Unlocking Locum Tenens Opportunities in Vascular Surgery: A Guide

Understanding Locum Tenens in Vascular Surgery

Locum tenens work—temporary physician coverage—has become an increasingly important part of modern healthcare staffing. For vascular surgeons, it can be a powerful way to build experience, maintain skills, explore different practice models, or bridge gaps between training and a permanent role.

In vascular surgery, locum tenens opportunities commonly arise when:

• A practice loses a partner or has unexpected turnover
• A surgeon takes parental leave, medical leave, or a sabbatical
• A hospital is expanding its vascular service line
• A facility is in a recruitment transition and needs short-term coverage
• Rural or underserved centers have chronic difficulty recruiting vascular specialists

Because vascular surgery is high-acuity and procedure-heavy, hospitals cannot afford gaps in coverage. This creates strong demand for locum tenens vascular surgeons across academic centers, community hospitals, and hybrid models.

If you’re coming out of an integrated vascular program or a traditional general surgery–then–vascular fellowship pathway, locum work can be a valuable option—either as a full-time career or as a short-term strategy while you finalize your long-term plans.

How Locum Tenens Contracts Typically Work

Most locum tenens physician arrangements in vascular surgery involve:

• An agency or direct contract

  • Many hospitals partner with locum tenens agencies that handle recruitment, credentialing, and logistics.
  • Some large health systems may contract with you directly, especially if you’ve worked with them before.

• Defined assignment length

  • Short stints: 1–2 weeks to cover a vacation or CME
  • Medium-term: 1–3 months for a recruitment gap
  • Longer-term: 6–12 months for new program development or extended leaves

• Scope of practice clarified upfront

  • Types of open and endovascular cases you’ll be expected to handle
  • Call responsibilities and backup support
  • ICU and step-down coverage expectations
  • Level of trauma and emergency vascular call (e.g., ruptured AAAs, acute limb ischemia, trauma-related vascular injuries)

For vascular surgeons specifically, your comfort level with complex endovascular techniques (e.g., EVAR/TEVAR, advanced peripheral interventions) and open operations (e.g., aortic reconstructions, complex bypasses) will heavily influence where you’re placed and how you negotiate your contract.

---

Why Vascular Surgeons Choose Locum Tenens Work

Locum tenens can offer meaningful professional and personal benefits, whether you’ve just finished a vascular surgery residency or you’re a mid-career attending seeking change.

1. Flexibility and Control Over Your Schedule

Vascular call is demanding, and burnout is a real risk. Locum work allows you to:

• Choose when you work and build in protected time off
• Adapt your schedule around family needs, research projects, or travel
• Take breaks between assignments instead of being locked into a continuous call schedule

Example:
A new graduate from an integrated vascular program might schedule three 2‑week assignments separated by 1–2 weeks off, evaluating different practice types while studying for boards and relocating their family.

2. Financial Advantages

Well-structured locum tenens roles can be financially competitive, especially in high-need markets:

• Higher hourly/daily rates than many employed positions on a per-shift basis
• Potential for overtime or call stipends
• Coverage for housing, travel, and malpractice (including tail, depending on contract)
• Ability to stack assignments during high-demand periods (e.g., winter surge, holiday seasons)

Keep in mind that as an independent contractor (common in locum arrangements), you’ll be responsible for:

• Your own taxes (estimated quarterly payments)
• Retirement planning (e.g., solo 401(k), SEP IRA)
• Health insurance (unless covered via spouse or a separate plan)

Strategic use of a tax professional or financial planner familiar with travel physician jobs and locum structures is highly advisable.

3. Exploring Different Practice Environments

Locum tenens work is one of the fastest ways to learn what you want—and don’t want—in your eventual permanent role:

• Academic vs community vascular programs
• High-volume tertiary centers vs regional referral hubs
• Environments with robust endovascular suites vs those more reliant on open surgery
• Places with mature multidisciplinary teams vs early-stage vascular programs

Example:
You spend 3 months at a large academic center where you do complex aortic and mesenteric work, followed by 2 months at a community hospital focused on peripheral arterial disease and dialysis access. The contrast can clarify your ideal mix of case complexity, teaching opportunities, and lifestyle.

