Unlocking Neurology Residency: A Guide to Locum Tenens Opportunities

Neurology is one of the fastest-evolving specialties in medicine—and that makes it an attractive field for physicians who value intellectual challenge, diagnostic reasoning, and long-term patient relationships. But not every neurologist wants a traditional, permanent full-time role right out of training. Many are now exploring locum tenens physician work as a flexible, lucrative, and strategically smart way to shape their careers.

This guide will walk you through everything you need to know about locum tenens opportunities in neurology—how they intersect with the neurology residency and neuro match process, how to get started, what to expect in different practice environments, and how to use locum work to build the career (and lifestyle) you want.

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Understanding Neurology Locum Tenens: What It Is and Why It’s Growing

Locum tenens—Latin for “to hold the place of”—refers to physicians who work temporary clinical assignments, filling in for vacancies, leaves of absence, or short-term staffing gaps. In neurology, these needs are especially common because:

• There is a nationwide shortage of neurologists, particularly in stroke, epilepsy, and neurocritical care.
• The demand for acute stroke coverage (including teleneurology) continues to grow.
• Many hospitals and groups struggle to recruit permanent neurologists, especially in rural or underserved regions.

Core Features of Neurology Locum Tenens Work

While details vary by assignment, most neurology locum tenens physician roles share several characteristics:

• Temporary contracts
  Assignments can range from a single weekend of stroke call coverage to several months of general neurology or subspecialty coverage.

• Defined scope of practice
  You may cover:

  • Inpatient neurology consults and admissions
  • Stroke code and thrombolysis decision-making
  • EEG/EMG reading
  • Outpatient clinics (general or subspecialty)
  • Telestroke or virtual neurology consults

• Flexible geography
  Travel physician jobs in neurology exist in community hospitals, academic centers, specialty clinics, and telemedicine platforms—across both urban and rural locations.

• Premium compensation
  Because locum neurologists fill urgent or hard-to-staff needs, pay rates are typically higher than equivalent W-2 employed salaries on an hourly or per diem basis.

Why Neurologists Choose Locum Work

Common motivations include:

• Post-residency flexibility – After the neuro match and completion of neurology residency, some physicians aren’t ready to commit to a permanent location or practice type.
• Exploration of practice settings – Locum tenens lets you “test-drive” academic vs. community vs. private practice neurology before signing a long-term contract.
• Income optimization – Many neurologists use locums to pay down loans more aggressively or supplement part-time faculty roles.
• Lifestyle control – Ability to cluster shifts, work seasonally, or take long stretches of time off.
• Transition points – Between jobs, after a move, or during a spouse/partner’s career transition.

For neurology in particular, locum tenens can also be a way to maintain specialized skills—such as neurocritical care, interventional neurology, or epilepsy—in institutions where those services are in high demand.

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Locums and the Neurology Career Path: From Residency to Practice

Locum tenens isn’t just for mid-career neurologists burned out on traditional jobs. It increasingly plays a role across the entire neurology career spectrum.

During Neurology Residency and the Neuro Match

While you cannot moonlight as a full independent locum tenens physician until you’re fully licensed and board-eligible/board-certified, understanding locums during residency can be strategically useful:

• Informs your fellowship choice
  Ask: Which subspecialties have strong locum demand? Common areas:

  • Vascular neurology / stroke
  • Neurocritical care
  • Epilepsy / EEG
  • General adult neurology
  • Pediatric neurology in certain regions

• Shapes your skill-building
  If you envision future travel physician jobs, prioritize:

  • Strong ICU and stroke code experience
  • Autonomy in inpatient consults
  • Exposure to multiple EMRs
  • Efficient clinic workflow and documentation skills

• Supports geographic exploration
  If you know you eventually want to settle in a certain region, aligning your neurology residency or fellowship location with that region may make future locum credentialing and networking easier.

Immediately After Training: A Strategic “Gap Year” (or Two)

Many new graduates use locum tenens work right after residency or fellowship as:

• A structured “bridge” between training and long-term practice.
• A trial period to compare academic vs. community neurology roles in real time.
• A way to earn at a high rate while delaying a permanent commitment.

Example trajectory:

• Complete neurology residency (and perhaps a stroke or epilepsy fellowship).
• Obtain full, unrestricted license and DEA.
• Register with one or more locum agencies, undergo credentialing.
• Accept 3–6 month inpatient neurology locum assignments in two different regions.
• Use these experiences to evaluate:
  • Call burden you can tolerate long term
  • Patient volumes and complexity
  • Team culture and support (APPs, hospitalists, radiology availability)
  • Whether you prefer teaching or purely clinical work

Mid-Career and Late-Career Neurologists

For established neurologists, locum tenens provides:

• Burnout relief and reset – Step away from administrative burdens of a permanent job while staying clinically active.
• Semi-retirement model – Work 7–10 days per month to maintain licensure, skills, and income, with extensive personal time.
• Subspecialty preservation – If your local market can’t support your niche (e.g., neuromuscular disease), you might do targeted locum work in centers needing that expertise.

