Locum Tenens Opportunities in Pediatrics: A Comprehensive Guide

Locum tenens opportunities in pediatrics are expanding rapidly, and they’re not just for mid‑career or late‑career physicians anymore. For pediatricians in residency, fresh graduates, or seasoned attendings considering a shift, locum work can offer flexibility, income, and geographic freedom—if you understand how to use it strategically.

Below is a comprehensive, residency‑applicant–friendly guide to locum tenens in pediatrics: what it is, how it fits into your career planning, how to navigate contracts, and ways to leverage it for long‑term success, including the peds match and beyond.

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Understanding Locum Tenens in Pediatrics

Locum tenens (Latin for “to hold the place of”) refers to temporary physician assignments that cover gaps in staffing. In pediatrics, this can span from a few days of clinic coverage to multi‑month inpatient or subspecialty assignments.

What Locum Tenens Looks Like in Pediatrics

Common settings for pediatric locum work include:

• Outpatient pediatric clinics
  • Well‑child visits, acute visits, follow‑ups
  • School entry or sports physicals
• Inpatient pediatrics
  • General pediatric wards
  • Newborn nursery
  • Step‑down units (depending on your training)
• Pediatric emergency departments and urgent care
  • Fast‑paced clinical environments, higher volume of acute complaints
• NICU / PICU
  • More common for fellowship‑trained neonatologists or intensivists
• Rural and critical‑access hospitals
  • Often lack full‑time pediatric coverage
  • Need help with deliveries, newborn care, and admissions
• Community health centers and FQHCs
  • Focus on underserved populations, immunizations, and chronic disease management

Assignments can range from:

• PRN/weekend coverage (1–2 days at a time)
• Short‑term locums (2–8 weeks)
• Medium‑term contracts (3–6 months)
• Ongoing locums with recurring dates (e.g., 1 week per month for a year)

Why Pediatrics Is a Strong Field for Locum Work

Several trends make pediatrics favorable for locum tenens:

• Persistent workforce shortages in rural and underserved urban areas
• Burnout and part‑time transitions, opening up coverage gaps
• Maternity leaves and sabbaticals among predominantly younger pediatric workforces
• Seasonal surges (e.g., RSV, influenza) requiring extra inpatient or ED support

While pediatrics rates are often lower than adult hospitalist or emergency medicine work, demand is stable and rising in many regions. For motivated pediatricians, locum work can be both financially and professionally rewarding.

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When Locum Tenens Makes Sense in a Pediatric Career

Locum tenens does not have to mean a “forever traveler” lifestyle. It can be a short‑term strategy, a side‑gig, or a long‑term career choice. Where it fits depends on your stage.

For Medical Students and Residents: Planning Ahead

You cannot moonlight independently as a locum tenens physician until you have:

• Completed residency (or at least met your state and hospital requirements), and
• A full, unrestricted medical license (not a training license)

However, thinking ahead during residency can help you leverage locum work early in your career:

• Gap year planning: If you’re uncertain about fellowship or a specific career path, a year or two of pediatric locum work after residency can:

  • Expose you to different practice models (rural vs. suburban vs. academic)
  • Help you narrow down interests (inpatient vs. outpatient, ED vs. nursery)
  • Strengthen your CV with diverse experiences

• Peds match narrative: Understanding locums can also color how you talk about your long‑term goals in residency and fellowship interviews:

  • Interest in serving rural or underserved communities
  • Desire for a flexible, portfolio‑style career
  • Plans to integrate global health, travel physician jobs, or academic pursuits

You don’t need to mention locum tenens explicitly in every peds match interview, but knowing that flexible options exist after training can give you confidence when you discuss career trajectories.

Early‑Career Pediatricians: First 5 Years Out

This is where locum tenens can be particularly valuable.

Common scenarios:

1. Undecided between inpatient and outpatient pediatrics

   • Try both through locum assignments without locking into a long‑term contract.
   • Example: 3 months as an inpatient pediatric hospitalist in a Midwestern community hospital, followed by 3 months of outpatient clinic in a coastal city.

2. Planning a geographic move or following a partner

   • Use locum work to bridge employment gaps while:
     • Awaiting partner’s match or job
     • Testing different regions before committing
   • Provides income and keeps skills up while you search for a permanent role.

