Unlocking Locum Tenens Opportunities in Plastic Surgery: A Complete Guide

Understanding Locum Tenens in Plastic Surgery

Locum tenens—Latin for “to hold the place”—refers to temporary physician assignments that fill gaps in coverage. For plastic surgeons, locum tenens work can offer remarkable flexibility, high earning potential, and exposure to diverse practice settings, from large academic centers to small community hospitals and private cosmetic practices.

While many residents aiming for a plastic surgery residency focus almost exclusively on the integrated plastics match and fellowship options, an increasing number are intentionally planning locum work into their early- and mid‑career strategies. Understanding this pathway early can help you design a career that balances clinical growth, geographic freedom, and financial goals.

In plastic surgery, locum tenens opportunities typically fall into three broad categories:

1. Reconstructive hospital-based roles

   • Trauma and hand call coverage
   • Burn and wound care
   • Oncologic reconstruction (breast, head and neck, sarcoma)
   • General reconstructive cases around orthopedics, general surgery, and OB/GYN

2. Mixed reconstructive and elective

   • Hospital-based practice with an affiliated cosmetic clinic
   • Post-bariatric body contouring within hospital systems
   • Academic departments needing interim attending coverage

3. Elective/cosmetic-focused assignments

   • Private aesthetic practices needing temporary coverage
   • Medspa and clinic-based procedures (injectables, minor surgeries)
   • Seasonally busy aesthetic practices (e.g., pre-summer body contouring spikes)

Understanding which clinical mix appeals to you will shape how you search for locum roles, how you negotiate contracts, and how locum work fits into your long-term plastic surgery career.

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Why Plastic Surgeons Consider Locum Tenens

Locum tenens used to be associated mostly with rural primary care or hospitalist work. Today, plastic surgeons—from fresh graduates of plastic surgery residency to seasoned attendings—are using locum opportunities strategically.

1. Flexibility and Control Over Your Schedule

As a locum tenens physician, you control:

• When you work: Pick up blocks of 1–2 weeks, a month, or multi‑month contracts.
• How often you work: Some plastic surgeons work locums full‑time; others pick up occasional assignments around a permanent job.
• Where you work: Rotate through different states or focus on a preferred region.

Example:
A newly board‑eligible plastic surgeon who just finished the integrated plastics match chooses a year of locum assignments to explore different practice environments before committing to a permanent job. They work 2–3 months each in a large academic center, a community hospital, and a private cosmetic practice to understand what feels right long term.

2. Income Optimization and Debt Management

Locum tenens work often pays a premium compared with many employed positions, particularly for high‑demand subspecialties such as:

• Hand and upper extremity
• Microsurgery
• Burn and complex wound care
• Breast reconstruction in areas with limited plastic surgery coverage

Compensation structures vary (daily rate, hourly rate, per‑case bonuses, or call stipends), but for many plastic surgeons, locum work is a powerful tool to:

• Accelerate student loan and residency debt repayment
• Build savings quickly for a future practice buy‑in or cosmetic practice start‑up
• Bridge income during transitions (e.g., between jobs, after a partner’s relocation)

3. Geographic Exploration and Lifestyle Design

If you’ve spent years focused on the integrated plastics match, you may have moved primarily for training rather than preference. Locum tenens allows you to reverse that: choose your work around your life.

Plastic surgeons commonly use travel physician jobs to:

• Test living in different cities or states before signing a long-term contract
• Combine work with personal interests (e.g., ski towns, coastal cities, or near family)
• Spend parts of the year in different climates, especially for dual‑career or remote‑work partners

Example:
A mid‑career plastic surgeon with school‑aged children arranges recurring 1‑week‑per‑month locum work in a high‑need region, flying out during school weeks and staying home for major holidays and summers. The locum income substantially supplements their local part‑time cosmetic practice and funds college savings.

4. Clinical Variety and Skills Maintenance

Locum work can broaden your surgical repertoire and keep you versatile:

• Exposure to different EMRs, OR teams, and institutional protocols
• A wider variety of cases than a narrow elective cosmetic practice might provide
• Maintenance of core reconstructive and trauma skills—even if your home practice is aesthetic‑heavy

This is particularly attractive for surgeons whose permanent jobs are extremely subspecialized or narrow, and who want to maintain a broader Board-eligible skill set.

