Explore Locum Tenens Opportunities in Ophthalmology: A Complete Guide

Understanding Locum Tenens in Ophthalmology

Locum tenens work—temporary clinical assignments to cover staffing gaps—has become an increasingly important part of the ophthalmology landscape. For residents, fellows, and early-career ophthalmologists, it can offer an appealing mix of income, flexibility, and exploration of different practice settings. For mid‑career and senior ophthalmologists, locum work can create a bridge to retirement, supplement income, or provide variety after years in one practice.

This guide focuses specifically on locum tenens opportunities in ophthalmology: how they work, how they intersect with the ophtho match and residency training, how to evaluate offers, and how to decide whether this pathway fits into your career strategy—whether you ultimately want a stable practice or a portfolio of travel physician jobs.

We’ll cover:

• What locum tenens looks like in ophthalmology
• Pros and cons at different career stages
• Compensation, contracts, and logistics
• How to find and evaluate locum opportunities
• Practical steps to get started

Throughout, examples and checklists will help you translate concepts into concrete next steps.

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What Locum Tenens Looks Like in Ophthalmology

Locum tenens in ophthalmology spans a wide range of practice types and clinical scopes. Understanding the common patterns will help you determine where you might fit.

Common Practice Settings for Ophthalmology Locums

1. Rural or Underserved Private Practices

   • Solo or small-group ophthalmology practices that lose a partner or have seasonal volume spikes.
   • Often need coverage for:
     • Comprehensive clinic
     • Cataract surgery
     • Basic glaucoma or retina management (refer complex cases out).
   • Ideal if you are broadly trained and comfortable practicing with relative independence.

2. Hospital-Based or Academic-Affiliated Services

   • Community hospitals, VA medical centers, or university-affiliated clinics.
   • Work may include:
     • Inpatient and ER consults
     • Outpatient clinics
     • Limited OR time, depending on credentialing and local needs.
   • Academic centers may use locum physicians to cover sabbaticals, maternity leaves, or recruitment gaps.

3. Multi-Specialty or Corporate Groups

   • Large, multi-site groups where an ophthalmologist is on leave or a satellite clinic is short-staffed.
   • Often well-organized but may have higher volume and more standardized protocols.
   • Could involve:
     • High-volume cataract surgery
     • Subspecialty clinics (retina, cornea, glaucoma) if you have fellowship training.

4. Government and Military Settings

   • VA hospitals, military bases, and public hospitals.
   • Typically offer:
     • Structured schedules
     • Good support staff
     • Strong systems for credentialing and compliance.

Types of Assignments

Locum tenens ophthalmology work can vary significantly in duration and structure:

• Short-Term (1–14 days)

  • Weekend or holiday coverage
  • Cataract block coverage for a specific OR day
  • ER call coverage
  • Good for testing the waters or adding supplemental income.

• Medium-Term (2 weeks–3 months)

  • Maternity or parental leave coverage
  • Short gaps between permanent hires
  • Often include both clinic and OR.
  • This is where many ophthalmologists start serious locum work.

• Long-Term (3–12+ months)

  • Extended coverage for hard-to-recruit locations
  • Bridge positions while a practice is sold or reorganized
  • Often very well-compensated, especially in rural areas.
  • May function much like a full-time job with periodic returns home.

Clinical Scope: What You Might Actually Do

Clinical expectations vary by site and your training, but common patterns include:

• Comprehensive Ophthalmology

  • Routine exams, cataracts, glaucoma, diabetic eye disease, ER consults for red eye/trauma, minor procedures (YAG capsulotomy, laser iridotomy, intravitreal injections if comfortable).
  • This is the backbone of many locum positions.

• Subspecialty-Focused Work

  • Retina: Injections, laser, clinic evaluation, possibly OR if credentialing allows.
  • Cornea: Transplants, complex anterior segment, refractive surgery (less common for locums).
  • Glaucoma: Complex surgeries, MIGS, laser.
  • Pediatric ophthalmology & strabismus: More niche, but can be in high demand regionally.

• On-Call Responsibilities

  • ER call coverage for ocular trauma, acute angle closure, endophthalmitis, etc.
  • Must clarify:
    • Call frequency
    • Access to OR and anesthesia
    • Backup coverage for complex cases.

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Why Ophthalmologists Choose Locum Tenens: Pros and Cons

Understanding the real-world benefits and trade-offs will help you decide whether locum tenens fits your goals.

Advantages of Locum Work in Ophthalmology

1. Flexibility and Control Over Your Schedule

   • Choose when and where you work.
   • Take prolonged breaks between assignments for:
     • Research or academic projects
     • International mission trips
     • Family responsibilities
     • Personal recovery from burnout
   • You’re not locked into a single practice’s vacation policies.

