Exploring Locum Tenens Opportunities in Nuclear Medicine: A Complete Guide

Locum tenens work is rapidly becoming a mainstream career strategy in nuclear medicine. Whether you are a resident planning your post-graduation path, an early-career attending exploring flexibility, or a mid-career specialist seeking variety, locum tenens opportunities in nuclear medicine can be both professionally rewarding and financially attractive.

This guide walks through how nuclear medicine physicians can leverage locum work—from understanding the market to evaluating contracts, balancing lifestyle, and integrating locums into a long-term career plan.

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Understanding Locum Tenens in Nuclear Medicine

Locum tenens literally means “to hold the place of.” In medicine, it refers to temporary clinical assignments where a physician fills in for another provider or covers short-term staffing gaps. In nuclear medicine, these assignments can range from a few days to several months and may be onsite, hybrid, or occasionally teleradiology-style remote reads (depending on regulations and institutional policies).

Why Locum Tenens Is Growing in Nuclear Medicine

A combination of factors has fueled demand for locum tenens nuclear medicine physicians:

• Specialist shortage in certain regions: Smaller hospitals and non-academic centers often struggle to recruit full-time nuclear medicine specialists, especially outside major metropolitan areas.
• Growth of advanced imaging: Increased PET/CT and SPECT/CT utilization for oncology, cardiology, and neurology drives demand, particularly where radiology departments lack robust nuclear subspecialty coverage.
• Coverage for extended leave: Sabbaticals, maternity/parental leave, retirement transitions, and unexpected physician departures create gaps that locum tenens providers fill.
• Regulatory and safety requirements: Given the complexity of radiopharmaceuticals, radiation safety, and licensing, many institutions prefer board-certified nuclear medicine physicians for oversight, QA, and protocol optimization.

For residents and fellows planning their nuclear medicine residency and future careers, understanding locum options early can help you build a flexible, resilient professional roadmap.

Typical Clinical Settings for Nuclear Medicine Locum Work

Locum tenens nuclear medicine assignments exist across a spectrum of practice settings:

• Community hospitals: Bread-and-butter nuclear cardiology, bone scans, HIDA, V/Q, thyroid, some PET/CT.
• Academic centers: More complex oncologic PET/CT, theranostics (e.g., Lu-177 DOTATATE, Lu-177 PSMA), research protocols, and rare indications.
• Private imaging centers: High-volume outpatient PET/CT, cardiac stress testing, and thyroid imaging.
• Hybrid radiology practices: Nuclear medicine embedded in larger diagnostic imaging groups, sometimes requiring cross-coverage or nuclear radiology skill sets.

Each environment has its own expectations for procedure mix, interdisciplinary communication, and administrative responsibilities. Understanding your strengths and preferences is key before committing to locum assignments.

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The Nuclear Medicine Locum Market: Demand, Roles, and Compensation

Locum tenens is no longer just for small-town primary care. Nuclear medicine is a niche subspecialty where temporary coverage can be crucial to maintaining imaging services.

Types of Locum Tenens Roles in Nuclear Medicine

1. Clinical Nuclear Medicine Reader

   • Primary duties: Interpret SPECT, SPECT/CT, PET/CT, planar studies; oversee stress testing and protocol optimization.
   • Common settings: Community hospitals, private imaging centers.
   • Consideration: Clarify whether you must also read general radiology or cross-sectional imaging.

2. Theranostics-Focused Locum

   • Primary duties: Evaluate and treat patients with therapeutic radiopharmaceuticals (e.g., I-131, Lu-177); manage consults and follow-up.
   • Common settings: Academic centers, large cancer centers.
   • Consideration: Credentialing may require documented volume and prior experience with specific agents.

3. Radiation Safety/Regulatory Oversight Role

   • Primary duties: Acting as Authorized User (AU), supervising radiopharmaceutical handling, policies, and compliance.
   • Common settings: Smaller hospitals lacking on-site nuclear medicine leadership.
   • Consideration: Confirm alignment of your AU status and documentation with local and NRC/state requirements.

4. Hybrid Nuclear Radiology / General Imaging Locum

   • Primary duties: Split between nuclear medicine and cross-sectional or general radiology.
   • Common settings: Radiology groups where nuclear volume alone does not justify a full-time nuclear FTE.
   • Consideration: Make sure expectations match your skills—especially if you are fellowship-trained but have limited recent general radiology experience.

