Doctors use locum tenens in different ways — to augment their income, satiate a thirst for travel, or ease their way into retirement, just to name a few. In the months immediately following her fellowship, psychiatrist Dr. Chinenyenwa Onyemaechi turned to locums to help pay off her student loans — also to delay having to choose a specific type of work environment. Inpatient, outpatient, emergency room — she wasn’t sure where she wanted to settle down. She was seeking financial freedom and flexibility.
Now that those needs have been met, you might think Dr. Onyemaechi would be ready to accept a permanent position. As it turns out, the exact opposite is true. Four years later, Dr. Onyemaechi is more excited about locum tenens than ever. It’s definitely not the career path she envisioned for herself as a student, but now that she’s on it, she’s unlikely to change course anytime soon. The benefits of locum tenens are just too good to give up.
Her first locums assignment
Dr. Onyemaechi didn’t know what to expect from her first locums assignment. She told her recruiter what her interests were, then waited to see what would happen next.
When the recruiter came back with an assignment in Portland, Oregon, which consisted entirely of ER shifts, Dr. Onyemaechi had to think about it. For someone raised in Maryland, moving to the West Coast was a big deal. She decided to give it a shot anyway. “If I’m taking this huge step,” she told herself, “why not just go full throttle?”
It didn’t take long for Dr. Onyemaechi to realize she made the right choice. Portland was new and exciting — “just beautiful,” she says. “A vibrant city, food mecca, the Columbia River Gorge, the Cascades.” She used the time off between shifts to explore. “I made it my goal to see the seven wonders of Oregon,” she says. “I got to six by the time I left.”
Of course, all good things come to an end, even locum tenens assignments that you can’t get enough of. But after Portland, Dr. Onyemaechi was all in on locums. “I realized this is what I like to do,” she says. She talked to her recruiter and asked for more of the same.
Locums job first, location second
Dr. Onyemaechi chooses her assignments based on the job rather than location. If she enjoys the professional setting of what she’s doing, there’s a good chance she’ll enjoy where she’s living as well. If the recruiter can’t give her exactly what she’s requested, she’ll consider other situations. But she makes sure the duration of the contract isn’t as long. Why accept a year contract when there are others that are only a month?
Early on, Dr. Onyemaechi worried that members of the staff would view her as some kind of mercenary, just “there to do my job, collect my paycheck, and move on.” But in her experience, working locums hasn’t been like that at all.
“In the majority of facilities where I’ve been, they’ve treated me like I’m a permanent doctor,” she says. “I go to meetings that involve staff morale and other concerns. I feel like my own concerns and voice are addressed. Overall, I’ve felt like part of the team.”
In the past four years, locum tenens assignments have taken Dr. Onyemaechi across America and even out into the Pacific. After Portland, she worked in the Amish country, near Lancaster, Pennsylvania. Since then, there have been stints in Michigan, the Jersey Shore, and the much-coveted locums assignment in Hawaii. Her current assignment is telehealth, so theoretically she could be living (and, of course, exploring) anywhere — assuming she has a solid internet connection.
A practical side to locum tenens
As much as Dr. Onyemaechi has enjoyed the adventurous side of locums, it’s important to keep in mind that her original motivations could hardly have been more practical. “I was really focused on my loans,” she says. “I didn’t want to be paying them for the rest of my life.” During her fellowship, she spent a lot of time thinking about the best way to tackle her debt. She’d overheard the phrase locum tenens, “but it wasn’t something really discussed as an option when I was in training,” she says.
Fortunately, Dr. Onyemaechi met a few “travelling” physicians just as she was finishing her fellowship. She didn’t have the full picture yet — it sounded more like moonlighting than anything else — but what she heard was enough to get her talking with a recruiter.
The more Dr. Onyemaechi learned, the more locum tenens felt like the right fit for her. Looking back, she firmly believes locums enabled her to pay off her loans much faster than a permanent position might have. She completed her fellowship in 2018 and says that by 2020 she was completely debt free.
“Many people look into other programs like the public service loan forgiveness and such,” she says. “But knowing myself, knowing that I enjoy working, and that I enjoy working hard — I decided to just spend a couple of years knocking it out. So that’s what I did — even faster than I anticipated.”
Locums without the travel
Dr. Onyemaechi trained in telepsychiatry during her residency, so her current assignment is actually a deliberate match. She works in the ER performing what the hospital calls “med surg consults,” which is meeting with her patients by video. Overall, she really likes the platform and thinks that working virtually can be even more effective than meeting in person. “I can do the documentation, put in orders, make phone calls, everything I need to do,” she says. “When you’re in person, you have to find a list of on-call doctors to reach out to, figure out who the nurse is. With telepsych, it’s all there in the platform.”
Working from home has likewise been a pleasant change to the locums routine she’s gotten used to. “I get to be there with my dog,” Dr. Onyemaechi says. He’s a Maltipoo named Archie, if you have to know. “Between patients we’re out going for walks. My parents are close by.” Bottom line: the arrangement is “working out really well so far.”
Locum tenens for the long haul
Dr. Onyemaechi’s advice for any early career physicians thinking about locum tenens is simple: “Just dive in and give it a try. It’s not a forever job.” Most of the young doctors she meets don’t really see it as an option though. “There’s a lot of fear of this not being a stable job,” she says. “I think in medicine we’re trained to look for what we think is ‘certainty.’ Doctors look at locums, and they’re like, what happens if you don’t have a job? How are you able to move so much?”
And yet, this hasn’t been Dr. Onyemaechi’s experience at all. So far, the transitions between all of her assignments have been essentially seamless, she says. That could have something to do with the locum tenens agency that she’s working with, of course. Still, the longer she does locum tenens, the more confident she feels about her direction.
“I can’t see myself settling down,” she says. “I just like the freedom that locums provides. I can set my schedule. I’ve paid off my loan. I can choose assignments that I enjoy. I’m not beholden to anything.” Four years in from residency, she’s exactly where she wants to be. “At this point, I think I’m going to be a career locumist — assuming that’s a word.”