Keeping locums in line: The importance of organization

Locum physician organizing paperwork

Dr. Trevor Cabrera, a veteran locum pediatrician, offers some valuable insight into how he stays organized as a locum tenens physician.

After completing medical training, many physicians may go the rest of their lives holding only one or two steady jobs. Understandably, people plant roots and become comfortable with a predictable routine. Physicians build relationships and tenure and working locum tenens, to some, may seem like an uncomfortable transition from a permanent position.

The paperwork that goes into the credentialing process for one hospital and medical license can seem tedious. For many, the thought of working multiple locum tenens jobs requiring additional licensing and other paperwork on a regular basis can be intimidating. While locum tenens agencies can help with credentialing and licensing, a large element of success is personal organization. After working many different locum tenens assignments, I’ve tried different ways of trying to stay organized with post-it notes, spreadsheets, and Word documents. I’ve also worked with multiple recruiters and licensing departments over the years, and I have found that focusing on the following points maximizes efficiency and minimizes the headache.

Multiple state licenses

For new graduates interested in pursuing locum tenens full time, this is the best time to obtain as many medical licenses as possible. Each medical board has its own set of individual requirements that only rarely overlaps from one state to the next. For instance, while one state may require a medical school transcript, another may have state-specific continuing medical education (CME) modules to be done.

As each medical board belongs to its own state, verifications of other state licenses are often needed — and this may include an associated fee. Fingerprints may be needed, and it can be difficult to find ink prints in the age of computers. For those interested in multiple state licenses, the IMLC (Interstate Medical Licensure Compact) helps to create an abbreviated path to obtaining a new medical license. However, the IMLC doesn’t completely get rid of the paperwork. The nuances go on and on, but one thing is for certain: the process becomes harder the more your history and CV grow.


Choosing to do locum tenens immediately after training gains you valuable connections that come from training in a teaching hospital. However, beyond that most facilities will only accept references of a colleague you have worked with in the last 24 months. As such, it’s crucial at each assignment to add new names to a rotating roster. One recruiter recommended grouping sets of three (the usual number of references needed), to stay organized without becoming an annoyance. I have built a web of other locum friends to maximize this potential with the mutual understanding that they might need my signature as well.

Malpractice, privileges, and affiliations

Every institution you work with will request a malpractice history. Generally, this will include the last decade of work, and it can be a mess keeping track of every Certificate of Liability Insurance (COI). While I keep a folder of my COIs organized by facility and date, a new hospital can often reach out to a previous employer or agency to obtain these records as well. Likewise, hospital privileges and affiliations can often be researched online, but sometimes direct contact with the medical staff office of a previous job is needed — another reason to keep bridges unburned.

Organizing commonly requested information

Inevitably, each new job will require your personal data, from passport photos and immunization records to respirator fit testing. Diplomas, CPR certificates, procedure logs, and CME will routinely be requested, so keeping neatly organized folders can make sending in records easy. Since I’m often on the go, I keep these files in cloud storage so they can easily be uploaded to if an urgent response is needed to rush credentialing.

Dates and expirations

If nothing else, don’t lose track of when things expire. No one wants to find out in the middle of an assignment that their BLS certificate or DEA won’t allow them to practice — hospitals don’t like it either. I check quarterly for any upcoming due dates and expirations, being sure to simultaneously update my CV.

Use whichever organizational method works for you, but the more time you spend keeping all your pertinent information organized, the easier working multiple locum jobs becomes. While the task can seem daunting, the payoff can be worthwhile — and it’s always easier to rest when your house is in order.

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