Compensation and Benefits: What to Expect

Locum tenens compensation in nuclear medicine is influenced by:

• Geographic location (rural vs urban, high-cost vs low-cost states)
• Urgency of need (last-minute coverage yields better rates)
• Case mix (theranostics and high-complexity PET/CT often command premium pay)
• Call responsibilities and off-hour reading
• Duration of assignment and guarantee of minimum shifts

While specific rates vary and change over time, nuclear medicine locum rates commonly:

• Are daily or hourly, with separate reimbursement for call or overage.
• Include travel and lodging (flight or mileage, hotel or apartment, rental car or stipend).
• Sometimes provide malpractice coverage (often claims-made, occasionally occurrence-based; tail coverage may be negotiated).

As a locum tenens physician, you are essentially an independent contractor in many settings, so:

• Plan for self-employment taxes.
• Budget for periods between assignments.
• Consider health insurance, retirement savings, and disability coverage independently.

Market Trends and Future Outlook

• PET/CT expansion: Growing use in oncology, neurology, and inflammatory conditions provides stable demand for skilled readers.
• New theranostic agents: As access expands, centers will need short-term experts to launch and supervise programs.
• Tele-nuclear medicine: Some systems are exploring remote nuclear interpretation where legally permissible, creating additional “virtual” travel physician jobs, especially for PET/CT reading.

For residents nearing the nuclear medicine match, awareness of these trends can shape fellowship focus (e.g., PET/CT heavy training, theranostics exposure) to better position you for future locum work.

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Getting Started: Pathway from Training to Locum Tenens

If you are in residency or fellowship now, you can begin planning for locums even before your first attending job. The transition is smoother when you understand prerequisites and timelines.

Training and Certification Foundations

To compete for strong locum positions in nuclear medicine, you should typically have:

• Completed an ACGME-accredited nuclear medicine residency or nuclear radiology fellowship.
• Board eligibility or certification (e.g., ABNM, ABR with nuclear radiology subspecialty, or equivalent in your country).
• Documented experience in key modalities:
  • High-volume PET/CT interpretation (especially oncologic)
  • Nuclear cardiology (stress testing, perfusion imaging)
  • Common diagnostic SPECT (bone, HIDA, V/Q, renal, thyroid)
  • Optional but highly valuable: theranostics, dosimetry, and advanced oncology protocols.

For trainees in the nuclear medicine residency pipeline, building a robust case log and seeking extra PET/CT and theranostic exposure will pay off later—both for permanent jobs and for locum flexibility.

Licensing and Credentialing: Timeline and Strategy

Locum work requires you to be very organized about:

1. State Medical Licenses

   • Each state (or country) has its own licensing process.
   • Obtaining a new license can take from 6 weeks to several months.
   • Consider targeting a few strategic states with high demand and licensure reciprocity or compact agreements (where applicable).
   • Some locum agencies will reimburse license fees and assist with paperwork.

2. Hospital Credentialing and Privileging

   • Typically 60–120 days, depending on the institution.
   • You will need detailed logs of:
     • Prior employment and training
     • Procedure volumes
     • Malpractice history
   • Keep your CV, case logs, and reference list updated and ready.

3. Nuclear Regulatory and AU Documentation

   • Institutions may request:
     • Authorized User (AU) documentation
     • Training and experience records with radiopharmaceuticals
     • NRC/state-specific forms
   • Keep copies of:
     • Residency/fellowship procedure logs
     • Letters attesting to AU-qualifying training from prior program directors.

A proactive approach—starting these steps 6–12 months before you want your first locum assignment—will greatly widen your options.

Choosing Between Full-Time Employment and Locum-First

Many new attendings default to a permanent job immediately after training. However, a “locum-first” strategy can be very deliberate:

Advantages of starting with locum work:

• Exposure to different practice models (academic vs community).
• Time to clarify your long-term preferences in case mix, leadership roles, and geography.
• Opportunity to pay down loans quickly with high-intensity, high-paying assignments.

Risks and considerations:

• Income variability between assignments.
• Less predictable schedule, especially if you’re only licensed in one state.
• Limited built-in mentorship structure compared with a traditional junior attending role.