5. Transitional and Bridge Roles

Locum tenens is especially useful during:

• Post‑residency or post‑fellowship gap years: While examining permanent opportunities
• Relocation: When a partner’s job or family needs drive a geographic move
• Burnout recovery: Taking a step back from administrative burdens while still practicing
• Practice build‑up time: Supplementing income while volume grows in a new cosmetic or private practice

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Types of Locum Tenens Assignments in Plastic Surgery

Locum tenens opportunities in plastic surgery range widely in scope, autonomy, and practice setting. Understanding these patterns will help you target assignments aligned with your goals.

1. Hospital-Based Reconstructive Coverage

Common settings:

• Regional trauma centers
• Community hospitals with orthopedic and general surgery programs
• Hospitals with breast surgery or oncology services but no permanent plastic surgeon

Typical responsibilities:

• Hand and facial trauma call
• Coverage for complex wounds and pressure sores
• Breast reconstruction, including tissue expanders and implants
• Occasional microsurgery in better-equipped centers
• Inpatient consults and emergency department coverage

Ideal for:

• Surgeons with strong reconstructive/trauma backgrounds
• Recent graduates from plastic surgery residency who want high case volume
• Surgeons maintaining broad skills while exploring practice options

Example assignment profile:

• 7–14 days per month of call coverage
• 24‑hour call with OR access for urgent cases
• Mix of inpatient consults, ED call, and scheduled follow‑ups
• Often higher daily rate when call is in-house or high volume

2. Academic or Teaching Assignments

Academic departments sometimes rely on locum tenens physicians when:

• A faculty member goes on sabbatical or family leave
• A program is between hires for a subspecialty (e.g., micro, hand)
• New services are being launched and volume is uncertain

Duties may include:

• Supervising residents and fellows in the OR and clinic
• Participation in didactics or M&M conferences
• Shared call with permanent faculty
• Limited involvement in research or QI projects

Ideal for:

• Surgeons who enjoy teaching and mentoring
• Those considering an academic career but wanting to “test drive” a department
• Graduates from an integrated plastics match who miss the academic environment but want flexibility

3. Outpatient Cosmetic and Aesthetic Locum Roles

These are less common but growing, especially as high-volume aesthetic practices look for:

• Temporary coverage during maternity leave or illness
• Surgeons to cover periods of peak seasonal demand
• Specialists in specific procedures (e.g., rhinoplasty, body contouring, blepharoplasty)

Assignments may involve:

• Clinic-based procedures (Botox, fillers, minor liposuction, scar revisions)
• OR-based aesthetic surgeries (breast augmentation, abdominoplasty)
• Pre‑ and postoperative care for the practice’s established patients

Key considerations:

• Credentialing in office‑based ORs or local surgery centers
• Alignment with the practice’s aesthetic philosophy and patient population
• Clear agreements on complications coverage and post‑op responsibilities

Ideal for:

• Surgeons transitioning into predominantly cosmetic practice
• Those who already have strong aesthetic portfolios and solid patient communication skills
• Surgeons wanting to sample different aesthetic markets before opening their own practice

4. Niche Subspecialty Assignments (Hand, Burn, Micro)

Certain subspecialties in plastic surgery are highly sought after for locum tenens roles, especially:

• Hand surgery: In regions with orthopedic programs but lacking hand-trained plastic surgeons
• Burn care: Specialized burn units needing temporary attending coverage
• Microsurgery: Larger centers that occasionally need overflow or vacation coverage

These assignments may carry:

• Higher compensation due to specialized skills
• More focused call responsibilities
• Steeper initial learning curve for local protocols and multidisciplinary teamwork

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How to Find and Evaluate Locum Tenens Roles in Plastic Surgery

The locum tenens market has grown significantly, and plastic surgeons now have multiple pathways to discover suitable travel physician jobs and short‑term assignments.

1. Working With Locum Tenens Agencies

Most plastic surgery locum roles are brokered through staffing agencies that specialize in physician coverage.