4. Bridge Between Training and a Permanent Job

New graduates from a vascular surgery residency or fellowship commonly use locum tenens to:

• Buy time to assess multiple offers
• Relocate slowly (e.g., spouse’s job constraints, school timing for children)
• Keep operative skills sharp if permanent positions are limited in a desired geographic area
• Build a track record of independent practice before committing to a long-term contract

Hospitals are often willing to consider converting a locum tenens role into a permanent position if the fit is right. Locum work can essentially serve as a “long interview” for both parties.

---

Types of Locum Tenens Opportunities in Vascular Surgery

Not all locum tenens assignments are the same. Understanding the major patterns can help you target roles that match your skill set and goals.

1. Pure Vascular Surgery Coverage

In mature centers with robust vascular teams, you may serve strictly as:

• OR and endovascular suite coverage
• Inpatient vascular consults and rounding
• Vascular call (including emergencies and limb salvage)
• Limited or no general surgery responsibilities

These assignments are attractive if you want to maintain a high level of subspecialty focus and avoid general surgery call. They’re more common in:

• Academic medical centers
• Regional tertiary referral centers
• Large integrated vascular programs

2. Vascular + General Surgery Hybrid Roles

In smaller hospitals, particularly rural or semi-rural areas, you may be recruited to:

• Provide vascular surgery coverage (e.g., carotids, AV access, basic peripheral work)
• Take general surgery call (appendectomies, cholecystectomies, basic laparotomy)
• Support trauma call (depending on designation of the trauma center)

These “hybrid” locum assignments can be very high-need and financially attractive, but they require:

• Maintenance of broad general surgery competencies
• Comfort with a wider call scope and possibly less subspecialty back-up
• Clear contract negotiation about which vascular operations are realistically supported by the facility

3. Program-Building or Service Line Expansion

Some locum tenens roles are specifically designed to:

• Launch or expand a new vascular surgery service line
• Help a hospital transition from sending out cases to keeping vascular in-house
• Mentor and train local general surgeons or interventionalists in collaborative care pathways

These assignments may be longer (6–12 months) and involve:

• Developing protocols for limb salvage, DVT/PE pathways, and carotid disease
• Working with cardiology, interventional radiology, and nephrology teams
• Advising on capital investments (e.g., hybrid OR, endovascular inventory)

For surgeons interested in leadership or future medical directorship roles, these locum positions offer experience in program development and systems design.

4. Urban vs Rural Locum Assignments

Urban / large-system assignments typically feature:

• Higher case volume and complexity
• More subspecialty support (ICU, IR, cardiology, nephrology, podiatry, wound care)
• Multiple vascular partners or fellows for backup
• More structured protocols and EMR workflows

Rural or critical-access settings often involve:

• Broader practice scope with more independence
• Limited local backup and possible transfer of complex cases
• A crucial community-impact role, especially for limb salvage and dialysis access
• Higher frequency of urgent/emergent presentations (late referrals, poor access to outpatient care)

Your comfort level with resource-limited environments and independent decision-making should drive your choice between these settings.

---

Finding and Evaluating Locum Tenens Vascular Surgery Positions

Once you’ve decided locum work might fit your goals, the next step is finding the right opportunities and vetting them carefully.

1. Where to Find Locum Tenens Roles

Common pathways include:

• Locum tenens agencies

  • Many specialize by specialty or region and maintain dedicated recruiters for vascular surgeons.
  • They can present multiple options, compare compensation, and handle logistics.

• Hospital and health system websites

  • Some post temporary or transitional vascular surgery openings directly.

• Professional networks and conferences

  • Society for Vascular Surgery meetings and regional conferences can be useful to meet recruiters and medical directors.
  • Former attendings, fellowship directors, or mentors may know institutions seeking temporary coverage.

• Physician job boards

  • Look for filters for “locum,” “temporary,” or “contract” within vascular surgery categories.
  • Many platforms list travel physician jobs and highlight regions with urgent demand.