Some physicians choose a hybrid model: a stable part-time permanent position plus intermittent locum work to supplement income and maintain variety.

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Evaluating and Negotiating Nuclear Medicine Locum Assignments

Not all locum positions are created equal. Careful evaluation protects you clinically, legally, and financially.

Key Questions to Ask Before Accepting an Assignment

1. Clinical Scope and Expectations

   • What specific nuclear medicine studies will you read?
   • Will you perform or supervise stress tests personally?
   • Are you expected to interpret general radiology or CT/MRI as well?
   • Is there any theranostic service, and what is your role?

2. Workflow and Support

   • Who are your colleagues? Any on-site nuclear-trained physicians?
   • Are there experienced nuclear technologists and medical physicists?
   • What is the average daily study volume?
   • What PACS, RIS, and voice recognition systems are used?

3. Call and After-Hours Responsibilities

   • Is there evening or weekend call?
   • Are there emergency nuclear studies (e.g., GI bleed, acute PE V/Q) and how frequently?
   • Is call in-person or remote?

4. Regulatory and Safety Infrastructure

   • Who is the Radiation Safety Officer (RSO)?
   • Are policies and procedures up to date?
   • What is your authority and responsibility regarding radiation safety decisions?

5. Professional Liability

   • Who provides malpractice coverage? What are the limits?
   • Is the policy claims-made or occurrence-based?
   • Who covers tail insurance if needed?

Reading the Fine Print: Contracts and Compensation

Common elements you should scrutinize:

• Rate structure

  • Daily vs hourly vs per-RVU.
  • Minimum guaranteed hours or days.
  • Overtime or extra-shift rates.

• Travel and Lodging

  • Are flights, car rental, and hotel fully covered?
  • Is there a per diem for food and incidentals?
  • Are you allowed to self-book and get reimbursed?

• Cancellation Policies

  • How far in advance can the facility cancel without penalty?
  • Do you receive a cancellation fee?
  • What happens if a credentialing delay is caused by the facility?

• Non-Compete or Restriction Clauses

  • Some contracts restrict you from taking a permanent job at the facility or within a certain radius for a specified time.
  • Make sure you understand any limitations that could affect your future options.

If you use an agency, they typically coordinate much of this, but you are still responsible for understanding and agreeing to every term you sign.

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Lifestyle, Career Strategy, and Long-Term Planning

Locum tenens in nuclear medicine is not merely a stopgap; it can be a core part of a sustainable career strategy—if you plan carefully.

Lifestyle Pros and Cons

Pros:

• Flexibility: Control over when and where you work; ability to cluster shifts and then take long stretches off.
• Variety: Exposure to diverse patient populations, protocols, and technology platforms.
• Geographic exploration: Try out different cities or regions before committing to a permanent move.
• Income potential: Intensified periods of locum work can generate substantial earnings, especially when demand is high.

Cons:

• Travel fatigue: Frequent flights, time away from home, and living out of suitcases can be draining.
• Limited continuity: Short-term relationships with teams and limited long-term patient follow-up.
• Administrative repetition: Repeated onboarding, EMR training, and policy refreshers with each new site.
• Benefits gap: No employer-sponsored retirement, health, or disability plans unless you arrange them independently.

For some nuclear medicine physicians, these trade-offs are ideal; for others, a stable single-institution role is preferable. Many find a middle ground by doing periodic locums alongside a base job.

Strategic Uses of Locum Work in Your Career

1. Early-Career Exploration

   • Try academic and community environments.
   • Assess how much you enjoy theranostics vs diagnostic imaging.
   • Identify systems where you may later seek permanent roles.

2. Mid-Career Pivot or Sabbatical

   • Step back from leadership-heavy jobs to rediscover hands-on clinical work.
   • Explore new geographic regions or practice styles.
   • Use locums as a bridge while retraining or upskilling (e.g., new theranostic or PET tracers).

3. Pre-Retirement Transition

   • Gradually reduce workload without fully leaving practice.
   • Choose shorter, lower-intensity assignments to maintain skills and licensure.

