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Using locum tenens to transition to fellowship

Illustration - locum physician after residency

Working locum tenens after residency can be a great way to transition to fellowship. Here are the stories of four doctors who used locum tenens as a way to bridge the gap and gain valuable experience in temporary assignments across the country. Here are their thoughts on locum tenens after residency and how it could benefit your career.

Paying off student loans more quickly

Dr. Melissa Macaraeg, a pediatrician based in New York, finished her residency in 2018 and began working locum tenens within two months.

“I’m a big fan of traveling and wanted to apply to fellowship in the next year, so I didn’t want to tie myself to a hospital and then have to get out of my contract,” Dr. Macaraeg recalls. “I wanted to leave as many doors as I could open for myself.”

While locum tenens allowed Dr. Macaraeg to travel as much as she likes, it also enabled her to pay down her student loan debt. The higher pay she made working locum tenens and her “live like a resident” philosophy have helped her save money and pay off her debt quickly.

“I keep the same, or almost the same, budget as I did in residency. Whatever is left over goes toward debt and loans,” she says. “I was also out of the country for four months doing international work, and locums helped me prepare for my trip. I really enjoy the locums and per diem lifestyle.”

Building confidence before taking a fellowship

For Dr. Bassam Rimawi, an OB/GYN based in North Carolina, locum tenens work was instrumental in building his confidence after residency.

“One of the biggest fears I had working in residency training was that I was always relying on a superior attending physician whenever I was making a decision concerning my patients,” Dr. Rimawi says. “When you go out in the real world by yourself, you just have to get ready, open up your arms, and catch whatever is thrown at you. Locum tenens work really gave me the work care and the extra self-esteem motivator to get me out there and to really push me.” Since you can specify where you’d like to work on a locum tenens assignment (for example, only in labor and delivery), Dr. Rimawi says locum tenens can help you take on patient care alone for the first time.

“With locum tenens work, you get to just build your way up. You could put yourself in any specific situation you like. People know that you are coming, and they’re ready for you,” he says. “It builds up your self-esteem to get you accepted into a field you have finished.”

Earning extra income before and during your fellowship

Though he planned to enter a program right after residency, Dr. Baraa Alrazzak, a pediatric gastroenterologist based in Texas, says a last-minute change in that plan left him stuck until a friend recommended working locum tenens.

“I completed almost one year with full-time locums work. Then when I started my fellowship, I continued working locum tenens on the weekends and on vacations,” Dr. Alrazzak says. “It has been a really great experience.”

He recommends other residents look at locum tenens jobs online and says he feels getting into locum tenens work when another option fell through was a result of good luck.

“You have the ability to arrange your schedule the way you like, visit other places, and meet new people. During my fellowship, I made the extra income I needed throughout it,” Dr. Alrazzak says. “I love traveling, seeing new places, and generating the income I need for my family and me.”

Having flexibility to apply for fellowships and other state licenses

After transitioning to locum tenens work so he could be closer to family, Dr. Franklin Mikell, an internal medicine physician based in Indiana, realized he had uncovered a desire to pursue a fellowship.

“In the process of working, I realized that I had extra time to apply and obtain recommendation letters, so I just went ahead and took my shot by pursuing it,” Dr. Mikell recalls. “Through locum tenens, I have control over my schedule. It’s really that flexibility and the freedom to morph the schedule to what I want at the drop of a hat.”

Dr. Mikell also has 12 state licenses, some in part thanks to locum tenens assignments. He doesn’t want to limit himself to any one region or state after finishing his fellowship.

“Every time you fill out a state application, they ask about your last location, and the program director and fellow physicians will need to fill out forms to vouch for your credibility. It can be fairly cumbersome,” he says. “I saw it as an opportunity at the end of my stay at a previous hospital to get a lot of that paperwork done while I was still located physically.”

Once his fellowship is complete, Dr. Mikell says he would like to continue working locum tenens because he believes it makes you a better clinician.

“It helps you improve the plasticity of your brain. I feel you gain a wrinkle or two every time you’re forced to learn a new electronic health record system or you’re exposed to a new pathology in a patient you probably didn’t have exposure to during residency,” Dr. Mikell says. “It’s very beneficial for me to also see the positive effects of new technology that’s not been used at my home hospital.”

Gaining experience that sets you apart from other fellowship candidates

Dr. Rimawi remembers “glowing” during his first year of fellowship and having many colleagues comment on the amount of experience he had just 18 months out of his residency. His explanation: locum tenens work really helped.

“A lot of residents in my department would ask about my locum work and whether I thought they should do it. I’d tell them, ‘It really guides you in a path where you get to make your own decisions,’” Dr. Rimawi says. “You don’t have to start from scratch and get everything thrown at you at once. You could really start off light.”

Locum tenens after residency also gave Dr. Rimawi a head start when he applied for a very competitive fellowship in reproductive infectious diseases.

“When I interviewed, I remember telling them about my locum work. One of the unique cases I saw as a locums was a young lady with a bad infection in her uterus who required a hysterectomy just to save her life,” he recalls. “I told them this story and that I would never have had that experience if I didn’t do locum work. I actually got two fellowship contracts at once because they cut each fellowship down a year for me. Without my locum tenens work, I would not have seen that patient and would probably not have gotten those fellowships.”

Working locum tenens after residency is a flexible option that can build your confidence, help you earn much-needed money, and set you apart from other fellowship candidates. It’s also a great way to expand your horizons.

“I think one of the best things about locum tenens work is meeting new physicians, getting to see different hospitals, and getting to see how they practice medicine,” Dr. Rimawi says. “Then you get to bring your experience into their hospital, and they’re like, ‘Wow, I’ve never seen a physician practice like that. Is that how you do it at your hospital?’”

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