Maximizing Your Transitional Year Residency: Locum Tenens Opportunities

Choosing a transitional year residency (TY) gives you flexibility, broad clinical exposure, and time to refine your long‑term career plans. One question many TY residents ask—especially if they’re considering a gap year, a more nontraditional path, or supplementing income—is: Can I do locum tenens work after my transitional year?

The short answer: yes, with planning and realistic expectations. This guide walks you through how locum tenens opportunities intersect with the transitional year, what’s feasible at each stage of training, and how to strategically use locums in your broader career plan.

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Understanding the Transitional Year and How It Fits with Locum Tenens

A transitional year residency is a one-year, broad-based clinical program that usually precedes advanced training in fields like radiology, dermatology, anesthesiology, PM&R, ophthalmology, neurology, or certain specialties that require a prelim-style intern year.

Key features of a TY program:

• Rotations across internal medicine, surgery, emergency medicine, and electives
• Emphasis on general clinical skills—admitting, cross-cover, managing common inpatient and ED issues
• Often more elective time and flexibility than a traditional categorical internal medicine or surgery internship

Because of this broad exposure, many residents ask how a TY year might set them up to work as a:

• Locum tenens physician
• Travel physician doing short-term coverage
• Flexible, per diem hospitalist or urgent care doctor between training stages

To consider these questions, you need to understand what locum tenens work actually entails and what’s required.

What Is Locum Tenens Work?

Locum tenens (Latin for “to hold the place of”) refers to physicians who temporarily fill clinical roles for hospitals, clinics, and practices. It’s often used to cover:

• Maternity or medical leaves
• Staffing shortages
• Seasonal or census surges
• Recruitment gaps in rural or underserved areas

In practice, locum work can look like:

• A 2-week hospitalist assignment in a rural community hospital
• A 3–6-month outpatient clinic position while a group recruits a permanent doctor
• Nights-only cross-cover or ED shifts
• Multi-state travel physician jobs with frequent, scheduled locums contracts

Most locums physicians are fully trained, board-eligible or board-certified attendings. That’s the crucial point for transitional year residents: a TY year alone does not confer eligibility for independent practice in most states or settings. But that doesn’t mean there’s no role for locums in your trajectory.

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Can You Do Locum Tenens with Only a Transitional Year?

This is where many applicants and residents are understandably confused.

Legal and Credentialing Reality

To work as a locum tenens physician in the classic sense—taking full attending-level responsibility—you generally need:

• An unrestricted state medical license (MD or DO)
• Completion of an ACGME- or AOA-accredited residency program (usually at least 3 years)
• Board eligibility or board certification in a specialty
• Hospital privileging and credentialing, which typically require residency completion

A transitional year residency by itself is:

• One year of postgraduate training
• Not a terminal training path for independent general practice in most states
• Often considered equivalent to a preliminary year in terms of training depth

Because of these requirements, pure post-TY, pre-board-eligible locum tenens clinical work as an attending is usually not feasible or recommended in the United States. There are rare exceptions in certain jurisdictions or low-resource areas, but they are shrinking and tend to be high-risk from a clinical, legal, and career standpoint.

Where Locum Tenens Fits in a Transitional-Year‑Based Career

Instead of thinking “Can I do locums after my TY year and nothing else?”—it’s more accurate to ask:

“How can I integrate locum tenens work before, during, and after my broader training that includes a transitional year?”

Common pathways:

1. TY → Advanced Residency → Locum Tenens

   • You use the TY to build broad skills.
   • Complete your advanced residency (e.g., radiology, anesthesia, derm, PM&R).
   • Work as a locum tenens physician after finishing full specialty training.

2. TY → Categorical Residency (Switch) → Locum Tenens

   • You start in a transitional year, realize another specialty fits better.
   • Switch into a categorical IM, FM, or EM program.
   • Later, take on hospitalist or ER locum work using that completed training.

