THE GUIDE

Everything you need to know about locum tenens (travel) medicine.

By TheLocumLady

FIRST: WHAT IS LOCUM TENENS?

Locum tenens is Latin for “to hold the place.”

In healthcare, it means temporarily stepping into a clinical role to provide coverage for a healthcare organization or another clinician.

The easiest way to think about it:

LOCUMS IS LIKE BEING A SUBSTITUTE TEACHER - BUT FOR HEALTHCARE.

A teacher is out. A substitute steps in.

A physician takes maternity leave. A hospital needs temporary coverage. A practice has an unexpected vacancy.

A qualified clinician steps in.

You aren't taking over someone's entire career.

You're holding their place.

And here's the important part:

LOCUMS IS NOT A SPECIALTY.

You don't need a “locums fellowship,” special locums certification, or separate locums training.

Your existing professional training, license, experience, and qualifications determine which assignments you're eligible for. Individual assignments may have additional licensing, credentialing, certification, procedural, or experience requirements.

For physicians, locums opportunities exist across every specialty - from anesthesiology and emergency medicine to psychiatry, radiology, surgery, OB/GYN, PM&R, dermatology, cardiology, gastroenterology, oncology, orthopedics, and more.

And temporary healthcare work isn't limited to physicians. Depending on the profession and employer, you may also find temporary, travel, or contract opportunities for:

• Nurses

• NPs

• PAs / physician associates

• Veterinarians

• Physical therapists

• Occupational therapists

• Speech-language pathologists

• Radiology Techs

• Surgical Techs

• Care Managers

• Other healthcare professionals

The terminology may vary…locums, travel, contract, temporary, per diem, but the basic concept is similar:

USE YOUR PROFESSIONAL SKILLS WITHOUT COMMITTING TO ONE PERMANENT EMPLOYER.

HOW LOCUMS WORKS

At its simplest:

Facility has a staffing need
↓
Qualified clinician is identified
↓
You agree to the assignment
↓
Licensing / credentialing / onboarding
↓
You work
↓
Assignment ends

You may work through 1) a staffing agency or 2) directly with a facility (direct contract).

An agency is helpful because they usually coordinate some combination of:

• Finding the job

• Contracting

• Licensing

• Credentialing

• Privileging

• Travel

• Housing

• Rental car

• Malpractice

• Assignment logistics

Never assume what's included. Responsibilities vary by agency, facility, profession, and contract.

WHY DO PEOPLE DO LOCUMS?

There isn't one “locums lifestyle.”

You might use it to:

✈️ TRAVEL/ADVENTURE (me!)

Work somewhere new without permanently relocating.

💰 EARN MORE

Pick up additional work around another job or commitment.

🏔️ TEST-DRIVE A CITY

Live somewhere before deciding whether you actually want to move there.

🔄 BURN OUT

Step away from a permanent position without stepping away from medicine.

🧪 TRY SOMETHING DIFFERENT

Experience a new hospital, practice setting, patient population, or schedule.

🕰️ CREATE FLEXIBILITY

Work less, work more, or structure your career differently.

And no—you do not have to quit your permanent job to do locums.

It can be a side gig, bridge, trial run, career transition, semi-retirement strategy, or full-time career.

HOW LONG IS AN ASSIGNMENT?

It depends, assignments can range from:

A single shift → days → weeks → months → a year or longer

You may also return to the same facility repeatedly.

That flexibility is one of the biggest differences between traditional employment and temporary work.

FINDING YOUR FIRST ASSIGNMENT

You can find opportunities through NEJM, JAMA, agencies, recruiters, professional networks, or directly through healthcare organizations.

When you contact a recruiter or facility, make it easy for them to understand what you're looking for.

Include:

• Specialty / profession

• Experience

• Location preferences

• Availability

• Desired schedule

• Practice setting

• Clinical skills or procedures

• Current licenses

• Willingness to obtain additional licenses

• Assignment preferences

SIMPLE INTRO

“Hi! I'm a ________ with ______ years of experience. I'm currently looking for locum opportunities in ________. I'm available ________ and am particularly interested in ________. I'm currently licensed in ________ and would consider additional licenses for the right opportunity. I'd love to hear what you have available.”

