What is a Locum Doctor?

In the UK, the term ‘locum doctor’ refers to a doctor who temporarily fills a role within a hospital, practice, or clinic. The name locum comes from the Latin phrase, locum tenens, which means placeholder.

In this article, we’ll provide a detailed guide to working as a locum doctor, covering topics including why locums are needed, where they work, how you can become one, how much money you could earn locuming, and how this compares to a junior doctor’s salary.

We’ll also weigh up the pros and cons of working as a locum doctor, so you can get an understanding of whether locuming would be a good fit for you.

❓  What's the Purpose of Locum Doctors?

Locum doctors step in to work shifts that are unfilled on the hospital or clinic rota of full-time staff. These gaps in the rota can occur for any number of reasons, but are usually due to either long-term staff shortages or short-term illness.

Locum shifts are different to working in a training post (referred to as a trainee) or a doctor working on a permanent contract (referred to as a substantive post or a permanent post).

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❓  Where Can Locum Doctors Work?

Most work that you’ll find as a locum will be with the NHS, particularly in hospitals and GP practices across the UK. They’ll tend to come either through a Trust’s Staff Bank or through a locum recruitment agency. This will vary, from picking up occasional shifts on an ad hoc basis to longer-term locum placements that last a couple of months or longer.

Occasionally, hospitals and clinical practices outside the NHS (private practice) and even some non-medical companies hire locum doctors as well. These tend to be well paid with lower work intensities.

For instance, an HGV company may hire doctors to do basic medical examinations on their drivers. However, most of the opportunities here tend to be for experienced doctors who have completed training (post-CCT).

❓  Who Can Work as a Locum Doctor?

Anyone with a medical degree and full GMC registration can become a locum. However, there are some caveats to this:

Foundation Year 1 (F1) Doctors: If you’re an F1 doctor you’ll only have provisional registration with the GMC, and this limits where you can work. Whilst you can pick up additional shifts on top of your F1 rota work, you can only do that at your current hospital, at your current grade, and in a specialty you have experience (rotation) in.

IMGs on a Skilled Worker Visa (Formerly Tier 2): If you’re in this situation you’ll be limited to a maximum of 20 hours of additional work, which includes locuming. These hours must also be worked within the same occupation, and at the same level, as your sponsored post. More information about this can be found on the government website here. If you're an IMG looking for your first locum role in the NHS, then you'll find this article useful.

** Due to the COVID-19 situation, this 20-hour cap has been temporarily paused so doctors in this bracket can pick up as many shifts as they want.

It’s also worth noting that you can usually only apply for locum shifts at your current grade, and you’ll need relevant experience of the specialty you’re looking to locum in. For SHO shifts, this means you’ll need to have done a rotation in it during Foundation Training. But this isn’t always a hard rule, and certain specialties are more relaxed about it.

For more senior roles, you’ll need to supply evidence of your competencies or training within the required specialty.

❓  How Does the Clinical Work Vary Against a Permanent Role?

The service provision is the same, so you'll see the same patients and be expected to have similar levels of clinical competence.

Depending on the specialty and the grade of each shift, you may occasionally be required to join in on ward rounds, leading clinics, performing surgery, or clerking patients.

As you're not a permanent or full-time member of the team, you'll have less involvement in teaching. You also won't have any ongoing oversight or support in your development.

We've provided plenty of additional information about what you can expect from your career prospects and progression as a locum doctor here.

❓  How Can Locum Doctors Find Work?

If you become a locum doctor, you’ll technically be classed as freelance worker. This means you can work as many shifts as you choose to. You can also decide to work, or avoid, certain types of shifts, like day on-calls, nights, or weekends. A good place to get started is to read out article 'Your timeline for finding locum work'.

Locum shifts are usually offered in-house to Staff Bank doctors first, then offered out to locum agencies. You can read more about how hospitals, their Banks, and locum agencies work together in our article, How Hospitals and Locum Agencies Work Together.

👉  Finding Locum Shifts Through a Staff Bank

If you’re a doctor already working in a Trust, or registered to a Staff Bank, you can take extra shifts on your days off to cover rota gaps within the hospital or practice.

This is the easiest way, as you won’t need to register with an agency. It will also save you from having to learn any new hospital’s IT systems and clinical pathways.

You can find more information on finding work through a Staff Bank in this article.

👉  Finding Locum Shifts Through a Locum Agency

Another option is to work with a locum agency, which is essentially a recruitment agency which specialises in filling vacant hospital shifts with locum doctors.

If you register with an agency, you’ll be assigned a recruitment consultant who will be your dedicated representative. The good ones are experts who know the locum market inside-out, and they’ll guide you through the process of finding the best shifts.