3. TY → Additional Clinical Experience → International or Nontraditional Locums

   • After TY and some additional training/experience, seek global health or NGO-type assignments, some of which resemble locums roles (often in low-resource settings, under different regulations).

The consistent theme: locum tenens is almost always leveraged after full residency completion, with the transitional year as an early foundational step rather than an endpoint.

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Strategic Reasons to Think About Locum Tenens as a TY Resident

Even if you cannot jump straight from a TY program to full-fledged locum work, planning early offers substantial advantages. Locums can be a powerful tool later in your career, especially if you anticipate wanting flexibility.

1. Career Flexibility and Geography

Many residents in specialties that begin with a transitional year eventually:

• Move frequently for training or partner jobs
• Have dual-career households needing geographic flexibility
• Want the freedom to live in one location while working in multiple states

By anticipating a future in travel physician jobs, you can:

• Plan for multi-state licensing (use the Interstate Medical Licensure Compact if eligible)
• Choose rotations and electives that emphasize high-demand skills for locums work (e.g., inpatient medicine, ED, ICU)

2. Financial Strategy

Locum tenens work is often well-compensated relative to employed positions, especially for hospitalist or emergency medicine roles. Long term, that can help with:

• Aggressive student loan repayment
• Saving a down payment or building an investment cushion
• Funding sabbaticals or part-time phases later in your career

As a TY resident, consider:

• Gaining strong inpatient and cross-cover skills to prepare for potential hospitalist locums work if you later complete an IM or FM residency
• Choosing electives that expand procedural comfort (central lines, paracentesis, LPs) that make you more competitive for ICU or high-acuity locums jobs after training

3. Clinical Breadth Early On

The broad exposure in a transitional year is ideal preparation for later locum roles where you may:

• Walk into a new hospital and manage unfamiliar workflows
• Care for a wide range of common inpatient and ED conditions with limited backup
• Adapt quickly to different EMRs and team cultures

Use your TY to:

• Get comfortable handling night float and cross-cover independently (within the supervised resident role)
• Seek constructive feedback on your clinical judgment and efficiency
• Learn to communicate clearly with nursing, consultants, and administrators—skills that are critical when you’re a new face on the unit as a locum

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How to Use Your Transitional Year to Prepare for Future Locum Tenens Work

Even if locums is years away, your transitional year is the right time to lay the groundwork. You’re building a portfolio of skills and experiences that will ultimately make you a safe, competitive, and marketable locum tenens physician.

1. Choose Rotations with a Locums Mindset

Common locums assignments—especially early in your attending years—often include:

• Hospitalist / inpatient internal medicine
• Emergency medicine
• Outpatient primary care
• ICU or step-down (for those with critical care experience)
• Urgent care

During your transitional year, try to:

• Maximize inpatient medicine rotations with real responsibility for patient lists
• Seek at least one solid emergency medicine month at a busy ED
• Consider a night float or cross-cover month to strengthen triage and acute management skills
• If allowed, add electives that build:
  • bread-and-butter outpatient skills (HTN, DM, preventive care)
  • procedural capabilities (lines, thoracentesis, arthrocentesis, etc.)

Example elective strategy:

• 3–4 months: Internal Medicine wards (daytime)
• 1–2 months: Night float/cross-cover
• 1 month: Emergency Medicine
• 1 month: ICU or step-down (if available)
• 1 month: Outpatient primary care clinic
• 2–3 months: Specialty electives aligned with your advanced field, but with strong generalist value (e.g., cardiology, pulmonary, infectious disease)

2. Focus Intentionally on Autonomy and Decision-Making

Locum tenens physicians often work with:

• Variable levels of in-house subspecialty support
• High expectations for independent decision-making
• Short on-boarding (sometimes only hours) before full responsibility

During your transitional year:

• Ask seniors and attendings to gradually expand your autonomy when appropriate.
• Practice formulating your own assessment and plan before hearing others’.
• Take the lead on:
  • Code and rapid response situations (with supervision)
  • Family discussions and goals-of-care conversations
  • Complex cross-cover calls at night

These skills translate directly into the confidence you’ll need as a future locum physician.

