Unlocking Locum Tenens Opportunities in Psychiatry: A Complete Guide

Locum tenens work has become an increasingly important part of modern psychiatric practice. Whether you are a resident about to graduate, an early‑career psychiatrist exploring flexibility, or a mid‑career clinician considering a change, understanding locum tenens opportunities in psychiatry can dramatically expand your career options.

Psychiatry is one of the most in‑demand specialties for locum coverage. High rates of burnout, persistent workforce shortages, expanding mental health needs, and telepsychiatry growth have created a robust market for flexible, well‑compensated positions across the country.

This guide will walk you through how locum tenens fits into a psychiatry career, how it interacts with the psych match and residency training, and how to evaluate, negotiate, and thrive in these roles—whether you want occasional extra shifts or a full‑time travel physician lifestyle.

---

Understanding Locum Tenens in Psychiatry

What is locum tenens?

“Locum tenens” is Latin for “to hold the place.” In medicine, a locum tenens physician is a temporary provider who fills gaps in coverage. In psychiatry, these roles typically involve:

• Covering for psychiatrists on leave (maternity, FMLA, sabbatical, illness)
• Filling vacancies while institutions recruit permanent staff
• Providing supplemental coverage during surges in demand
• Supporting hard‑to‑staff locations (rural, correctional, inpatient units)

Locum work can range from:

• Per diem (single days or weekends)
• Short‑term contracts (1–3 months)
• Medium‑term contracts (3–6 months)
• Long‑term assignments (6–12+ months, often renewable)

These assignments can be on‑site or remote, especially with the growth of telepsychiatry.

Why psychiatry is ideal for locum work

Psychiatry is especially well‑suited to locum tenens for several reasons:

1. High national demand
   There is a chronic shortage of psychiatrists, especially in:

   • Rural communities
   • Community mental health centers
   • Correctional systems
   • Child & adolescent services

2. Shift‑friendly structures
   Many psychiatric services are organized around:

   • Inpatient units with defined shifts or weeks on/off
   • Consultation‑liaison services with predictable schedules
   • Emergency psychiatry with shift‑based work
   • Outpatient clinics that can be covered by specific clinic days

3. Telepsychiatry compatibility
   Psychiatry lends itself well to virtual care. This has expanded:

   • Fully remote locum tenens positions
   • Hybrid roles (some in‑person, some virtual)
   • Multi‑state coverage with the right licensure

4. Lifestyle alignment
   Many psychiatrists value:

   • Control over schedule
   • Protected time for psychotherapy, teaching, or research
   • Work that can be flexibly increased or decreased
     Locum tenens opportunities can support all of these goals.

---

When to Consider Locum Tenens in Your Psychiatry Career

During and immediately after residency

While you generally cannot work independently as a locum tenens physician until you are board‑eligible or board‑certified, locum tenens fits naturally into the late‑residency and early post‑residency period.

For senior residents (PGY‑3/4):

• You cannot bill independently as an attending, but you can:

  • Learn how locum contracts work
  • Network with locum tenens agencies
  • Attend career fairs and virtual info sessions
  • Talk to faculty who do locum work on the side
  • Identify states where you may want licensure to enable future locum jobs

• You can sometimes:

  • Do moonlighting shifts internally (under supervision)
  • Use these experiences to prepare for eventual locum work

Immediately post‑residency (BE/BC period):

Many recent graduates from psychiatry residency consider:

• Taking a year or two of full‑time locum work before committing to a permanent position
• Using locums to:
  • Pay down student loans quickly
  • Test different practice settings (VA, community, academic, private hospitals)
  • Explore different regions of the country
  • Maintain flexibility while a partner completes training or a psych match in another specialty

Case example:
A PGY‑4 psychiatry resident, about to graduate and board‑eligible, is unsure whether to pursue academic consultation‑liaison psychiatry or community inpatient work. They accept a series of three‑month locum tenens assignments—one at a VA hospital, one in a rural community hospital, and one in a large academic center. Within a year, they have:

• Clarified their preferred setting
• Built a financial cushion
• Strengthened their CV with diverse experiences

Mid‑career and late‑career transitions

Locum tenens can also be a strategic choice later in your psychiatry career:

• Mid‑career psychiatrists may use locum work to:

  • Transition out of a burned‑out full‑time role
  • Bridge between positions (e.g., leaving a private group while searching nationally)
  • Relocate gradually with repeated assignments in a new region
  • Increase income temporarily to reach financial goals

• Late‑career psychiatrists might:

  • Scale down gradually by taking intermittent locum assignments
  • Focus on telepsychiatry locum roles rather than on‑site inpatient work
  • Maintain clinical engagement after “retirement” from a full‑time job

---

Types of Psychiatry Locum Tenens Assignments

Locum tenens opportunities in psychiatry are diverse. Understanding the major practice types helps you target roles that match your strengths and interests.

