Career Progression as a Locum Doctor

So you’ve decided you want to take a year out of training, and you’re going to carry out short-term locum jobs. But how can you ensure you’ll still be making progress that you can demonstrate to future employers, and keep fuelling your career progression?

In this article, we’ll discuss some useful tips and advice to help you make sure your time working as a locum doctor in short-term positions is still contributing to your long-term career.

Identifying the Challenges

There are a few perceived challenges with career progression for locum doctors, some more valid than others. Some of these may still be applicable and others are more akin to “old wives’ tales” nowadays.

So here are some of those perceived challenges, and our take on them...

“It’s a wasted year when you could have just been in training.”

“People who locum, rather than focus on their training, aren’t committed.”

It’s no longer the case that in order to progress to specialty training, you have to demonstrate your commitment by going straight into it without taking any time out.

A large proportion of Junior Doctors now choose to take time out of training to find work as Locum Doctors, Trust Grade Doctors or Clinical Fellows, especially for an F3 year. Following this year, most doctors are successful in applying for specialty training

Taking time out can even help you explore a specialty more and develop skills in that area, especially if you haven’t been able to get a specific rotation as a Foundation or core trainee. This could actually give you an advantage when it comes to applying, as long as you make the most of these experiences.

If you can explain how you’ve developed as a clinician, what extra experience and skills you’ve gained, and how this relates to the person specification, taking ayear out shouldn’t hold you back in any way at specialty applications or interviews.

“How can I get involved with projects that I can complete if I’m on a short-term contract?”

“If my contract is cancelled before I finish a project, then it’s been a waste of time.”

There are plenty of projects you can get involved with that can show you’re developing desirable skills, and that demonstrate commitment and enthusiasm for a specialty, that don’t have to take a long time to do!

If you want to take on a bigger piece of work, you might need to be flexible and willing to complete projects in your own time after your work there is done. This may be easier than you think, though, as a lot of work can be done remotely. It just depends how much you want to do the work compared to how much time you’re willing to spend on it.

Further on in this article, we’ll discuss examples of some of the projects you could get involved with (some of which you could do in just a day).

“You’re not a trainee, so everyone else will get priority for audits or projects over you.”

“You need to do a clinical fellowship or Trust grade job to get the same training and opportunities as trainees.”

Often a caveat to your contract as a Trust grade or equivalent will be that you’re there for service provision first. So trainees will often still get priority access to teaching sessions and other learning opportunities.

You’re not really at any disadvantage with locuming compared to Trust grades or clinical fellows, and you may even have more time to make the most of your CV-building opportunities because you’re not tied into a full-time rota or annual leave restrictions.

If you show that you’re keen from the beginning, your seniors will usually be very supportive in helping you find CV-building projects to get involved with. There are a huge number of Quality Improvement (QI) activities that go on in every department and usually not enough volunteers to help with them!

Try asking the audit or QI lead for any ongoing projects that require a junior doctor to help, and make sure all the consultants you meet know you’re looking as well.

You might identify a potential QI project from your work in the department that you’re keen to do. In this case, approach a senior for advice on how to get started.

Accessing Opportunities to Build Your CV

Being a locum doctor means you have more flexibility, and if you’ve chosen not to work full-time then it means you have more time to get involved with extra things. Some ideas for CV-building activities you could pursue are:

  👉  Audits

  👉  QI activity, such as Plan Do Study Act (PDSA) cycles

  👉  Writing up case reports on interesting cases

  👉  Research projects

  👉  Presenting at local meetings, like Morbidity & Mortality (M&M) meetings or case reviews

  👉  Teaching opportunities like departmental, medical student teaching, OSCE examining, or running courses

Some of these might become opportunities for national presentations or publications, which would give you another point of differentiation in specialty training applications.

You may also be able to use your spare time to attend skills courses and take any specialty exams that you want to take early. It’s best to take advice on this from current trainees you meet, as sometimes you may not get extra points on your specialty applications for doing exams early. Obviously you’ll incur the cost of it yourself if you’re not in training.

The Need to Apply to Specialty Training in Future

Taking a year out of training, or more, is no longer seen as a disadvantage for specialty training. In fact, as we’ve discussed above, there can be many advantages to your application from taking time out to explore your specialty in more depth.

However, you do need to be careful and read the guidelines on how much experience you can have in a particular specialty before you apply to CT1/ST1 level. For example, in Obstetrics and Gynaecology, you can only have up to 24 months’ experience before starting ST1 (not including Foundation modules), otherwise they expect you to complete the ST1/ST2 competencies and apply at ST3 level instead.

Taking a year out also gives you the opportunity to try out a different deanery that you may not have worked in before, if you’re thinking of preferencing that area for specialty training. This means you can confirm you want to live in the area, as well as having the benefit of preferencing your hospitals and rotations based on an informed decision rather than guess-work.

This also allows you the chance to make connections with consultants in your preferred region and specialty, so you’re able to build relationships with senior mentors, or even meet the Training Programme Director for the deanery, who can all advise you on maximising your application points and preparing for interviews.

Deciding Not to Apply to Specialty Training

There are many doctors who try locuming, or other work outside the NHS, and decide that starting specialty training isn’t actually for them.

“Career locums” are an example of this, where doctors work as long-term locums and choose not to enter training. They can often continue to progress in seniority despite not being in a training programme, as long as they can show that they meet the competencies for the level they’re working at.

If you decide to go this route, you can still change your mind at a later time and choose to re-enter training. You can sometimes also use the experience you’ve gained locuming as time spent towards your training, as long as you can show you’ve achieved the competencies expected for each level.

Check out our F3 Resource Hub for information about alternative careers for doctors, and for an upcoming interview with a career locum doctor!

Our Top Tips

    1. Be keen and get involved. Make sure everyone knows what you’re looking to achieve.

    2. Be prepared to give up a bit of spare time in exchange for a great project if you need to.

    3. Use the opportunity to make contacts for advice or mentoring, and try out regions you’re interested in for specialty training.

    4. If you want to continue locuming, look into your options for progression, and be sure to check out our upcoming interview with a career locum.

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If you follow the tips above, you should be able to make the most of your time locuming and build the career you want from the experience!

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Specialty-Specific Guides

We're also working hard to provide you with a guide for each of the main specialties, giving you tips on how to settle into those departments. These will be especially useful if you haven’t rotated through that specialty in your Foundation Training rotations before.

Tips for Locuming in a New Specialty – General Medicine

Tips for Locuming in a New Specialty – General Surgery

Tips for Locuming in a New Specialty – Orthopaedics

Tips for Locuming in a New Specialty – Paediatrics

Tips for Locuming in a New Specialty – Obstetrics & Gynaecology

Tips for Locuming in a New Specialty – Emergency Medicine

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This article is part of a wider series, supporting doctors like yourself with a comprehensive set of guides to ensure your F3 year is a success. These guides cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience. Click here to visit our F3 Resource Hub to explore the full list of guides and articles.

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