2. Income Potential and Financial Strategy

   • Locum tenens ophthalmology can be highly lucrative, especially for:
     • Rural and high-need areas
     • Surgeons comfortable with high-volume cataract lists
   • Common structures:
     • Daily rate + bonus for exceeding a volume threshold
     • Hourly rate
     • Fixed stipend for call coverage
   • Can be used to:
     • Aggressively pay down student loans
     • Build a down payment for a home
     • Save capital to buy into a practice or surgery center.

3. Test-Driving Different Practice Environments

   • Exposure to:
     • Small private practice vs. large group vs. academic center
     • Different EMRs and workflows
     • Different regional patient populations
   • Helpful if you are:
     • Early in your career and unsure where you fit
     • Re-evaluating your career after dissatisfaction with a prior job.

4. Geographic Freedom and Travel Opportunities

   • Travel physician jobs in ophthalmology allow you to:
     • Spend part of the year in a different region (e.g., winters in the South, summers in the Pacific Northwest).
     • Sample life in multiple cities before committing to a permanent move.
   • Some ophthalmologists bring family or partners for longer assignments, combining work and exploration.

5. Reduced Administrative Burden

   • As a locum tenens physician, you generally:
     • Avoid partner-level practice management decisions
     • Have limited involvement with billing disputes, HR, or marketing
   • You can focus more on clinical work and less on business operations.

6. Transition Tool Between Career Stages

   • Post-fellowship: A buffer to explore locations while searching for a permanent job.
   • Mid-career: A reset after burnout or a failed partnership.
   • Pre-retirement: Gradual ramp-down of hours while maintaining skills and income.

Potential Downsides and Challenges

1. Lack of Long-Term Continuity

   • You may not see patients you operate on for long-term follow-up.
   • Harder to build deep doctor–patient relationships.
   • Some ophthalmologists miss the continuity of watching patients over years.

2. Variable Practice Environments

   • EMR systems may be clunky or unfamiliar.
   • Staff support (technicians, scribes, OR teams) may vary widely.
   • Intake and flow processes may be inefficient, especially if a site is understaffed.

3. Professional Isolation

   • You might:
     • Be the only ophthalmologist on-site
     • Have limited peer interaction for complex case discussions.
   • Mitigation strategies:
     • Maintain strong connections with prior mentors and residency colleagues
     • Join professional societies and online case-discussion forums.

4. Complex Logistics

   • Credentialing, licensure in multiple states, travel, housing, and insurance all require planning.
   • If you use agencies, they help—but you still need to oversee details.

5. Uncertainty and Income Variability

   • Periods between assignments may be unpaid if you choose not to work.
   • Cancellation risk:
     • Contracts may allow facilities to cancel if they fill a permanent role.
     • Clear cancellation clauses and guaranteed minimums are essential.

6. Impact on Long-Term Career Narrative

   • For those fresh from the ophtho match, spending years in locums without a clear narrative can raise questions in future job interviews.
   • Important to frame locum work as:
     • A deliberate choice (e.g., to explore practice types, support family needs, advance skill set)
     • Not merely a default option because other paths were unavailable.

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When Locum Tenens Makes the Most Sense in an Ophthalmology Career

Locum tenens can be valuable at various stages; how you use it should align with your broader objectives.

During Residency and Ophthalmology Residency Application Phases

While you cannot work as an attending physician during ophthalmology residency, you can begin strategic preparation even during medical school or preliminary year:

• Research Early Interests

  • Learn about locum tenens through:
    • Senior residents who have graduated
    • Alumni network
    • Faculty who have done locum work between roles.
  • This context can shape how you think about future practice models, even as you focus primarily on a strong ophtho match outcome.

• Develop Marketable Skills

  • During ophthalmology residency:
    • Seek broad exposure to comprehensive ophthalmology.
    • Build surgical volume (especially cataracts) and procedural confidence.
    • Gain experience with common lasers and intravitreal injections.
  • Locum sites often prefer ophthalmologists who can handle a full range of bread‑and‑butter cases independently.

Early Career (0–5 Years Post-Training)

This is a prime window for locum tenens for several reasons:

1. Exploration Phase

   • Not sure whether you want academic, private, or hybrid practice?
   • Locum work lets you:
     • Test practice cultures
     • Experience real-world workflow outside the residency/academic bubble.

2. Negotiation Leverage

   • Exposure to multiple systems and compensation models makes you:
     • A more informed negotiator for your eventual permanent contract.
   • You can realistically compare:
     • RVU rates
     • Surgical block time
     • Support staff ratios.

3. Financial Acceleration

   • Many early-career ophthalmologists:
     • Mix a part-time permanent role with intermittent locum assignments.
     • Use extra locum income specifically to pay down high-interest loans quickly.