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Types of Neurology Locum Tenens Assignments

Neurology is diverse, and so are locum jobs. Understanding assignment types will help you match roles to your skills and goals.

1. Inpatient General Neurology and Stroke

Most common and often highest-need assignments. Typical characteristics:

• Setting: Community hospitals, regional referral centers, or academic medical centers.
• Duties:
  • ED stroke alerts and thrombolysis decisions
  • Inpatient consults (encephalopathy, seizures, neuromuscular crises, etc.)
  • Rounding on neurology admissions
  • Coordination with ICU and hospitalist teams
• Schedule:
  • 7-on/7-off is common.
  • 24-hour call (in-house or beeper) in smaller hospitals.
• Ideal for:
  • Vascular neurology and neurocritical care-trained neurologists.
  • General neurologists comfortable managing acute and complex cases.

Key questions to ask before accepting:

• What is the annual stroke volume and door-to-needle time?
• Is there 24/7 neuroradiology coverage?
• Are there residents or APPs, or will I be solo?
• What is the expected number of consults per day and number of calls overnight?

2. Outpatient Neurology Clinics

Often more lifestyle-friendly, outpatient neurology locum tenens roles may involve:

• General neurology clinics with headaches, neuropathy, movement disorders, MS, and cognitive complaints.
• Subspecialty-focused clinics (epilepsy, movement disorders, demyelinating disease).
• Procedural clinics including EMG and Botox for chronic migraine or spasticity.

Pros:

• Predictable hours (usually weekdays, minimal call).
• Longitudinal follow-up possible in longer assignments (>3–6 months).
• Good fit for neurologists wanting continuity with patients.

Cons:

• Less acute pathology and limited hospital exposure.
• Productivity expectations may be high (e.g., 16–20 patients per day).

3. Teleneurology and Telestroke

Teleneurology is a major growth area for locum tenens physician work:

• Scope:
  • Acute stroke evaluation and tPA/EV (endovascular) decision-making.
  • Remote neurology consults to smaller hospitals.
• Requirements:
  • Strong broadband infrastructure at your work location.
  • Comfort with rapid video assessments.
  • Multi-state licensure (often supported by the telemedicine company).
• Benefits:
  • No travel; work from home office or dedicated telehealth hub.
  • Flexible scheduling (nights/weekends often in demand and better compensated).
• Considerations:
  • High cognitive load during peak times.
  • Need excellent documentation skills.

4. Academic and Teaching-Focused Assignments

Less common but highly valued by neurologists who enjoy teaching:

• Filling in for faculty on sabbatical or parental leave.
• Supervising residents on inpatient neurology or stroke services.
• Leading subspecialty clinics at academic centers.

These roles may offer slightly lower pay compared to purely clinical locums, but they provide:

• Teaching opportunities.
• Academic affiliation and potential research collaboration.
• Exposure to cutting-edge neurology practice.

5. Rural and Underserved Community Assignments

Rural hospitals and underserved urban centers often have the most urgent need for neurology coverage:

• You may be the only neurologist on site, with:
  • High autonomy.
  • Broad clinical variety.
• These roles often provide:
  • Premium pay.
  • Travel and housing benefits.
• They can be uniquely rewarding for physicians committed to health equity and access.

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Compensation, Logistics, and Lifestyle: What to Expect

A realistic understanding of the financial and practical aspects of neurology locum tenens work is critical before you jump in.

Compensation Models in Neurology Locums

While rates vary by region, subspecialty, and demand, over recent years typical ranges (subject to market changes) have been:

• Inpatient neurology / stroke:
  • Daily rate for 24-hour call, or
  • Hourly rate for days plus separate call stipend.
• Outpatient neurology:
  • Hourly clinic rate, sometimes with productivity bonuses.
• Teleneurology:
  • Per consult, per shift, or hourly rate for coverage blocks.

Key compensation elements to clarify:

• Is malpractice covered, and is it claims-made or occurrence?
• Are travel, lodging, and rental car included?
• Is there pay for:
  • Extra consults beyond a set number?
  • Additional call or weekend coverage?
  • Holidays?

Travel and Housing: The “Locum Lifestyle”

Travel physician jobs in neurology can be as light or as intense as you wish:

• Short-drive regional work
  Stay within 1–3 states, driving or taking brief flights for 7–10 day blocks.
• Cross-country assignments
  Explore different practice environments and regions (e.g., West Coast stroke centers, Southern rural communities).