1. Inpatient psychiatry

Settings:

• General adult inpatient units
• Geriatric psychiatry units
• Adolescent or child inpatient units
• State hospitals or long‑term facilities

Typical duties:

• Admission evaluations
• Daily rounding, medication management, documentation
• Coordination with social work, nursing, and therapy teams
• Participation in treatment team meetings and discharge planning

Why psychiatrists choose it:

• Intense clinical exposure
• Clear, structured schedules (e.g., 7 on / 7 off)
• High demand, often with premium compensation
• Opportunities in both urban and rural areas

Considerations:

• Acuity and complexity can be high
• Documentation and safety demands are significant
• Need to clarify expectations around call, seclusion/restraint policies, and interdisciplinary support

2. Outpatient psychiatry

Settings:

• Community mental health centers
• Hospital‑affiliated clinics
• Private practice coverage
• VA outpatient clinics

Duties:

• Diagnostic assessments
• Longitudinal medication management
• Occasional psychotherapy or supportive therapy
• Coordination with therapists and primary care providers

Why it appeals:

• More predictable daytime hours
• Opportunity to build ongoing therapeutic relationships (when contracts are longer)
• Often compatible with telepsychiatry

Considerations:

• Panel inheritance: you may inherit complex, under‑treated caseloads
• Need to understand productivity metrics (RVUs, visit counts)
• Clarify expectations for therapy vs med management

3. Consultation‑Liaison (C‑L) psychiatry

Settings:

• General hospitals
• Academic medical centers
• Oncology, transplant, or specialty medical units

Duties:

• Psychiatric evaluation of medically ill or surgical patients
• Capacity assessments, suicide risk evaluations
• Delirium management and behavioral disturbance management
• Collaboration with multiple medical and surgical teams

Benefits:

• High intellectual variety
• Close collaboration with other specialties
• Strong fit for psychiatrists with internal‑medicine interest

Considerations:

• Pace can be variable and unpredictable
• Clarify expectations about weekend coverage and call

4. Emergency psychiatry

Settings:

• Psychiatric emergency services (PES)
• General EDs with psychiatric consult coverage
• Crisis stabilization units

Duties:

• Rapid triage and risk assessment
• Disposition decisions (admit, discharge, partial, crisis beds)
• Management of acute agitation, psychosis, and intoxication

Pros:

• Shift‑based structure—an excellent fit for locum work
• Clear separation between work and off‑time
• Often strong compensation due to intensity and need

Cons:

• High acuity and stress
• Need carefully defined security and staffing support

5. Correctional psychiatry

Settings:

• Jails and prisons
• Forensic hospitals
• Court‑related forensic units

Duties:

• Psychiatric evaluations and follow‑up for incarcerated individuals
• Risk assessment and management
• Collaboration with security teams and legal entities

Benefits:

• Steady demand and often lucrative contracts
• Unique clinical population and forensic experience
• Structured environments

Considerations:

• Security protocols and ethical complexities
• Need to understand boundaries of confidentiality and legal issues

6. Telepsychiatry locum opportunities

Many locum tenens physician roles in psychiatry are now fully or partially remote:

Settings:

• Nationwide telehealth companies
• Hospital systems branching into virtual care
• Community clinics using remote coverage

Pros:

• No geographic relocation required
• Flexible scheduling (evening/weekend options)
• Work from home with minimal commute or overhead

Cons:

• Need robust technology and private workspace
• Multi‑state licensing challenges
• Variable integration with on‑site care teams

---

How Locum Tenens Fits With the Psych Match and Career Planning

Thinking ahead during residency

Even before you complete the psych match and start residency, you can think strategically about how your training will prepare you for later locum work.

When ranking psychiatry residency programs, consider:

• Breadth of exposure: Programs with strong inpatient, outpatient, emergency, C‑L, and geriatric experiences prepare you to accept a wider range of locum assignments.
• Moonlighting culture: Programs that allow PGY‑3/4 moonlighting (within duty hour rules) help you build independent practice confidence.
• Mentor access: Ask during interviews if there are faculty who engage in locum or travel physician jobs; they can share real‑world advice later.

Building a locum‑friendly skill set

During residency, deliberately build competencies that will make you attractive as a locum tenens psychiatrist:

• Comfort managing acute agitation, suicidality, and psychosis
• Efficient yet thorough documentation
• Familiarity with common EMRs (Epic, Cerner, etc.)
• Exposure to different patient populations (SUD, geriatrics, child/adolescent)
• Ability to quickly integrate into new teams and systems

Transitioning from training to locum work

Steps to take in your PGY‑4 year as you near graduation:

1. Clarify your goals

   • Is locum work a temporary bridge, a side gig, or a long‑term career structure?
   • How much travel are you willing to do?
   • Are you interested in telepsychiatry or strictly on‑site roles?