What agencies typically provide:

• Access to nationwide job listings (many not posted publicly)
• Contract negotiation support
• Assistance with credentialing and obtaining state licenses
• Travel and housing arrangements (or stipends)
• Malpractice coverage (often including tail for the assignment)

How to select an agency:

• Ask which plastic surgery residency graduates or attendings they’ve recently placed—and where
• Check whether they have dedicated surgery or surgical subspecialty recruiters
• Clarify which expenses they cover (travel, lodging, rental car, licensure fees, credentialing costs)
• Compare agency contracts regarding restrictive covenants and non‑compete clauses

2. Direct Hospital or Practice Contracts

Some larger systems and practices hire locum tenens physicians directly, without an agency middleman. This can sometimes mean:

• Higher pay (no agency cut)
• More direct communication with clinical leadership
• Flexibility in contract structure

However, you may need to:

• Arrange your own malpractice coverage
• Handle more of the travel logistics
• Manage your own negotiations without a recruiter buffer

3. Professional Networks and Word of Mouth

Plastic surgery is a relatively small specialty. Your network can be a powerful resource:

• Program directors and faculty from plastic surgery residency
• Colleagues from your integrated plastics match cohort
• Fellows and faculty from subspecialty training (hand, micro, craniofacial)
• Professional societies (ASPS, ASAPS, hand societies, etc.)

Actionable steps:

• Let trusted mentors know you’re open to locum work in certain regions.
• Attend national meetings and visit the jobs or career development booths.
• Join specialty‑specific listservs and online communities where short-term needs are shared.

4. Key Questions to Ask Before Accepting an Assignment

Use this checklist to evaluate potential locum tenens roles:

Clinical scope and expectations

• What specific procedures are expected (trauma, breast, hand, micro, cosmetic)?
• What does “call coverage” actually entail—frequency, typical volume, in-house vs from home?
• Are you expected to build clinic volume or mainly cover inpatient/ED needs?
• What support services exist (hand therapists, microsurgery team, wound care, anesthesia availability)?

Logistics and support

• How long is the assignment (and is there potential for renewal)?
• What EMR system is used?
• Will there be orientation before your first shift?
• What are OR block times and access like for locum surgeons?

Compensation and benefits

• Is pay daily, hourly, per call, or per case?
• Are there overtime rates beyond a certain number of hours?
• Who covers malpractice, and does it include tail?
• Are travel, lodging, and rental car included or stipend-based?

Professional and legal considerations

• Are there any non‑compete or non‑solicitation clauses that could limit future permanent job options?
• How are complications handled when your assignment ends but the patient still needs follow up?
• Are you eligible for hospital leadership roles if the contract extends?

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Contract, Credentialing, and Practical Considerations

Once you identify a promising locum tenens opportunity in plastic surgery, the next steps involve credentialing, licensing, and contract review.

1. Licensing and Credentialing Timeline

For travel physician jobs, especially across multiple states, plan for:

• State medical license: 1–6 months depending on the state, unless you already hold a license or can use an expedited compact.
• Hospital credentialing and privileges: 60–120 days is common.
• Insurance paneling (if relevant): Less critical for short-term assignments, but relevant for clinic-heavy roles.

Actionable advice:

• Start multi-state licensure early if you anticipate significant locum work.
• Maintain a detailed, updated CV with exact dates and no gaps.
• Keep documentation organized: training certificates, Board status, case logs, malpractice history, immunizations, and references.

2. Malpractice and Tail Coverage

Clarify malpractice details for each assignment:

• Claims‑made vs occurrence policies
• Coverage limits (per claim and aggregate)
• Whether tail coverage is included after the assignment ends
• How cross‑coverage of other surgeons’ patients is handled

For plastic surgeons—particularly those performing aesthetic or complex reconstructive procedures—ensuring robust malpractice protection is critical. Consider consulting a healthcare attorney or independent broker if you are arranging your own coverage.

3. Financial Planning as a Locum Tenens Physician

Locum work typically classifies you as an independent contractor (1099) rather than an employee (W‑2), though some direct‑hire locum roles are W‑2.