Agencies typically arrange:

• Round-trip airfare or mileage reimbursement.
• Pre-booked hotel or furnished apartment.
• Rental car, rideshare credits, or local transportation arrangements.

To stay comfortable and efficient on the road:

• Pack a “locum bag” with:
  • Extra scrubs, stethoscope, tablet/laptop, chargers.
  • Portable Wi-Fi hotspot.
  • Copies (physical or digital) of your CV, licenses, and certifications.
• Develop personal routines for:
  • Sleep alignment, especially when switching time zones or night shifts.
  • Meal planning and exercise in new environments.

Tax and Financial Considerations

Most locum tenens neurologists work as independent contractors (1099) rather than W-2 employees:

• You are responsible for:
  • Quarterly estimated taxes.
  • Self-employment tax.
  • Retirement account contributions (e.g., Solo 401(k), SEP IRA).
• On the upside, you may be able to deduct:
  • Some travel costs.
  • CME expenses.
  • Home office costs (if applicable; consult a tax professional).

It is strongly recommended to:

• Work with an accountant experienced in physician 1099 income.
• Maintain meticulous records of assignments, expenses, and reimbursements.
• Consider disability and life insurance that are independent of any single employer.

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How to Get Started: Step-by-Step Path Into Neurology Locum Tenens

If you’re seriously considering locum work, especially around the time you’re finishing neurology residency or fellowship, a structured approach helps.

Step 1: Confirm Eligibility and Credentials

Before accepting neurology locum tenens assignments, you typically need:

• MD/DO degree and completed ACGME-accredited neurology residency.
• Board-eligible or board-certified status in neurology (and subspecialty, if applicable).
• An unrestricted state medical license (or multiple).
• DEA registration and, in some cases, individual state-controlled substance registrations.
• Updated CV, references, and procedure logs (e.g., number of stroke codes, EEG interpretations).

For travel physician jobs that cross state lines, talk to your agency about:

• Interstate Medical Licensure Compact (IMLC) if your home state participates—it can speed multi-state licensing.
• Which states are highest-demand for locum neurologists; target those for early licensing.

Step 2: Choose How You’ll Find Assignments

You can work as a locum tenens neurologist through:

1. Locum agencies (most common)

   • They handle:
     • Job matching.
     • License assistance.
     • Credentialing paperwork.
     • Travel and lodging arrangements.
   • You negotiate compensation and terms through their recruiter.

2. Direct contracts with hospitals or groups

   • More common for experienced physicians or those already networked in a region.
   • May result in higher net pay but require more personal administration (contracts, malpractice, logistics).

3. Hybrid approach

   • Use agencies for most placements but maintain direct relationships with a few institutions you like.

When evaluating locum agencies, look for:

• Neurology-specific or hospitalist/stroke-heavy divisions.
• Transparent pay structures and clear contracts.
• Strong reviews from other neurologists.

Step 3: Negotiate Scope and Schedule Thoughtfully

Before signing an assignment, clarify:

• Scope of practice
  • Inpatient vs. outpatient vs. mixed.
  • Stroke call responsibilities.
  • Procedures (LPs, EMG, Botox, EEG reads).
• Schedule
  • Days vs. nights.
  • In-house vs. beeper call.
  • Expected patient volumes.
• Support
  • Presence of residents, APPs, or hospitalists.
  • Availability of neurosurgery, neuroradiology, and ICU teams.

For example, you might negotiate:

• No more than 15 inpatients per day plus consults.
• Shared stroke call with another neurologist.
• Protected time for documentation.

Step 4: Prepare for Credentialing and Onboarding

Credentialing can take weeks to months, especially for multi-state work. To streamline:

• Maintain a digital portfolio with:
  • Current CV.
  • Copies of licenses and certificates.
  • Immunization records and TB screenings.
  • DEA license and NPI.
• Respond quickly to hospital medical staff office requests.
• Ask about:
  • EMR training (Epic, Cerner, Meditech, etc.).
  • Stroke protocol orientation.
  • Call room and workspace logistics.

Step 5: Build a Sustainable Locum Career Plan

Think about your 1–3 year horizon:

• Are you using locums as:
  • A bridge to a targeted permanent job in neurology?
  • A long-term career model?
• How many weeks per year do you ideally want to work?
• How will you balance:
  • Income goals.
  • Time off.
  • Geographic preferences (e.g., limit to certain regions or time zones)?

Reassess at regular intervals (every 6–12 months) and adjust which assignments and agencies you work with.

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Strategic Advantages and Common Pitfalls for Neurology Locum Tenens Physicians

Locum tenens neurology can be deeply rewarding, but like any career path, it comes with tradeoffs.