Mid-Career (5–20+ Years)

For established ophthalmologists, locum tenens can:

• Provide a reset after:
  • Practice buyout
  • Academic restructuring
  • Burnout in a high-volume job.
• Allow for family flexibility:
  • Spouses’ career moves
  • Children’s schooling or special needs.
• Serve as a bridge:
  • While pursuing an MBA or nonclinical roles.
  • While relocating to a new state and waiting for permanent job opportunities.

Late Career and Pre-Retirement

Locum work can be a flexible glide path to retirement:

• Gradually reduce OR days while maintaining limited clinic.
• Work a few weeks or months per year in known, comfortable sites.
• Provide ongoing mentorship:
  • Locum physicians in academic sites can help train residents and fellows, sharing decades of surgical experience.

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Finding, Evaluating, and Negotiating Ophthalmology Locum Tenens Assignments

To make locum life sustainable and rewarding, you need a deliberate strategy for finding and vetting opportunities.

Pathways to Locum Tenens Assignments

1. Locum Tenens Agencies

   • Most common route for ophthalmology:
     • Agencies maintain relationships with practices, hospitals, and groups.
     • They negotiate basic contract terms, arrange travel, and assist with credentialing.
   • Look for agencies with a track record in ophthalmology (not just general surgery or internal medicine).

2. Direct Contracts with Practices

   • Some private groups prefer to contract with locum physicians directly:
     • Eliminates agency fees
     • May lead to better compensation but more administrative responsibility for you.
   • Often found via:
     • Word of mouth
     • Professional society listservs (AAO, subspecialty societies)
     • Regional networking.

3. Hospital or System HR Departments

   • Large health systems may:
     • Maintain their own pool of locum or per diem ophthalmologists.
   • Offers:
     • More standard HR practices
     • Access to system resources and benefits (sometimes health insurance for longer stints).

4. Networking and Alumni Connections

   • Former co-residents, attendings, and fellows often know:
     • Practices in need of temporary coverage.
   • Joining:
     • State ophthalmology societies
     • AAO and subspecialty societies
   • Can increase your exposure to opportunities.

Key Questions to Ask Before Accepting an Assignment

Use these categories as a structured checklist:

1. Clinical Scope & Volume

   • What is the expected patient volume per clinic day?
   • How many OR days per week? Typical number of cases per day?
   • What procedures are expected (e.g., cataract, YAG, SLT, injections, complex glaucoma, retina)?
   • Are there procedures you are not comfortable doing that they expect?

2. Support Staff & Infrastructure

   • How many technicians per physician?
   • Is there access to scribes?
   • What equipment is available? (OCT, visual fields, topography, biometry, fluorescein angiography, lasers)
   • Which EMR is used? Is there training time?

3. Call Responsibilities

   • How often are you on call?
   • Is call in-house or home?
   • What is the typical call volume?
   • Is there backup from another ophthalmologist for complex cases?

4. Credentialing & Licensure

   • Which state license is required? Will they support additional licenses?
   • How long does credentialing typically take at this facility?
   • Who handles malpractice coverage and tail insurance?

5. Compensation and Contract Terms

   • Daily rate, hourly rate, or per-case structure?
   • Overtime or extra call compensation?
   • Minimum number of guaranteed days per month?
   • Cancellation policies—for both parties.
   • Are travel, housing, and a rental car included? Any per diem?

6. Practice Culture and Expectations

   • Is this coverage for:
     • A vacancy due to leaves?
     • A challenge with recruitment?
     • A high-growth phase?
   • How do they measure success of a locum assignment?
   • Are they hoping to recruit you permanently (locum-to-perm)?

Negotiating Effectively as a Locum Tenens Physician

1. Know Your Market Value

   • Compare offers from:
     • Multiple agencies
     • Different regions (urban vs rural).
   • Recognize subspecialty premiums:
     • Retina and complex anterior segment often command higher rates.

2. Clarify Compensation Structure Up Front

   • Negotiate:
     • Higher base daily rate if volume expectations are high.
     • Clear thresholds for productivity bonuses.
   • Ensure:
     • Call coverage is explicitly compensated if it adds meaningful burden.

3. Protect Yourself Contractually

   • Seek:
     • “Guaranteed minimum” days once travel is booked.
     • Reasonable cancellation notice and partial compensation if canceled late.
   • Confirm:
     • Malpractice coverage type (claims-made vs occurrence)
     • Who pays for tail coverage when needed.

4. Non-Compete and Future Employment Clauses

   • Some contracts restrict:
     • Your ability to work permanently at the site.
   • If a location seems promising as a future home, negotiate:
     • Either no non-compete
     • Or a clear, reasonable pathway to transition to a permanent role.

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Practical Steps to Get Started in Ophthalmology Locum Tenens

If you are seriously considering locum work, here’s a stepwise approach to launch efficiently.

