From residency to fellowship: How to bridge the gap with locums

Many residents look forward to the day they finish residency and begin their work, but some may discover they want more training in a specific area. If that training involves a fellowship, figuring out a way to earn income without signing a job contract can be tricky. Here’s how one physician used locum tenens to earn money while allowing him the time to research and apply for fellowship programs.

Using locums to pursue a fellowship dream

Dr. Franklin Mikell, an internal medicine physician who finished his residency in 2016, started working locum tenens as a hospitalist both to be closer to his family and so that he can pursue a fellowship in critical care or infectious disease critical care medicine.

“I realized an undiscovered desire to pursue fellowship,” he explains. “It had kind of always been in the background. In the process of working locum tenens, I realized that I had extra time to apply and obtain recommendation letters, so I just went ahead and gave my shot by pursuing it.”

Out of residency, Dr. Mikell worked primarily as a nocturnist. He took a job in Ohio while doing per diem work elsewhere and learned a lot about the ICU while working freelance.

“They gave me the opportunity to cover the ICU for them at night until they found a board-certified intensivist, with the understanding that there was always a board-certified intensivist on call in case I got into a jam and needed some backup assistance by phone,” he explains.

He became proficient working night shifts — often as the only doctor — providing mechanical ventilation, if necessary, or placing a central line using ultrasound guidance. That made him realize he wanted to do a fellowship in critical care.

“You do fairly minimum invasive surgical procedures to keep people alive, and that’s kind of what has drawn me to the whole critical care medicine field. It’s a way of utilizing higher-level thinking to solve a problem that may or may not exist when they enter the ER,” he explains.

“It’s a pretty hefty responsibility at night when you’re the only person on and responsible for performing a lot of important tasks just to get people through the night, to make sure they remain alive by the time the daytime physicians come in.”

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Locum tenens allows for schedule flexibility

After those two years of full-time and per diem work, he transitioned to full-time locum tenens with Weatherby Healthcare to pursue fellowship opportunities. Many physicians begin working locums early in their career, with 38% of locum physicians working their first assignment within the first five years of practicing medicine, according to an internal study conducted by CHG Healthcare.

“Locums gave me more flexibility because I had control over my schedule as opposed to having a set regimented schedule created by the hospital,” Dr. Mikell explains. “It was just that flexibility and the freedom to morph the schedule to what I wanted.”

Locums has also meant that he could change his schedule from overnights.

“I no longer work nights, and that’s also why I like locums,” he says. “The ability to choose whether or not you can do days, whether or not you can do nights, and you can do what is called a swing shift, which suits my sleep pattern. It’s essentially noon to midnight. You admit patients, and if there is a code blue in which you need to perform resuscitative efforts, you do. But outside of anything to stabilize patients or admit a new patient, you’re not responsible for following the patients already in the hospital. That suits my personality and my sleep pattern.”

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Improving medical skills with locums

Dr. Mikell says that locums makes him a better doctor. “I like the ability to test out new health systems I’ve never been exposed to. It enables you to take on any other task anywhere you go. I think it makes you a better clinician. It has definitely improved my clinical ability,” he says.

Furthermore, locums allows him to stay on the cutting edge. “Medicine is an ever-evolving field, and there are newly developed technological advances to better address what the patients are presenting for, and sometimes certain healthcare facilities will be more advanced in implementing those.

“For instance, there’s this one procedure called EKOS, and it’s a fairly aggressive way of performing an intervention to tackle any potential concerns that a patient may present with a PE — a pulmonary embolism. At my home hospital, that was not performed, so I wasn’t really aware of what that was until I went to a hospital in Southern Indiana, where they performed it every few days. It was very beneficial for me to see the positive effects of the new technology.”

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Multiple licenses provide more opportunity

Dr. Mikell knew that he wanted to be able to work in multiple states and now has 12 state licenses. He began working on getting the licenses while he was still employed full time.

“Every time you fill out a state application, they ask for the last location you were at and ‘can we please speak to that program director?’ There are forms that they will need to fill out for you and fellow physicians who will need to fill out forms to vouch for your credibility. I saw an opportunity at the end of my stay at the previous hospital to get a lot of that paperwork done while I was still physically located there,” he explains.

He looks forward to putting more of these licenses to work as a locums, and they will give him more flexibility to pursue options once he has completed his fellowship.

Want more schedule flexibility and control of your career? Give us a call at 954.343.3050 or view today’s locum tenens job opportunities.

Curious how locum tenens could fit into your career after residency or fellowship? This webinar will enhance your understanding of locums, its benefits, drawbacks, and how it may work for you.