Intended for healthcare professionals


Why locum?

BMJ 2012; 345 doi: (Published 19 September 2012) Cite this as: BMJ 2012;345:e5966
  1. Jennifer Turner, core medical trainee
  1. 1Maidstone Hospital, Maidstone and Tunbridge Wells NHS Trust, UK
  1. jennifer.turner{at}


Jennifer Turner outlines her experiences of locuming as a junior doctor

Last year I was jobless, my foundation programme was finished, and owing to family commitments I hadn’t taken up a training post. We still had a mortgage and bills to pay and I had no regular income—to be honest, I was pretty scared. I started doing ad hoc locum shifts across southeast England, during which I learnt some valuable lessons on how to survive a year as a locum.

Pros and cons of working as a locum

The most obvious benefit of being a full time locum doctor is that it affords you greater flexibility in your home and work life. This can give you time to study for exams or to combine medicine with other employment or hobbies. For a junior doctor, locum work can allow you to earn money while you explore career options and locations, or it can provide you with temporary employment while you wait for a permanent job to be advertised in your specialty of choice. There is a wealth of clinical experience to be gained from locuming, because working in different hospitals exposes you to a variety of working systems and procedures.

On the down side, no one pays you when you are sick or on holiday. I found myself working two weeks back to back in December so that I could take some time off over Christmas and New Year. Also, sometimes there is just no work available in your local area and you may find yourself having to travel long distances or get accommodation on site; most trusts and agencies won’t pay travel expenses.

Locum work can be inconsistent sometimes, and it can be quite hard to get all your shifts to line up. You might find yourself with days of nothing to do; conversely you might be called at the last minute to do a shift when you had other plans. Also because I was locuming full time my indemnity insurance was higher.

How can you locum?

Locum shifts are available in two different ways, either via the internal “bank” of a hospital trust or through an agency. Generally, bank rates are lower, but you’ll be called first for the shifts. If you build up a good relationship with the medical staffing unit, then having first refusal on shifts can be invaluable.

Agencies promise higher rates but may try to send you all over the country, and often the shifts come in at the last minute. Agency locum shifts do pay more, but you may find the shift cancelled as hospital trusts try to save money by booking bank doctors instead. This can be very frustrating, especially if you’ve declined other work because you thought you had a shift booked.

Ad hoc versus long term locum work

I mainly did ad hoc locum shifts, but many long term locum posts are available, especially for more senior grades. These can be very lucrative because you’re able to work more hours by being on the rota; however, this does mean a loss of flexibility. Also, with long term locum posts it is easier to arrange appraisal for revalidation. Many doctors find it easier to locum long term as they are able to learn the systems and procedures at a particular trust. There are more training opportunities available as a long term locum because you are treated like one of the team. Locuming long term is also a great way to build up your CV. I have friends who have taken locums in particular specialties, such as the intensive care unit or infectious diseases, which they hope will help them to get a job in that field in the future.

Professional regulation

Being a locum doctor does not exempt you from revalidation. If you have a regular job and are locuming on the side, the annual review of competence progression you do with that job will cover you for revalidation purposes. If you don’t have a regular job, however, you need to arrange the annual review with the agency you locum with most regularly, which should have a responsible officer who will oversee your revalidation.

The 10 do’s and don’ts of surviving a year as a locum

  • “Acquire” a set of scrubs for different hospital trusts, because there will never be any in your size

  • Always carry your own roll of micropore

  • Register with at least three agencies

  • Take your own lunch to avoid wasting your hard earned cash on terrible hospital food

  • Obtain copies of your occupational records and your hepatitis B and HIV records before you register with an agency

  • Ask a couple of friendly consultants to act as your references before you leave your current hospital trust

  • Be afraid to haggle over your rate

  • Feel pressured to take shifts you don’t really want

  • Stay late: no one will notice, thank you, or pay you, unless of course it’s an emergency

  • Be tempted by back to back shifts; you will need time to sleep


Doing a period of time as a locum is a great way to build up your experience, build up your CV, and make medicine work around you. There is a lot to think about financially and in terms of training and revalidation, but it is not impossible. If you’re brave enough to take the risk then you could find that some time locuming will bring with it all sorts of rewards.


  • Competing interests: None declared.

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