2. Critical Questions to Ask Before Accepting

You should thoroughly vet any potential assignment. Key questions include:

Clinical Scope and Volume

• What is the expected case mix (open vs endovascular, elective vs emergency)?
• What procedures are must-have competencies? (e.g., EVAR, TEVAR, complex peripheral, dialysis access, carotids, mesenteric work)
• How many cases per week/month do locum surgeons typically do?
• What is the call frequency (weekday, weekend, home vs in-house)?

Support and Infrastructure

• Is there a hybrid OR or modern endovascular suite?
• What onsite specialties are available? (ICU, IR, nephrology, podiatry, wound care, cardiology, cardiothoracic surgery)
• Is there vascular lab support (ultrasound, vein mapping) and 24/7 radiology?
• Are there experienced vascular PAs/NPs or residents to assist?

Organization and Culture

• Will you be the only vascular surgeon on site?
• What is the relationship between vascular surgery and other services (e.g., IR, cardiology)? Collaborative or competitive?
• How are emergent transfers handled if resources are insufficient?

Operational Details

• What EMR is used, and is there locum orientation?
• Who handles documentation for billing and coding?
• Will you have scheduling input for elective cases?

3. Evaluating Location and Lifestyle Fit

Even high-paying assignments can be draining if the location or lifestyle fit is poor. Consider:

• Distance from home and ease of travel (airports, direct flights)
• Local housing options provided by the agency or stipends
• Safety and amenities in the area (gyms, grocery stores, outdoor activities)
• Whether you prefer commuting-style locums (fly in for 1–2 weeks, then home) vs temporary relocation for several months

Locum work can be an opportunity to sample different regions while still advancing your vascular career.

---

Contract, Compensation, and Practical Logistics

Understanding how locum tenens contracts function—especially in a high-responsibility field like vascular surgery—is essential before you sign anything.

1. Compensation Models for Vascular Locum Work

Locum vascular surgeons are typically compensated via:

• Daily rate (e.g., 8–12 hour shifts, plus defined call coverage)
• Hourly rate for clinical hours plus separate call pay
• Blended models with base rate plus productivity incentives (RVU-based or case volume bonuses)

Factors that influence pay:

• Geographic region and local shortage severity
• Case complexity and call burden
• Whether general surgery or trauma coverage is included
• Length of assignment and your willingness to take nights/weekends/holidays

Ask for market comparisons from multiple agencies to ensure your rate reflects your skill set and the intensity of the role.

2. Key Contract Clauses to Understand

Pay close attention to:

• Malpractice coverage

  • Who provides it—agency, hospital, or you?
  • Is it occurrence-based or claims-made?
  • If claims-made, who pays for tail coverage when the assignment ends?

• Non-compete or restrictive covenants

  • Can you later accept a permanent job at the same site?
  • Are you barred from working with certain hospitals or health systems in the region?

• Cancellation terms

  • How much notice is required for the facility to cancel the assignment?
  • Is there guaranteed minimum pay if the assignment is cut short?
  • What happens if you must withdraw for health or family reasons?

• Call expectations and backup

  • Ensure the contract clearly outlines call responsibilities and backup coverage.
  • Clarify policies about maximum call frequency and post-call expectations.

• Travel and housing

  • Who arranges flights, rental cars, and lodging?
  • Are you given a stipend or booked directly by the agency?
  • What are reimbursement policies for meals, incidentals, and licensing fees?

A healthcare attorney or an experienced locum tenens physician in vascular surgery can provide valuable insights before you sign.

3. Credentialing, Licensing, and Onboarding

Vascular surgery is a high-liability field, so credentialing can be rigorous and time-consuming.

Expect to provide:

• Proof of completion of general surgery and/or vascular surgery residency/fellowship
• Board certification or board eligibility in vascular surgery
• Detailed case logs documenting operative experience
• Letters of reference, particularly from program directors and recent partners
• Records of any malpractice claims or disciplinary actions

Many locum agencies will help with:

• State medical licenses
• DEA registration and controlled substance requirements
• Hospital credentialing packets

However, you should build lead time into your planning—3–6 months is common from initial conversation to first day on site, especially in states with slower licensing processes.