3. Build a Reputation and References

Locums agencies, hospital credentialing committees, and medical staff offices will all want:

• Detailed references from faculty who can speak to your clinical ability, professionalism, and reliability
• Documentation of your case volume and procedural experience
• Confirmation of good standing in all training programs

During your TY year:

• Identify 2–3 attendings who can become strong future references.
• Show up consistently—on time, prepared, responsive to feedback.
• Keep a simple log of:
  • Key procedures performed
  • Types of patients managed
  • Notable leadership roles (e.g., code leader under supervision in late TY)

Even if you don’t apply for locum positions until years later, these early relationships and data points will support you during credentialing.

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When Locum Tenens Makes Sense in a Transitional-Year Career Timeline

To make this concrete, here are three realistic trajectories where locum work fits well around a transitional year.

Pathway 1: TY → Advanced Residency → Locum Tenens (Specialty-Based)

Example: TY → Diagnostic Radiology Residency → Attending Radiologist

In this scenario:

1. Transitional Year

   • Build broad clinical understanding of inpatient medicine and ED presentations.
   • Gain insight into how imaging is used and how reports impact care.

2. Radiology Residency

   • Develop procedural and interpretive skills.
   • Consider moonlighting (if allowed) in later years to get used to independent work.

3. Early Attending Years

   • Take locum tenens assignments in radiology groups or hospitals:
     • Teleradiology roles (remote reads)
     • On-site coverage in community hospitals
   • Leverage locums to compare practice environments before committing long-term.

Pathway 2: TY → Switch to Categorical IM/FM → Locum Hospitalist or Outpatient

Example: TY → Categorical Internal Medicine → Hospitalist Locums

1. Transitional Year

   • Realize you enjoy inpatient medicine and continuity of adult care.
   • Transition from a planned advanced specialty to categorical IM.

2. Internal Medicine Residency

   • Build robust inpatient and outpatient skills.
   • Gain experience in ICU, ED, and subspecialty rotations.

3. Post-Residency

   • Accept locum tenens hospitalist roles:
     • 7-on/7-off schedules in multiple hospitals
     • Higher pay rates for rural or underserved areas
   • Use locums to pay down loans or explore permanent positions.

Pathway 3: TY → Advanced Specialty → Hybrid Career with Partial Locums

Example: TY → Anesthesiology → Mix of Academic and Locums Work

1. Transitional Year
   • Strengthen your clinical fundamentals and team communication skills.
2. Anesthesia Residency
   • Develop OR, ICU, and regional skills.
3. Early Career
   • Hold a primary job at an academic medical center.
   • Supplement with locum tenens assignments:
     • Short-term community hospital coverage
     • High-demand seasonal needs (e.g., orthopedic-heavy sites)

This hybrid model can provide both stability and the financial and professional benefits of locum work.

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Practical Steps: From Transitional Year Resident to Future Locum Tenens Physician

Even if you’re still in medical school or early in your TY year, you can start laying foundations for future locum tenens opportunities.

Step 1: Clarify Your Long-Term Specialty and Training Path

Because a stand-alone transitional year rarely supports full attending-level practice, your first priority is confirming:

• What advanced or categorical residency will follow?
• How competitive is that specialty, and how can you strengthen your application?
• Are you open to specialties that are well-suited to locum work (e.g., EM, FM, IM, anesthesiology)?

If you’re unsure, use your TY rotations and mentors to:

• Arrange shadowing in potential fields.
• Seek advice from program leadership and faculty who’ve worked locums or nontraditional roles.
• Attend departmental conferences and career talks in specialties of interest.