2. Get licensed strategically

   • Maintain your primary state license.
   • Consider adding one or two high‑demand states that frequently advertise psychiatry residency graduates and locum needs (e.g., states with major rural shortages).
   • If eligible, explore interstate compacts or expedited licensure options.

3. Start conversations with agencies

   • Reach out to reputable locum tenens agencies 3–6 months before graduation.
   • Ask about:
     • Typical compensation ranges for your desired settings
     • Common contract lengths
     • Volume of psychiatry jobs in your preferred regions

---

Practical Steps to Finding and Evaluating Psychiatry Locum Jobs

Step 1: Choose how you will search

You can identify locum tenens opportunities in psychiatry through:

• Locum staffing agencies (most common route)
• Direct hospital or system outreach (sometimes bypassing agencies)
• Professional networks (colleagues, mentors, listservs)
• Job boards featuring travel physician jobs and locum postings

Agency vs. direct contracting:

• Agencies

  • Pros: Handle credentialing, travel logistics, malpractice, negotiations
  • Cons: They take a cut of the bill rate, may push certain assignments

• Direct contracting

  • Pros: Potentially higher pay, more direct relationship with site
  • Cons: You handle more admin, must ensure malpractice coverage, and negotiate your own terms

Many psychiatrists use a hybrid strategy: sign up with 2–3 agencies while remaining open to direct opportunities through networking.

Step 2: Clarify compensation and benefits

Key elements to review:

• Hourly or daily rate

  • Ask specifically about:
    • On‑site hours vs. call coverage
    • In‑person vs. telepsychiatry rates
  • Compare to regional market norms (ask multiple agencies for benchmarks).

• Travel and housing

  • Flights or mileage reimbursement
  • Rental car vs. local transportation support
  • Hotel vs. apartment housing (and who arranges it)

• Malpractice coverage

  • Confirm:
    • Claims‑made vs. occurrence policy
    • Tail coverage responsibility
    • Coverage limits and whether they meet hospital requirements

• Licensing and credentialing support

  • Some agencies will pay for new licenses in high‑demand states.
  • Ask about coverage for DEA fees, data bank checks, and other credentialing costs.

Step 3: Understand the clinical environment

Before committing to a locum position, ask detailed questions:

• What is the typical patient volume per day?
• What is the case mix (e.g., SMI, SUD, child/adolescent, geriatrics)?
• What support staff are available (NPs/PAs, therapists, social workers)?
• What is the call schedule and how is it compensated?
• Which EMR is used and is training provided?
• How are safety and security managed (especially for ED, inpatient, or correctional work)?

Request a brief phone or video conversation with:

• The medical director or chief psychiatrist
• A current or recent locum in that setting, if possible

Step 4: Review and negotiate the contract

Key clauses to examine or negotiate:

• Duration and termination

  • Start and end dates
  • Conditions for early termination by either party
  • Notice periods required

• Schedule structure

  • Exact days and hours
  • Call responsibilities and compensation
  • Expectations for overtime or extra coverage

• Non‑compete and conversion clauses

  • Are you prohibited from working directly for the facility afterward?
  • What are the terms if you decide to become permanent staff there?

• Documentation and productivity

  • RVU expectations or visit quotas, if any
  • Requirements for notes and turnaround times
  • Expectations regarding psychotherapy vs brief med visits

If you are uncertain, consider having a healthcare attorney review your first few locum contracts—especially if you are negotiating directly without an agency.

---

Pros and Cons of Locum Tenens in Psychiatry

Advantages for psychiatrists

1. Enhanced income potential

   • Locum rates in psychiatry are often higher than salaried positions, especially in understaffed regions.
   • You can stack assignments or take additional shifts if desired.

2. Flexibility and autonomy

   • You decide when and where to work.
   • You can build work around life milestones, family needs, or academic commitments.

3. Geographic exploration

   • Experience different states, practice environments, and patient populations.
   • Try out new regions before committing to a permanent move.

4. Skill diversification

   • Exposure to varied systems (VA, academic, community, private) and roles (inpatient, C‑L, ED, telepsych).
   • Builds resilience and adaptability—skills valuable in any future permanent role.

5. Reduced administrative burden

   • Less long‑term committee work or system politics.
   • No long‑term panel management or practice ownership headaches.