Major Advantages

1. Clinical Breadth and Depth
   You’ll see diverse pathology across multiple systems—from high-volume academic stroke centers to community hospitals where neurology expertise is rare.

2. Professional Autonomy
   You can:

   • Decline assignments that don’t fit your values or lifestyle.
   • Avoid long-term committee work, politics, and some administrative burdens.

3. Career Clarity
   Experiencing different models of neurology practice often clarifies what you truly want in a potential permanent position—making future negotiations stronger and more targeted.

4. Negotiation Leverage
   When you eventually consider a permanent job:

   • You can benchmark offers against what you’ve earned as a locum.
   • You’ll better understand reasonable patient volumes, staffing ratios, and call expectations.

5. Geographic and Lifestyle Freedom
   Whether you want extended international travel between assignments, to live in multiple cities, or to move closer to family, locum work can accommodate it.

Common Challenges and How to Mitigate Them

1. Inconsistent Workflow and Systems

   • Each new site means new:
     • EMR.
     • Order sets.
     • Stroke pathways.
   • Mitigation:
     • Keep personal templates/phrases for notes.
     • Arrive early for EMR training.
     • Ask for neurology-specific quick guides or pocket cards.

2. Limited Institutional Influence

   • As a short-term provider, you may have less say in:
     • Clinic scheduling.
     • Policy changes.
     • Quality improvement.
   • Mitigation:
     • Focus on delivering excellent patient care and being a good teammate.
     • Choose longer assignments if you value impact and continuity.

3. Variable Support and Resources

   • Some hospitals may lack:
     • Subspecialty neurosurgery.
     • EEG technicians 24/7.
     • Robust imaging access.
   • Mitigation:
     • Clarify resources before you accept.
     • Understand transfer protocols for complex neurocritically ill patients.

4. Financial and Benefits Complexity

   • You handle your own:
     • Health insurance.
     • Retirement.
     • Malpractice tail coverage (depending on policy type).
   • Mitigation:
     • Work with financial and insurance advisors.
     • Understand every contract’s malpractice terms before signing.

5. Professional Isolation

   • Constantly rotating sites can feel isolating compared to stable colleagues.
   • Mitigation:
     • Stay connected with peers from residency or prior jobs.
     • Join neurology professional societies and online communities.
     • Consider a “home base” institution where you return regularly.

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FAQs About Neurology Locum Tenens Opportunities

1. Can I do locum tenens work during neurology residency?

No, not in the classic sense. You generally need:

• Completion of neurology residency.
• Full, unrestricted state license.
• Board-eligible or board-certified status.

However, as a resident, you can:

• Moonlight internally (depending on program policies).
• Learn about locum work early to plan your neuro match choices, fellowship decisions, and skill development strategically for future locum opportunities.

2. Does doing locums hurt my chances of getting a permanent neurology job later?

Usually not—if anything, it can help:

• You gain broad experience across settings and EMRs.
• You can demonstrate adaptability, strong clinical skills, and productivity.

When applying for permanent posts:

• Be ready to explain why you chose locum tenens (e.g., exploration, geographic flexibility, family needs).
• Highlight what you learned about efficiency, telemedicine, stroke systems, and varied practice models.

Programs and employers are increasingly familiar with locum tenens physician experience and often view it as a positive if framed well.

3. How does locum tenens work affect my board certification maintenance?

As long as you maintain:

• An active clinical practice.
• Required CME credits.
• Any specific procedure or case log requirements (depending on subspecialty).

Locum tenens neurology generally counts fully toward your practice criteria. Make sure to:

• Track your patient volumes and case types.
• Save documentation from each site in case your board requires verification.

4. Is neurology a good specialty for a long-term locum tenens career?

Yes, neurology is relatively favorable for ongoing locum work because:

• Demand for neurologists—especially for stroke coverage and teleneurology—remains high.
• Many institutions lack full-time neurology coverage and rely on locums.
• There is increasing integration of telemedicine, creating both onsite and remote options.

A sustainable long-term locum career in neurology does require:

• Willingness to adapt to new environments.
• Attention to financial planning as an independent contractor.
• Ongoing commitment to maintaining high standards of care despite being “temporary.”

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Neurology locum tenens opportunities offer a powerful alternative to the traditional, single-employer career path. Whether you’re emerging from neurology residency, re-evaluating your mid-career goals, or seeking a flexible semi-retirement model, locum work can provide rich clinical experiences, geographic freedom, and strong earning potential.

By understanding the landscape—types of assignments, compensation models, practical logistics, and common pitfalls—you can decide whether this path aligns with your professional goals and personal life. With thoughtful planning and the right support, locum tenens can be more than a stopgap; it can be a deliberate, rewarding, and sustainable way to practice neurology.