You don't need a complicated pitch.

You need clear information and clear preferences.

BEFORE YOU SAY YES

This is where locums gets more interesting.

Don't evaluate an assignment based on the rate alone.

Ask about the entire job.

🩺 THE CLINICAL SIDE

• What exactly will I be doing?

• What is the patient population and acuity?

• What's the typical volume/census?

• What procedures are expected?

• What support staff are available?

• What are the hours?

• Is there call?

• What happens after hours?

• What EMR is used?

• Why does the facility need temporary coverage?

💰 THE MONEY

• What is the hourly/daily rate?

• Are there separate call, weekend, or holiday rates?

• Are hours guaranteed?

• Is overtime available?

• Are travel days paid?

• What expenses are covered?

• When and how am I paid?

• What happens if the facility cancels?

✈️ THE LOGISTICS

• Who books travel/housing?

• Who pays for housing?

• What type of housing is available - airbnb vs. hotel?

• Is a rental car provided?

• Can I bring a spouse, partner, child, or pet?

• What happens if I want to extend?

📄 THE CONTRACT

• Who is the contracting entity?

• What is the cancellation policy?

• What is the termination language?

• Who pays licensing and credentialing costs?

• What malpractice coverage is provided?

• Is tail coverage included?***

• Are there non-solicitation or direct-hire restrictions?

THE RULE:

IF IT MATTERS, GET IT IN WRITING.

MALPRACTICE: READ THE FINE PRINT

Many locums assignments include malpractice coverage—but policies aren't interchangeable.

Ask:

• What type of policy is it?

• What are the limits?

• Who is covered?

• Where does coverage apply?

• What happens when the assignment ends?

• Is tail coverage provided?

If it's claims-made coverage, understand what happens after the policy ends.

DON'T ASSUME:

“Malpractice is included.”

means:

“I'm covered forever.”

Know what the actual policy says.

LICENSING & CREDENTIALING

This is one of the least exciting parts of locums—and one of the most important.

Depending on your profession and assignment, you may need things such as:

• State licenses

• DEA registration, when applicable

• Board certification

• Training history

• References

• Hospital affiliations

• Procedure logs

• Malpractice history

• Background checks

• Immunization records

• CME

• BLS/ACLS or other certifications

• NPI information

• Work history

For physicians, some may qualify for expedited licensure through the Interstate Medical Licensure Compact, depending on their circumstances and participating states.

1099 VS. W-2

Locums clinicians may work as independent contractors or employees, depending on the arrangement.

If you're working as an independent contractor, you'll need to understand things like:

• Estimated taxes

• Self-employment taxes

• Business expenses

• Recordkeeping

• Retirement planning

• Health insurance

• Disability insurance

• Professional expenses

• Business structure

And please don't fall for:

“1099 = unlimited tax write-offs.”

That's not how it works.

Your tax situation depends on your circumstances. If you're making significant changes to your work structure, work with a qualified tax professional.

DO I NEED AN LLC?

Highly Recommended

You can potentially work as an independent contractor without an LLC, but many opt to form a business:

Some clinicians choose an LLC or another business structure for legal, organizational, or tax-planning reasons.

But an LLC does not automatically:

• Eliminate taxes

• Eliminate malpractice liability

• Make every expense deductible

• Protect you from every lawsuit

• Save you money

Don't create a business entity just because someone on social media told you that you “need one.”

Understand why you're creating it first.

THE LOCUMS RATE TRAP

Here's where a lot of people get fooled.

Someone says:

“I'm making $200/hour!”

Okay.

But…

$200/hour DOING WHAT?

An assignment paying $200/hour with:

• 8-hour shifts

• No call

• No weekends

• 3 days/week

is a very different job from $200/hour with:

• 10-hour shifts

• Heavy call

• Weekend coverage

• High volume/census

• Additional administrative responsibilities

DON'T COMPARE RATES.

COMPARE ASSIGNMENTS.

Think about:

RATE × HOURS × WORKLOAD × SCHEDULE × EXPENSES × BENEFITS × RISK

The highest hourly rate isn't automatically the highest-value assignment.