As a 1099 plastic surgeon, you are responsible for:

• Quarterly estimated taxes
• Your own retirement contributions (e.g., solo 401(k), SEP‑IRA)
• Health, disability, and life insurance coverage
• Business expenses (licensing, CME, some travel if not reimbursed)

Actionable steps:

• Work with an accountant familiar with physician 1099 income.
• Track all professional expenses meticulously.
• Consider forming an LLC or professional corporation if advantageous in your state.
• Build a 3–6 month financial cushion, as assignment gaps can occur.

4. Lifestyle and Travel Logistics

Locum tenens in plastic surgery often involves regular travel, even for regional work.

Practical tips:

• Choose consistent airline and hotel chains to maximize points and status.
• Maintain a ready‑to‑go “locum bag” (scrubs, loupes, basic reference materials, chargers).
• Understand call backup and fatigue policies before accepting high‑intensity trauma roles.
• Clarify housing quality and distance from the hospital; being 45 minutes away on home call can be unsafe and impractical.

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Integrating Locum Tenens Into a Long-Term Plastic Surgery Career

Locum work doesn’t have to be “all or nothing.” Many plastic surgeons use it strategically across different career phases.

Early Career: After Plastic Surgery Residency or Fellowship

Potential uses:

• Explore different practice types—academic, community, cosmetic.
• Build a robust case log and gain independence rapidly.
• Pay down educational debt quickly before settling into a lower‑paying academic or specialty role.

Key considerations:

• Maintain strong mentorship connections so you’re not isolated professionally.
• Be intentional about the mix of reconstructive vs cosmetic volume you’re building.
• Keep your CV cohesive; list locum assignments with clear dates and responsibilities.

Mid‑Career: Balancing Family, Burnout, and Growth

Locum tenens can help mid‑career plastic surgeons:

• Step away from demanding administrative roles without leaving medicine.
• Create more predictable blocks of time for family or personal projects.
• Transition between jobs or geographic locations more gracefully.

Example:
A plastic surgeon who has been a partner in a busy practice for 10 years sells their share, then spends 12–18 months doing locum tenens work while exploring where to settle next. They maintain income, minimize burnout, and have the time and flexibility to choose a next step deliberately.

Late Career: Transitioning Toward Retirement

For senior plastic surgeons, locum tenens offers:

• Gradual reduction in workload without abrupt retirement
• Opportunities to focus on teaching roles or lighter clinical responsibilities
• Flexibility to balance work with travel or family commitments

They may prioritize:

• Assignments with fewer overnight calls
• Clinic‑heavy or consultative roles
• Regions where they are considering eventual retirement

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Frequently Asked Questions (FAQ)

1. Can a new graduate right out of plastic surgery residency realistically start with full‑time locum tenens work?
Yes, many do. The key is to be organized about licensing and credentialing, seek assignments that match your training (e.g., robust reconstructive exposure if that’s your background), and maintain mentorship relationships. Early-career locum surgeons should pay particular attention to malpractice coverage and avoid taking on assignments that demand procedures they are not yet comfortable performing independently.

2. How does locum tenens experience look on a CV if I later apply for a permanent plastic surgery position?
If structured clearly, it can be a strength. List each locum assignment with dates, locations, and scope of practice. Highlight volume, case mix, and any leadership or teaching contributions. Program directors and hiring committees increasingly recognize that locum work can reflect adaptability, broad clinical exposure, and intentional career exploration—especially when you can articulate what you learned from those roles.

3. Are there many locum tenens opportunities focused on cosmetic surgery rather than reconstruction?
Reconstructive and hospital-based roles are more common in the locum market, but cosmetic-focused opportunities are growing, especially in busy urban and destination markets. These positions may be more selective, often requiring a strong aesthetic portfolio, references from recognized aesthetic surgeons, and excellent communication skills. Networking through aesthetic societies and conferences can be especially important for securing these assignments.

4. How do I decide if I should pursue a permanent job right after the integrated plastics match vs. starting as a locum tenens physician?
Reflect on your priorities:

• If stability, mentorship, and a clear academic or subspecialty path matter most, a permanent position may be better initially.
• If you’re uncertain about geography, practice type, or want a period of exploration and flexibility, locum tenens can be a strategic bridge.

Some surgeons blend both paths—accepting a permanent role but maintaining a small amount of locum work for additional income and variety. The best choice depends on your financial needs, risk tolerance, and long‑term career goals in plastic surgery.