Potential drawbacks and how to mitigate them

1. Income variability

   • Assignments may gap or cancel unexpectedly.
   • Mitigation:
     • Maintain an emergency fund (3–6 months’ expenses).
     • Work with multiple agencies to diversify opportunities.

2. Lack of continuity

   • Brief relationships with patients and teams.
   • Mitigation:
     • Seek longer contracts (3–6+ months) if continuity is important.
     • Choose outpatient roles with renewable terms.

3. Benefits and retirement

   • As a 1099 contractor, you manage your own:
     • Health insurance
     • Retirement savings (SEP IRA, solo 401(k), etc.)
   • Mitigation:
     • Work with a financial planner familiar with locum tenens physicians.

4. Frequent onboarding

   • Repeated credentialing, orientations, and learning new EMRs.
   • Mitigation:
     • Keep organized digital copies of all credentials and documents.
     • Build templates and strategies for rapid adaptation to new systems.

5. Professional isolation

   • Harder to build long‑term collegial ties.
   • Mitigation:
     • Join professional societies (APA, local chapters).
     • Maintain peer supervision or consultation groups remotely.

---

Making Locum Tenens a Sustainable Part of a Psychiatry Career

Blending locum and permanent roles

You don’t have to choose between a purely permanent job and a purely locum career. Many psychiatrists use a hybrid model, such as:

• A 0.6–0.8 FTE salaried position plus 1–2 locum weekends per month
• A part‑time outpatient practice plus periodic inpatient travel physician jobs
• Telepsychiatry locums in evenings supplementing a day job in academia

This hybrid approach can:

• Increase income
• Offer variety
• Reduce burnout by changing clinical contexts regularly

Managing your professional brand

As you accumulate locum experiences:

• Keep an updated CV that clearly lists:
  • Each assignment’s setting, duration, and main responsibilities
  • Any leadership or teaching contributions
• Request letters of reference or brief testimonials from:
  • Site medical directors
  • Supervising psychiatrists

This record will be valuable if you later apply for permanent psychiatry positions, fellowships, or leadership roles.

Prioritizing wellness and boundaries

Locum work can be exhilarating but also exhausting if boundaries are not kept clear:

• Set maximum hours per week and stick to them.
• Avoid serial 7-on/7-off contracts with no downtime for months on end.
• Use breaks between assignments intentionally for rest, family, or professional development.
• If doing telepsychiatry from home, create clear spatial and temporal boundaries between work and personal life.

---

Frequently Asked Questions (FAQ)

1. Can a new graduate from psychiatry residency work as a locum tenens physician immediately?
Yes—once you are board‑eligible (typically after completing an ACGME‑accredited psychiatry residency) and have at least one active state license, you can work locum tenens. Many facilities are comfortable with recent graduates, especially if your training aligns with their clinical needs. Some highly specialized roles may prefer board‑certified psychiatrists or require specific subspecialty experience.

---

2. How does locum tenens work affect future job prospects or fellowship applications?
Locum tenens experience is generally viewed positively if:

• Your assignments are clinically substantive
• You maintain good references
• You can articulate what you learned from each setting

For fellowship directors and future employers, locum work can signal adaptability, initiative, and broad clinical exposure. Be prepared to explain any long gaps between assignments and emphasize consistent engagement in psychiatry.

---

3. Are there locum tenens opportunities for subspecialty psychiatrists (e.g., child & adolescent, C‑L, addiction)?
Yes. High‑need areas such as:

• Child & adolescent psychiatry
• Geriatric psychiatry
• Addiction psychiatry
• Forensic psychiatry
• Consultation‑liaison psychiatry

often have dedicated locum postings. Your subspecialty training can command higher rates and more targeted roles. However, some small hospitals may expect flexibility (e.g., a C&A psychiatrist also seeing adult patients); clarify expectations before signing.

---

4. Is it realistic to do only telepsychiatry locum work?
Increasingly, yes. Many organizations now recruit psychiatrists for fully remote locum roles providing:

• Outpatient medication management
• Collaborative care consultations
• Follow‑up for community clinics or integrated behavioral health programs

You will need:

• Reliable high‑speed internet and a private workspace
• Appropriate state licensure for all states where your patients reside
• Comfort with video‑based clinical assessment

Telepsychiatry locums can be an excellent choice for psychiatrists seeking geographic stability while still enjoying the flexibility and earning potential of locum tenens work.

---

Locum tenens opportunities in psychiatry offer a powerful combination of flexibility, financial upside, and professional growth. Whether you are emerging from the psych match, building a career after residency, or restructuring your work in mid‑ or late‑career, thoughtfully chosen locum roles can help you design a psychiatry practice that truly fits your values, interests, and life outside of medicine.