Step 2: Think Ahead About Licensing and Geography

Future locum tenens physicians benefit greatly from multi-state licensure. To position yourself:

• Maintain a clean professional record:
  • Avoid lapses in malpractice coverage.
  • Respond promptly to institutional inquiries or concerns.
  • Document remediation or educational interventions if any issues arise.
• Consider residency programs in states you might want to return to as a locum.
• Check whether you might qualify for the Interstate Medical Licensure Compact (IMLC) down the line, which can streamline multi-state licensure.

Step 3: Learn the Business Side Early

Even as a TY resident, you can start educating yourself about:

• How locum tenens agencies operate
• Common contract structures and pitfalls:
  • Hourly vs. daily rates
  • Travel and housing stipends
  • Malpractice coverage (claims-made vs. occurrence-based)
• Tax considerations for independent contractors (1099) vs. employed locums (W-2)

Practical resources:

• Free webinars from major locums staffing firms
• Talks from your institution’s GME office or career development programs
• Conversations with senior residents or attendings who have done locum work

Step 4: Focus Relentlessly on Clinical Competence and Professionalism

No amount of clever planning will substitute for being a solid, reliable clinician. Locums clients and agencies consistently value:

• Strong generalist foundations
• Low complication rates and good clinical judgment
• Excellent communication with nursing staff and consultants
• Professionalism, adaptability, and cultural sensitivity

Your transitional year is the training ground for all of these. Approach each rotation as if your future reference letter from that attending will determine whether a hospital feels safe hiring you as a new locum doctor.

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Frequently Asked Questions About Locum Tenens and Transitional Year Residency

1. Can I work as a locum tenens physician right after my transitional year, before completing a full residency?

In almost all cases in the U.S., no. Most hospitals and clinics require:

• Completion of a full residency (3+ years)
• Board eligibility or certification
• An unrestricted state license

A transitional year residency alone does not qualify you for independent specialty practice. While rare exceptions may exist (e.g., in certain jurisdictions or non-standard roles), they’re typically high-risk and not recommended.

2. Does doing a transitional year help or hurt my chances of doing locum work later?

A well-executed transitional year helps. It gives you:

• Broad inpatient and ED exposure
• Comfort working across multiple services and teams
• Early development of adaptability, a key trait for locums

What matters more is that you ultimately complete a full residency in a specialty that lends itself to locum tenens work, such as internal medicine, family medicine, emergency medicine, anesthesiology, radiology, or certain subspecialties.

3. Which specialties that start with a transitional year are best suited for locum tenens careers?

Many advanced specialties that begin with a TY can support locum opportunities after full training, including:

• Diagnostic radiology (teleradiology, on-site coverage)
• Anesthesiology (OR coverage, pain, procedural roles)
• Neurology (inpatient consults, outpatient clinics, stroke coverage)
• Physical medicine & rehabilitation (PM&R) (inpatient rehab units, outpatient clinics)
• Some dermatology and ophthalmology roles, though these may be more niche

Additionally, residents who switch from a TY into internal medicine, family medicine, or emergency medicine often find particularly robust opportunities for hospitalist and travel physician jobs once trained.

4. How can I use my elective time in a TY program to prepare for a future locum tenens career?

Use electives strategically by:

• Prioritizing high-yield generalist experiences: inpatient wards, ED, ICU, outpatient primary care
• Seeking rotations with gradual autonomy and high patient volume
• Gaining procedural experience relevant to your eventual specialty
• Working with attendings known for strong teaching and willingness to mentor

Tell your program leadership that you’re interested in a flexible or locum tenens–friendly career path after full training, and ask for guidance on rotation selection.

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A transitional year residency won’t make you a locum tenens physician on its own—but it can be the ideal launching pad. By using your TY to build broad clinical competence, cultivate mentors, and think strategically about your long-term specialty and goals, you’ll be well positioned to enter a future career where locum work, travel physician jobs, and flexible practice models are not only possible, but powerful tools to shape the life and career you want.