clinics

Because credentialing and licensing can take months, start this process in your PGY-3/PGY-4 year if you know you’re interested in locums.

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2. Is locum work compatible with pursuing fellowship training later?
It can be. Options include:

• Taking a gap year between residency and fellowship applications to do locums and clarify your subspecialty interests
• Using locums strategically while waiting for fellowship start dates
• Doing limited locums during or after fellowship (if allowed by your program and visa status, where relevant)

Be prepared to explain in fellowship interviews how locum experience enhanced your skills, adaptability, and understanding of real-world practice.

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3. How do locum tenens opportunities affect my ability to work as a permanent locum tenens physician long-term?
Many physicians build full careers around locum work. Long-term viability depends on:

• Maintaining licensure, board certification, and clean practice history
• Cultivating good relationships with agencies and client hospitals
• Balancing travel and personal life to prevent burnout

Over time, you might focus on a specific niche (e.g., rural Med-Peds hospitalist, urban pediatric hospitalist, or mixed telehealth/in-person work).

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4. What’s the difference between a locum tenens physician and other travel physician jobs?
“Locum tenens physician” usually means a formal temporary assignment via an agency or direct hire. “Travel physician jobs” is a broader, informal term that can include:

• Traditional locum tenens roles
• Short-term contracts directly negotiated with hospitals or groups
• Telemedicine-only positions that serve multiple states

For Med-Peds physicians, both frameworks can let you combine adult and pediatric practice in flexible, travel-based or remote roles; the key differences lie in how the job is structured, paid, and supported logistically.

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Locum tenens in Medicine-Pediatrics offers a rare blend of flexibility, variety, and full use of your dual training. Whether you envision it as a short bridge, a periodic side pursuit, or the cornerstone of your career, understanding the logistics and strategy will help you turn locum tenens into a powerful, sustainable part of your Med-Peds journey.