3. Loan repayment and income optimization

   • Some locum roles in high‑need areas offer competitive compensation or loan‑repayment–eligible positions.
   • Strategic locum work can help you pay down debt faster than many starting salaried jobs.

4. Job rebuilding after a mismatch

   • If your first permanent job is not a good fit, locum assignments can act as:
     • A “soft landing” financially
     • A way to quickly pivot without unemployment gaps on your CV

Mid‑Career and Late‑Career Pediatricians

For more experienced pediatricians, locum work may serve different purposes:

• Transition to part‑time practice
  • Work one or two weeks per month instead of full‑time.
• Supplementing income
  • Especially for private practitioners or academic pediatricians with lower salaries.
• Travel and lifestyle flexibility
  • Choose assignments in locations you want to explore or near family.
• Bridge to retirement
  • Gradually reduce workload, switch to seasonal or PRN locum assignments, and maintain clinical skills without full‑time pressure.

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Types of Pediatric Locum Tenens Assignments

Understanding assignment types will help you filter offers and match them to your skills and preferences.

1. Outpatient General Pediatrics

Typical setting: Community pediatric practice, FQHC, or multispecialty clinic.

Duties:

• Well‑child visits, immunizations, developmental screening
• Acute sick visits (fever, URI, asthma flares, minor injuries)
• Basic chronic disease management (ADHD, asthma, obesity, allergies)

Ideal for:

• Pediatricians who enjoy continuity of care (even if only brief)
• Those seeking daytime, more predictable schedules
• Early‑career physicians building outpatient comfort and speed

Questions to ask:

• Typical patient volume per day? (Common range: 18–26)
• Support staff: Are there NPs/PAs, RNs, MAs?
• EMR system and training time?
• How are vaccines and well‑child schedules managed/documented?

2. Inpatient Pediatrics and Newborn Nursery

Typical setting: Community hospitals, regional centers.

Duties:

• Management of admitted pediatric patients (bronchiolitis, pneumonia, dehydration, etc.)
• Rounding in the newborn nursery, occasional high‑risk deliveries (depending on role)
• Coordination with subspecialists and transfer centers

Ideal for:

• Pediatric hospitalists or general pediatricians who enjoy acute care
• Those seeking fewer clinic‑style visits and more diagnostic complexity

Considerations:

• Level of nursery (well‑baby vs. Level II/III)
• Expectation for deliveries and resuscitation (NRP, PALS up to date)
• In‑house vs. home call and frequency of overnight responsibilities

3. Pediatric Emergency Department or Urgent Care

Typical setting: Pediatric ED in children’s hospitals or mixed EDs; urgent care centers.

Duties:

• Evaluation and stabilization of acute complaints (fever, trauma, asthma, seizures)
• Procedural work: suturing, splinting, lumbar punctures (depending on site)
• High patient throughput, shift‑based work

Ideal for:

• Pediatricians who enjoy fast pace and variety
• Physicians comfortable with acute care triage and emergent decision‑making

Key questions:

• Expected patients per shift and acuity mix
• Availability of backup: pediatric ED attendings, surgeons, intensivists
• Procedural expectations vs. comfort zone

4. Subspecialty Pediatric Locum Work

Common in: Neonatology, pediatric hospitalist medicine, adolescent medicine, pediatric cardiology, heme/onc, and others (depending on markets).

Subspecialty locum tenens may:

• Command higher rates
• Require board certification and significant recent experience
• Involve regional or national travel with longer block assignments (e.g., 7 on / 7 off)

5. Rural and Underserved Locum Assignments

These can be among the most rewarding and impactful roles.

Features often include:

• Broadened scope of practice (within safety and credentialing)
• Strong community relationships
• Potential for loan repayment or special incentives

This type of travel physician job is especially aligned with applicants who expressed interest in underserved care during the peds match process. It can be a meaningful continuation of that mission.

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How to Get Started: Practical Steps for Pediatric Locum Tenens

Transitioning into locum tenens as a pediatrician is manageable if you approach it systematically.

