How I used locum tenens as a detour to fellowship

Illustration Dr Cabrera locums detour to fellowship

Veteran locum tenens pediatrician Dr. Trevor Cabrera shares his story of choosing to work locums between residency and fellowship, and how it didn’t hamper his career in medicine.

I will never forget the day I opened an email that would change my life forever: “Congratulations, you have matched!” Because by that point, I’d worked in 13 hospitals in nine different states over three years as an exclusive locum tenens general pediatrician. Receiving my acceptance letter was a rare moment of clarity, and I found myself following the road most frequently traveled by physicians.

Time and time again, those skeptical of my path have questioned my decisions and many have asked me if it is possible to return to the world of academic medicine and further subspecialty training in fellowship. Well, I matched into my first choice of programs in the entire country, so you tell me.

A career in medicine doesn’t need to follow a linear path

Historically, American doctors followed a very straight path in their education: undergrad, then medical school, and onto residency. And for some, to fellowship. Deviating from this path is often referred to as “nontraditional.” However, it has become increasingly popular for students to deviate from this path. Beyond so-called gap years, some doctors may even have worked their entire careers in another profession before turning to medicine. For myself, I chose locum tenens immediately after residency to broaden my experiences, hone my clinical skills, and focus on personal growth while always keeping in mind the goal of returning to fellowship training. As a locum tenens doctor, I’ve found there are pros and cons to working locums right out of residency.

The pros of deviating from the traditional trajectory of medicine

After only a few years of working locum tenens, I’ve discovered that the practical and world knowledge that I focused on acquiring is one of my most prized possessions. Here are just a few of them:

Pull quote about broadening experiences with locum tenens

Broaden my clinical experience

Working in the real world, often as the only provider with a certain skill set, has fostered innovation, problem-solving skills, and perseverance. Because of this, I’ve grown to become more autonomous and developed leadership skills. Locum tenens has also given me clinical experiences I wouldn’t otherwise have had, which will help me for future patient encounters.

Flexibility in the way I practice medicine

Learning to adapt to new situations allows me to approach new patient encounters with an open perspective. Locums has allowed me to delve into the art of medicine just as equally as the science of it, realizing guidelines and practice-style variations are never black and white.

More insight into how the broader healthcare system works

Unavoidable as it is, commerce and consumerism now drive medicine. Working in multiple practice settings provides a broader view of how healthcare works — but also how it can help combat burnout with the right tools in place.

pull quote from Dr Cabrera

The importance of humility as a physician

The more I’ve learned while working locum tenens, the more I realize how much I don’t know. Even the smallest rural town can teach you something new — and everyone you meet knows something you don’t.

More control over my finances

Focusing on saving and loans, the relatively higher pay of working locum tenens has allowed me to pay off student loans before I return to a training salary.

Dr Cabrera quote on higher pay with locum tenens

Obstacles to overcome

There are a few obstacles to overcome, but it can certainly be done.

Less exposure to hard and rare cases

Leaving academia decreases exposure to some of the more difficult or rare cases. Management of complex conditions is often deferred to the “destination medical center,” sometimes taking away from the learning experience.

Dr Cabrera quote on how locums fosters innovation

Staying up to date on new and innovative ways of practicing medicine

We live in a time of fast and frequent growth of information and research. Changes in practice guidelines can be difficult to keep up with, and it’s easy to become outdated when you’ve left academia. Self-motivation and discipline are crucial to keeping up with the literature and practicing evidence-based medicine. 

Fading connections

Staying in touch with former mentors can become harder the farther a doctor is out of training. Physicians should plan to get letters of recommendation before finishing training, as most programs will prefer references from academic institutions over community members.

While it may not be the norm for physicians to choose the path of locum tenens before returning to fellowship, training, careful planning, and continued personal drive can yield benefits that will carry on through the rest of your career. Locum tenens has opened my mind as a doctor and given me a unique outlook in my return to fellowship. I wouldn’t trade this for the world.

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