They can tell you which hospitals have shifts that suit you, who pays the most, and where the work might be easier or more difficult. It’s a bit like working with an estate agent who understands the local area when looking to buy or rent a flat.

Having a good relationship with your recruitment agent is important, as they’ll be the person working to get your CV accepted by each Trust and helping you with things like negotiating how much you'll be paid.

Choosing agencies with good reputations, who can provide access to the types of shifts you’re looking for, is crucial for any locum. That’s why we’ve developed a new service to help you determine which agencies are best suited to your own unique situation and preferences, all before you make any commitment with them. Discover how it works here.

❓  How Much Are Locum Doctors Paid?

If you work as a locum, you’ll be paid considerably more than the equivalent junior doctor salary for someone with the same experience.

For a detailed breakdown of how much you can earn as a locum doctor, read our article on what to expect from locum rates. For advice on interpreting your locum payslips, click here.

You can also check out our Locum Doctor Salary Calculator to help you work out how much your could earn annually, based on your grade, specialty and region. You can use this to work out the answer to questions such as "Can I earn £100,000 as a Locum SHO?", "How many days a week will I need to work to match my F2 Salary?" amongst many others. To find out more about how it works, read this article here.

For tips on how to increase your locum pay, check out this article here.

❓  Is there an ideal time to become a locum doctor?

It’s becoming increasingly popular for doctors to take time out of training to spend a year or two as a locum. There’s not really any ideal time to do this, but most locums tend to be SHOs, particularly those doing F3 years.

The increase in popularity of becoming a locum is likely due to the greater control it gives you over your work hours, shift types, and how much you’ll earn.

An SHO working three days per week as locum will earn more than their equivalent in a full-time Trust or training grade post. With that in mind, it's now common for doctors to use this as an opportunity to save quickly for things like a house deposit or a year travelling.

If you’re currently an F2, have read through our helpful article here to explore whether taking an year F3 would suit you.

🤔  The Pros and Cons of Locuming

✅  Pros

📅  Flexibility - As a locum, you’ll have more control over when you work. It’s a great advantage to be able to set your own hours and days. You’ll never have to work a weekend or night shift again if don’t feel like it.

🏥  Location - You can choose where you work based on how far you’re willing to commute for a shift, offering more freedom and variety.

💰  Pay - You’ll enjoy a lucrative salary, potentially up to three times the amount you’d earn in a similar training role.

🌍  Freedom - As you won’t be tied into any long-term role in one location, you’ll have more time to travel or pursue other hobbies outside of work.

🥼  Specialty - You can gain experience in a specialty of your choice, using this to add to your core training portfolio.

❌  Cons

💣  Risk - There’s a risk that you might not find regular work, particularly if your circumstances mean you’re less flexible in terms of the specialties, locations, or work patterns you can commit to.

😷  Sick Pay and Rights - As a locum, you won’t be entitled to the same full set of rights as a trainee doctor. Read our guide to understanding your rights as a locum here for more information.

🏋️‍♀️  Teaching and Supervision - Locums don’t usually get to work with clinical supervisors or have any dedicated teaching time. However, you can still get impromptu teaching and advice from your seniors and consultants, especially if you make the effort to build a good relationship with them.

🚗  Hospitals - Most locum work is likely to be short-term or part-time contracts, which can result in commuting back-and-forth between different hospitals or practices each week. Here’s a useful guide to ensuring your first day in a new hospital goes as smoothly as possible.

🏢  Solitude - It’s easy to feel isolated when you’re working alone, turning up to a different hospital each week where the doctors all know each other well. If you enjoy the camaraderie and teamwork aspects of your job, locuming may not be ideal for you.

🔭  High Expectations - This is more true as you become more senior, but there are high expectations for you to hit the ground running and know exactly what you’re doing when you turn up to work a locum shift. This can be even more difficult when you’re learning to use an unfamiliar IT system at the same time as carrying out your duties.

💡  How Messly Can Help

To help you have the best possible experience as a locum doctor, Messly has created the new way to find locum work. Our free app lets you browse through the best shifts from only the best agencies before you share any personal details with anyone.

Once up and running, most doctors on Messly get pitched shifts tailored to their specific preferences by three or more agencies within 24 hours. More choice means better rates, less travel, and your pick of departments.

As a company founded by doctors, we’ll always put you first. Find out more about our free locum app here.

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This article is part of a wider series of resources and guides designed to support you as a locum doctor. Whether you need help starting out as a locum, finding the best agencies, or tips for managing your finances, we’ve got you covered. Click here to view all our locum-related articles on our Locum Doctor Hub.

And, if you're considering an F3 year, you might also want to check out our F3 Resource Hub, which features a comprehensive list of articles to help you understand your options and make the most of your year.