Step 1: Clarify Your Goals

Before contacting agencies, decide what you want:

• Primary goals:

  • Maximize income
  • Explore locations
  • Sharpen specific skill sets (e.g., inpatient, nursery, ED)
  • Achieve flexible schedule or part‑time work

• Non‑negotiables:

  • Minimum rate
  • Maximum call responsibilities
  • Geographic limits (e.g., must be within direct flight distance of home)

Write down your must‑haves and dealbreakers. It helps anchor negotiations and prevents accepting unsuitable roles out of urgency.

Step 2: Licensure and Credentialing

Locums requires proactive paperwork.

• State licenses:

  • Each assignment generally requires a license in that state.
  • The Interstate Medical Licensure Compact (IMLC) can significantly speed this up if you qualify.
  • Work with agencies that help sponsor and manage licensing costs.

• Hospital privileges and credentialing:

  • Expect 60–120 days for full credentialing in many hospitals.
  • Keep an updated CV, procedure logs, CME documentation, board certificates, immunization records, and references ready.

Best practice: maintain a “locums packet”—a digital folder with all needed documents, updated every 3–6 months.

Step 3: Choose How to Find Locum Assignments

You generally have three paths:

1. Locum Tenens Agencies

   • Advantages:
     • Access to multiple opportunities
     • Assistance with licensing, credentialing, travel, and housing
     • Liability insurance typically provided (often claims‑made)
   • Disadvantages:
     • Agency takes a margin that might otherwise go to your rate
     • Variable transparency about bill rates

2. Direct Hospital or Group Contracts

   • Advantages:
     • Higher pay potential since there’s no middleman
     • More direct relationship with the site
   • Disadvantages:
     • You must negotiate all terms yourself
     • You usually handle travel, housing, and insurance arrangements

3. Hybrid Approach

   • Work with a couple of trusted agencies while also remaining open to direct contracts in preferred regions or systems.

For pediatricians just starting locum work, agencies often provide a smoother initial experience.

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Contracts, Compensation, and Logistics in Pediatric Locum Work

Understanding the nuts and bolts will protect you and help you choose the right roles.

Compensation Basics

Common payment structures for a locum tenens physician in pediatrics:

• Hourly rate (most common for ED, inpatient, and some clinics)
• Per‑diem daily rate (e.g., flat rate for a clinic day plus call stipends)
• Shift‑based rates (e.g., 12‑hour ED shifts, 24‑hour call)

Factors affecting pediatric locum rates:

• Location (rural / high‑need regions tend to pay more)
• Subspecialty vs. general pediatrics
• Call burden (in‑house vs. beeper; frequency of overnight duties)
• Short‑notice or “crisis” coverage

While pediatric locum rates may be lower than high‑demand adult specialties, smart negotiation can still yield strong compensation, especially with multiple offers.

Key Contract Elements to Review

1. Rate and Overtime

   • Base hourly or daily rate
   • Overtime triggers: after 8, 10, or 12 hours?
   • Weekend or holiday differentials

2. Call Expectations

   • In‑house vs. home call
   • Frequency of nights, weekends
   • Compensation for call and for call‑back time

3. Scope of Practice

   • Level of patients you are expected to manage (e.g., gestational age limits in nursery, acuity of inpatient cases)
   • Expectations around procedures (LPs, intubations, central lines, etc.)
   • Whether you are the sole pediatric coverage or part of a team

4. Malpractice Insurance

   • Provided by agency/hospital or self‑arranged?
   • Claims‑made vs. occurrence policies
   • Who pays for tail coverage?

5. Cancellation Terms

   • Notice required if you cancel an assignment
   • Penalties or fees for cancellations (on both sides)
   • Guaranteed minimum hours or days per month

6. Travel and Housing

   • Reimbursed or pre‑paid travel costs (flights, rental car, mileage)
   • Housing: hotel vs. apartment vs. stipend
   • Per‑diem for meals and incidentals

Locum Work and Taxes

If you work locum assignments as an independent contractor (1099):

• You are responsible for:
  • Quarterly estimated tax payments
  • Self‑employment tax
  • Retirement savings (e.g., solo 401(k), SEP‑IRA)

Consider working with a tax professional early. Deductions related to travel physician jobs (mileage, lodging gaps, licensing fees, CME, etc.) may be substantial if handled correctly.