WHAT CAN YOU NEGOTIATE?

Potential negotiation points may include:

• Rate

• Call rate

• Weekend/holiday pay

• Guaranteed hours

• Schedule

• Assignment length

• Cancellation terms

• Travel

• Housing

• Rental car

• Licensing expenses

• Credentialing expenses

• Start/end dates

• Extension terms

YOUR FIRST ASSIGNMENT: THE TIMELINE

Once you accept an assignment, the process generally looks like:

1. Contract signed
↓
2. Licensing / credentialing
↓
3. Privileging / facility onboarding
↓
4. Travel + housing
↓
5. Orientation
↓
6. You work
↓
7. Submit hours / invoices
↓
8. Get paid

The exact process varies, but knowing the general sequence makes the whole thing feel much less intimidating.

AFTER THE ASSIGNMENT

Don't just move on to the next job.

Learn from the one you just finished.

Ask yourself:

MONEY

What did I actually make?

What did I spend?

What was covered?

MEDICINE

Did I like the work?

Was the workload reasonable?

Did I feel supported?

LIFESTYLE

Did I like the location?

Did the schedule work for me?

PEOPLE

Did I like the team?

Would I work with them again?

FUTURE

☐ Extend
☐ Return
☐ Take another assignment
☐ Consider permanent employment
☐ Pass

Keep track of this.

After several assignments, you'll start building your own locums database—and that information becomes incredibly valuable.

10 LOCUMS MISTAKES TO AVOID

1. Chasing the highest rate.
The rate doesn't tell you the whole story.

2. Signing without reading the contract.
“It's standard” isn't a contract review.

3. Assuming everything is covered.
Ask. Then get it in writing.

4. Ignoring cancellation terms.
Understand what happens if the assignment changes or disappears.

5. Not asking about workload.
“Eight-hour shifts” tells you almost nothing by itself.

6. Starting credentialing too late.
Licensing and credentialing can take time.

7. Saying yes to everything.
You are allowed to say no.

8. Comparing assignments by rate alone.
Look at the whole package.

9. Forgetting about taxes.
That big 1099 check still comes with tax obligations.

10. Assuming one recruiter is your only option.
You can build multiple professional relationships and compare opportunities.

HOW MANY AGENCIES SHOULD I WORK WITH?

There is no magic number.

Some clinicians work primarily with one agency. Others maintain relationships with several.

The important thing is understanding:

• Who has the job?

• Who represents you?

• Who contracts with the facility?

• Who pays you?

• Who provides malpractice?

• Who handles licensing?

• Who handles travel?

• What happens if another agency presents the same assignment?

THE GOAL ISN'T TO COLLECT RECRUITERS.

It's to understand your options and build relationships with people who are useful, responsive, and transparent.

YOUR PRE-ACCEPTANCE CHECKLIST

Before signing, make sure you know:

THE JOB

☐ What am I actually doing?
☐ What's the schedule?
☐ What's the workload?
☐ What's the call structure?
☐ What's expected of me?

THE MONEY

☐ What's the rate?
☐ Are there different rates?
☐ Are hours guaranteed?
☐ What's covered?
☐ When do I get paid?

THE CONTRACT

☐ Cancellation terms
☐ Termination terms
☐ Malpractice coverage
☐ Tail coverage
☐ Restrictive provisions

THE LOGISTICS

☐ Licensing
☐ Credentialing
☐ Travel
☐ Housing
☐ Rental car
☐ Start/end dates

THE FACILITY

☐ Why do they need temporary coverage?
☐ What happened to the previous clinician?
☐ Is there a permanent search?
☐ Would I want to return?

THE LOCUM LADY'S GOLDEN RULES

✨ 1. YOU DON'T HAVE TO TAKE THE FIRST ASSIGNMENT.

✨ 2. YOUR RATE IS NOT YOUR COMPENSATION.

✨ 3. GET IMPORTANT PROMISES IN WRITING.

✨ 4. READ THE CONTRACT.

✨ 5. ASK ABOUT THE WORKLOAD — NOT JUST THE SCHEDULE.