Step 1: Clarify Your Goals and Limits

Write down:

• Why you want to pursue locum work—financial, lifestyle, exploration, or transition.
• Acceptable ranges for:
  • Minimum daily rate or compensation benchmark.
  • Minimum and maximum duration of assignments.
  • Regions you are open to (and regions that are off-limits).
  • Types of cases and surgeries you are comfortable managing solo.

Step 2: Prepare a Locum-Friendly CV and Portfolio

Your application materials should highlight:

• Training and Credentials

  • Ophthalmology residency and any fellowship (program, dates).
  • Board certification or board eligibility.
  • State licenses (active and pending).

• Clinical and Surgical Skills

  • Approximate cataract case numbers and comfort with complex cases.
  • Familiarity with lasers and common procedures.
  • EMR systems you’ve used (Epic, NextGen, eClinicalWorks, etc.).

• Professional References

  • At least 2–3 ophthalmologists who have supervised or worked closely with you.
  • Ideally including:
    • Residency or fellowship program director
    • Section chief
    • Senior colleague from a prior job.

Step 3: Align with 1–3 Reputable Agencies (or Direct Opportunities)

• Start with a small number of agencies specialized in physician locums.
• Ask recruiters:
  • How many ophthalmology placements they do per year.
  • Typical locations and practice setups.
  • Average compensation ranges for your subspecialty and experience.

Step 4: Plan Licensure and Credentialing Strategically

• If you enjoy travel physician jobs:
  • Consider states with:
    • High demand for ophthalmology
    • Relatively efficient licensure processes.
  • Explore the Interstate Medical Licensure Compact if applicable.
• Keep:
  • Licenses current
  • Required CME up to date
  • Background checks and immunization records organized for rapid credentialing.

Step 5: Prepare Logistically for Travel

• Develop a personal travel checklist:
  • Licenses and hospital ID cards
  • Copies of contracts and schedules
  • Scrubs (if not provided), professional clothing, clinic tools (e.g., indirects if you prefer your own)
• Decide:
  • Whether you’ll maintain a permanent home base and fly out for assignments
  • Or adopt a more nomadic lifestyle for a period.

Step 6: Reflect and Iterate After Each Assignment

After each locum job, ask yourself:

• What about this setting worked well for me?
• What didn’t work—and can it be avoided or mitigated in future assignments?
• Did I feel fairly compensated given the workload and call?
• Would I return to this site, or even consider a permanent role here?

Use this feedback to refine your filters for the next set of assignments.

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Frequently Asked Questions (FAQ)

1. Can new ophthalmology residency graduates go straight into locum tenens work?

Yes, many comprehensive ophthalmologists start locum tenens soon after graduation, especially if they’ve developed solid surgical skills in residency. For new graduates, locum work can be a useful bridge while exploring long-term options. However:

• Be honest about your comfort level with independent surgery and complex cases.
• Initially prioritize:
  • Sites with good backup
  • Settings where you’re not the only ophthalmologist in the region.

Consider how locum work fits into the career narrative you’ll later present to permanent employers.

2. How does locum tenens experience affect future job prospects?

Locum experience can be an asset if you:

• Present it as a deliberate choice:
  • To explore different systems and refine your preferences.
• Highlight:
  • Versatility with EMRs and practice models.
  • Consistently strong clinical and surgical performance across diverse sites.
• Avoid:
  • Extremely short, repetitive stints that might suggest difficulty maintaining positions.

Many permanent employers appreciate candidates who have seen multiple systems and still choose their practice intentionally.

3. Do locum tenens ophthalmologists typically receive benefits (health insurance, retirement)?

In classic locum tenens models, you are usually a 1099 independent contractor:

• You’re responsible for:
  • Health insurance
  • Retirement savings
  • Disability insurance
• Some longer-term hospital-employed locum roles may offer:
  • Limited benefits or access to group plans.

Many locum ophthalmologists work with financial advisors or CPAs to structure:

• Solo 401(k) or SEP-IRA accounts
• Health insurance through ACA marketplaces, spouse’s plan, or professional groups.

4. Is locum tenens feasible for ophthalmologists with families?

Yes, but it requires thoughtful planning:

• Shorter, regional assignments allow you to:
  • Drive home on weekends
  • Maintain more consistent presence with family.
• Some physicians:
  • Bring spouses or children for longer assignments during school breaks or summers.
• Important considerations:
  • School calendars, partner’s career, and family support networks.
  • Setting clear expectations with agencies and sites about your maximum time away.

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Locum tenens opportunities in ophthalmology can be a powerful tool—whether you use them to test drive practice environments after the ophtho match, supplement a permanent job, or structure an entire career around flexible travel physician jobs. With careful planning, strong clinical skills, and thoughtful negotiation, locum work can offer both professional satisfaction and a high-quality lifestyle tailored to your priorities.