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Lifestyle, Career Strategy, and Long‑Term Planning

Locum tenens shouldn’t be treated only as a short‑term financial move. Thoughtful planning can integrate it into a healthy and sustainable pediatric career.

Balancing Lifestyle and Burnout

Pros for burnout prevention:

• You can say no to assignments that don’t fit your values or schedule.
• You have more control over time off, vacations, and family logistics.
• Clear boundaries—when your assignment ends, you’re not pulled into ongoing clinic politics or committees.

Potential downsides:

• Travel fatigue and frequent onboarding to new systems.
• Less continuity with patients.
• Periods of uncertainty between contracts if not well planned.

Strategies:

• Try to maintain at least one or two “anchor” sites where you return regularly, reducing cognitive load from constantly new environments.
• Schedule planned breaks for rest and CME; avoid back‑to‑back stretches without down time.
• Maintain social and professional ties (e.g., online pediatric communities, local colleagues, mentors).

Building Skills and a Marketable Profile

Use locum tenens strategically to strengthen your CV:

• Seek assignments that:
  • Align with your long‑term interests (e.g., high volume of asthma, obesity management, or complex inpatient cases)
  • Give you exposure to different EMRs and practice structures
  • Demonstrate adaptability and team integration

Keep a log of:

• Case types and numbers (de‑identified)
• Procedures
• Leadership roles (e.g., covering as lead pediatrician, helping build protocols)

These experiences can be powerful when applying for permanent roles, academic positions, or fellowships later.

Transitioning from Locums to Permanent (If You Choose)

Many pediatricians ultimately decide to settle into a permanent role after a period of locum work.

Locum experience helps you:

• Evaluate different systems before committing.
• Negotiate more confidently (you know your worth and what you want).
• Potentially convert a locum site into a permanent offer if you and the group are a mutual fit.

When considering leaving locums for a permanent role:

• Prioritize places where you’ve already worked and liked the team culture.
• Ask for structured onboarding and realistic clinical volumes.
• Consider a hybrid approach: part permanent, part locum—especially if you want to keep a variety of practice experiences.

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FAQs: Locum Tenens in Pediatrics

1. Can locum tenens experience help or hurt my chances for fellowship or academic pediatrics later on?
It usually helps—if framed properly. Locum work demonstrates adaptability, clinical breadth, and often a commitment to underserved areas. For fellowship or academic roles, emphasize:

• Skills gained (acute care, independent decision‑making)
• Exposure to diverse patient populations and systems
• Ongoing scholarly activity or QI involvement if applicable
  Avoid prolonged CV gaps without explanation; structured locum work can fill those periods positively.

2. When should I start thinking about locum tenens if I’m still in pediatric residency?
During PGY‑2 and PGY‑3, start:

• Clarifying your post‑residency goals (fellowship vs. general pediatrics vs. locums)
• Learning about licensing requirements and timelines
• Networking with mentors who have done locum work
  Actual contracts usually begin after graduation and board eligibility, but early planning—especially around geography and state licensure—gives you more options.

3. Are locum tenens positions a good way to explore rural pediatrics before committing long‑term?
Yes. Locum assignments are an excellent “test drive” of rural or underserved practice. You can:

• Experience the clinical scope and resource limitations
• Assess community fit and lifestyle
• Decide if you’d want to pursue a permanent role there
  Many communities use locums as a pathway to recruit permanent pediatricians; you can keep that door open while retaining your freedom to decline if it’s not the right fit.

4. How does locum work compare financially to a traditional pediatric salary?
Financial comparisons depend heavily on:

• Your locum rate
• Volume and consistency of work
• Tax management and benefits (or lack thereof)
  Per‑hour, locum tenens often pays more than salaried positions, especially including overtime and differentials. However, you’ll typically be responsible for your own health insurance, retirement, and periods between contracts. With disciplined planning and good assignments, many pediatric locum physicians meet or exceed traditional pediatric income, particularly early in their careers or during high‑demand seasons.

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Locum tenens opportunities in pediatrics can offer flexibility, exploration, and strong earning potential across all career stages. Whether you are planning your path during the peds match, finishing residency, or reevaluating your mid‑career options, understanding locum work empowers you to design a pediatric career that fits both your professional goals and personal life.