✨ 6. KNOW WHAT YOUR MALPRACTICE POLICY ACTUALLY COVERS.

✨ 7. START LICENSING AND CREDENTIALING ASAP.

✨ 8. YOU ARE ALLOWED TO SAY NO.

✨ 9. YOUR TIME IS PART OF YOUR COMPENSATION.

✨ 10. YOU DON'T HAVE TO BUILD YOUR LOCUMS CAREER ALONE.

OKAY…BUT HOW DO I ACTUALLY DO THIS?

Now you know what locums is.

But knowing the definition is very different from knowing how to make it work for you.

You may still be wondering:

Where do I start?

Which agencies should I contact?

What should I say to recruiters?

Is this rate actually good?

What should I negotiate?

That's where the deeper strategy comes in.

🚀 READY TO GO DEEPER?

💬 BOOK A 1:1 CALL WITH THE LOCUM LADY

Sometimes you don't need another checklist.

You need someone to look at your specific situation.

A 1:1 call can help you think through things like:

• Your first assignment

• Comparing opportunities

• Recruiter conversations

• Negotiation strategy

• Leaving a permanent job

• Transitioning to full-time locums

• Combining locums with another job

• Building a lifestyle around temporary work

LET'S TALK ABOUT YOUR SITUATION.

[BOOK A 1:1 LOCUMS CALL →]

🎥 TAKE THE LOCUM TENENS VIDEO COURSE

Think of this guide as:

“What the heck is locums?”

The video course is:

“Okay, now show me how to actually do this.”

Go deeper into the process, strategy, and practical steps of getting started—without trying to piece everything together from random recruiter calls, Facebook groups, Reddit threads, TikToks, and Google searches.

[CHECK OUT THE VIDEO COURSE →]

📖 GET THE LOCUM TENENS JUMP START GUIDE

If you're thinking:

“Okay, I'm interested. But what do I actually do first?”

The Locum Tenens Jump Start Guide takes you further into the practical roadmap for getting started.

[DOWNLOAD THE LOCUM JUMP START GUIDE →]

YOU DON'T HAVE TO FIGURE IT ALL OUT AT ONCE.

Maybe locums becomes your entire career.

Maybe it's one assignment.

Maybe it's a side gig.

Maybe it gives you the freedom to spend a few months somewhere you've always wanted to live.

Maybe it helps you transition out of a job that isn't working anymore.

Or maybe you try it and decide it's not for you.

That's okay, too.

The point is knowing what's possible.

And now you do.

WELCOME TO THE WORLD OF LOCUMS. ✈️

THELOCUMLADY

QUICK-REFERENCE CHEAT SHEET

BEFORE YOU SEARCH

☐ Update CV
☐ Know your availability
☐ Know your preferred locations
☐ Know your non-negotiables
☐ Organize credentials

BEFORE YOU INTERVIEW

☐ Clinical expectations
☐ Schedule
☐ Workload
☐ Call
☐ Support
☐ Why they need coverage

BEFORE YOU ACCEPT

☐ Rate
☐ Guaranteed hours
☐ Call/weekend/holiday terms
☐ Cancellation
☐ Malpractice
☐ Tail
☐ Licensing
☐ Travel
☐ Housing
☐ Contract

BEFORE YOU START

☐ License
☐ Credentialing
☐ Privileging
☐ Travel
☐ Housing
☐ Orientation

AFTER

☐ Submit hours
☐ Confirm payment
☐ Save documents
☐ Evaluate the assignment
☐ Decide whether you'd return
☐ Update your locums database

Sincerely,

@TheLocumLady

DISCLAIMER

This guide is for educational purposes only and is not legal, tax, financial, medical, or employment advice. Locum tenens and other temporary healthcare arrangements vary by profession, state, agency, facility, employer, and contract. Licensing, credentialing, malpractice coverage, compensation, tax obligations, and assignment terms can vary significantly. Review your specific circumstances and applicable agreements with the appropriate qualified professional before making legal, tax, financial, or contractual decisions.

Information in this guide is intended as a general starting point and should be independently verified before acting.

Ready to embark on this adventure together? Let's explore the possibilities of locum tenens with a private call!