Financial and Tax Planning for Locum Physicians

Because locum tenens positions often treat you as a 1099 independent contractor (in the U.S.) or equivalent structure elsewhere, you should:

• Work with a physician-friendly accountant.
• Track:
  • Travel expenses not reimbursed.
  • Licensing and credentialing fees.
  • Continuing medical education (CME) related to nuclear medicine.
• Consider:
  • Setting up a professional entity (e.g., LLC, S-corp) where appropriate.
  • Solo 401(k) or SEP-IRA for retirement savings.
  • Appropriate disability insurance, especially if you rely heavily on locum income.

Locum work can be a powerful tool for rapid debt reduction or accelerated savings, but only if you approach it with a deliberate financial strategy.

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Integrating Locum Tenens into Training and the Nuclear Medicine Match Journey

Even before you graduate, decisions you make during residency and fellowship can support a future in locum practice.

Building a Locum-Ready Skill Set During Training

If you anticipate doing locums, aim for:

• Broad procedural exposure

  • PET/CT with various tracers (FDG, PSMA, DOTATATE, amyloid where available).
  • Cardiac nuclear imaging with pharmacologic and exercise stress.
  • Bread-and-butter SPECT imaging and problem-solving.

• Robust case logging and documentation

  • Keep clear records of your volumes and types of procedures.
  • Save formal letters from program leadership attesting to your expertise and AU-qualifying experience.

• Comfort with different EMR/PACS

  • If your institution uses multiple systems, pay attention; this flexibility will help you adapt quickly on locum assignments.

How the Nuclear Medicine Match Fits In

Although the nuclear medicine match is about securing your residency or fellowship spot, your choice of training program affects your long-term locum prospects:

• Programs with strong PET/CT and theranostics training make you highly marketable.
• Centers with academic and community affiliate sites can expose you to multiple practice styles, mirroring the variety you’ll see as a locum physician.
• Seek mentors who have done locums or travel work; they can provide insight into which skills are most in demand and how to plan for them.

Even if you do not plan to start with locums right after training, building a portable skill set gives you options later—during career transitions, geographic moves, or family-related schedule shifts.

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FAQs: Locum Tenens in Nuclear Medicine

1. Can a new graduate from nuclear medicine residency realistically start with locum tenens work?

Yes, many new graduates successfully begin their attending careers with locum work. The keys are:

• Completing all relevant board exams (or at least being board-eligible).
• Having strong PET/CT and nuclear cardiology skills.
• Securing at least one or two state licenses well before your graduation date.
• Working with a reputable locum agency (or several) that has experience placing nuclear medicine physicians.

Some physicians do a short initial permanent position to gain experience and references before transitioning into heavier locum schedules.

2. Do I need to be comfortable reading general radiology to find nuclear medicine locum jobs?

Not always. There are pure nuclear medicine assignments, especially at larger centers or specialized nuclear medicine services. However, in smaller hospitals or private radiology groups, you may be expected to cover some cross-sectional or general radiology.

During contract negotiations, be explicit about your:

• Comfort level with CT, MRI, or plain films.
• Recent experience and case mix during fellowship/residency.
• Willingness—or unwillingness—to expand scope with appropriate support.

Clarifying this early prevents misunderstandings and protects your practice quality.

3. How does locum work compare financially to a full-time nuclear medicine job?

Locum tenens daily rates are often higher than the equivalent day rate of a salaried job, especially for urgent or hard-to-fill locations. However:

• Locum income can be variable, with gaps between assignments.
• You typically must fund your own benefits: health insurance, retirement, disability.
• Taxes for independent contractors are more complex, requiring planning.

Many physicians find that well-chosen locum assignments can meet or exceed the income of traditional employment, especially when combined with disciplined saving and tax strategies.

4. Can I combine locum tenens nuclear medicine work with other roles, like academics or teleradiology?

Yes. Common combinations include:

• Part-time academic appointment + locum work during academic breaks or non-clinical weeks.
• Tele-nuclear medicine reporting from home with periodic on-site locum assignments for hands-on or theranostic work.
• Permanent half-time community job + locum stints in other regions to vary practice patterns and augment income.

Be sure to review any contractual restrictions (moonlighting clauses, non-competes) in your primary job before adding locum work. Clear communication with your main employer is essential.

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Locum tenens opportunities in nuclear medicine offer a rare blend of professional autonomy, clinical variety, and financial flexibility. With thoughtful planning around training, licensure, contracts, and long-term goals, you can integrate locum work into a sustainable, rewarding career—whether as your primary practice model or a strategic supplement to a traditional role.