4. Tax, Legal, and Business Considerations

As a locum tenens physician, you are often classified as an independent contractor rather than an employee. Practical implications include:

• You’ll receive 1099 income (in the U.S.) and must manage your own tax withholdings.
• You may want to create a professional LLC or similar entity for liability and tax planning.
• You can deduct certain business expenses (travel not reimbursed, CME, licensing fees, equipment, home office, etc.), subject to tax law.

Work closely with:

• A tax advisor familiar with independent contractors and multi-state income
• A financial planner to structure retirement and savings for an irregular income stream

---

Strategic Use of Locum Tenens Across Your Vascular Career

Locum tenens isn’t just a temporary fix; it can be purposefully woven into your long-term professional trajectory.

Early Career: From Training to Independent Practice

For new graduates of an integrated vascular program or a fellowship:

• Confirm readiness for independent practice by choosing assignments with robust backup and reasonable call.
• Use locum tenens to see what type of vascular practice suits you best:
  • Heavy endovascular vs open
  • Limb salvage–focused vs broader aortic/visceral work
  • Academic teaching vs pure clinical
• Build a solid professional reputation; every assignment is effectively an audition and generates references for future roles.

Mid-Career: Recalibration and Flexibility

For established vascular surgeons:

• Locum work can create a buffer for career transitions, such as leaving a high-burnout job, relocating, or pursuing leadership roles.
• It allows time for professional recalibration—e.g., shifting from heavy trauma to elective vascular, or testing academic vs private practice environments.
• Some surgeons choose to maintain a hybrid career, combining a part-time permanent role with select locum assignments for additional income and variety.

Late Career: Gradual Transition and Mentorship

Senior vascular surgeons may use locum work to:

• Gradually reduce clinical load without fully retiring
• Focus on lower-intensity settings or elective-heavy practices
• Offer mentorship to younger surgeons in developing vascular programs
• Continue practicing in a way that supports personal health and work-life balance

---

Frequently Asked Questions (FAQ)

1. Can new graduates from a vascular surgery residency or fellowship safely start with locum tenens work?

Yes, but it requires careful selection of assignments. New graduates should:

• Choose sites with strong support systems, including ICU, experienced OR staff, and subspecialty backup.
• Avoid being the sole vascular surgeon in a hospital without clear transfer arrangements.
• Start with shorter, lower-intensity assignments before taking on heavy call or highly complex tertiary work.

Mentorship from senior vascular surgeons—through your former program or professional society connections—can help you vet opportunities.

2. How does locum tenens work affect board certification and maintenance of certification?

Locum work itself does not negatively affect board certification, provided you:

• Maintain an appropriate case volume and case mix
• Keep up with CME requirements and any ongoing practice improvement activities
• Ensure your case logs and operative reports are accessible for certification or re-credentialing reviews

If you move frequently, be intentional about tracking cases and outcomes in a consistent, portable system.

3. Is it possible to convert a vascular surgery locum tenens position into a permanent role?

In many cases, yes. Hospitals often use locum coverage while they search for a permanent vascular surgeon. If both you and the institution feel it’s a good fit, they may offer:

• A formal employment or partnership track
• Negotiated credit for prior service as a locum (e.g., seniority, sign-on bonus structure)

If you think you might want this option, clarify any non-compete clauses or restrictions upfront before accepting the assignment.

4. Are there risks unique to vascular surgery when doing locum tenens work?

Unique considerations in vascular locum practice include:

• High-acuity emergencies (ruptured AAAs, acute limb ischemia) that demand immediate action and strong system support.
• Potential mismatch between your skill set and what the facility expects (e.g., complex endovascular work without adequate equipment or imaging).
• Need for clear handoffs and communication with local teams for post-op and long-term follow-up, given that you may leave after the assignment ends.

Mitigate these risks by thoroughly vetting each site’s resources, support, and realistic expectations before committing.

---

Locum tenens opportunities in vascular surgery can be professionally rewarding, financially attractive, and personally liberating when approached strategically. Whether you are transitioning out of training, recalibrating mid-career, or thoughtfully winding down your operative volume, locum work offers a flexible pathway to practice high-level vascular surgery while exploring different regions, systems, and practice models. With careful planning around contracts, logistics, and case mix, it can become a powerful—and sustainable—component of your vascular surgery career.