How does locum tenems work function?

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Rumalum

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I am finishing up my residency and starting fellowship, but I am stuck in this cycle of not being able to save much with rent/loans and medical/dental bills because I only earn 40k after taxes. If my 17 year old car breaks down, I am ****ed. After 11 years of post secondary education and training, I want to actually earn money. How does locum tenems work logistically? It is possible to do something like that in fellowship (e.g. on weekends where I don't have call)

Cheers

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I am finishing up my residency and starting fellowship, but I am stuck in this cycle of not being able to save much with rent/loans and medical/dental bills because I only earn 40k after taxes. If my 17 year old car breaks down, I am ****ed. After 11 years of post secondary education and training, I want to actually earn money. How does locum tenems work logistically? It is possible to do something like that in fellowship (e.g. on weekends where I don't have call)

Cheers

If you want to make money 1) why did u do peds
2) why are u doing a peds fellowship
3) yes u can moonlight during fellowship on the weekend and potentially make some money
 
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I am finishing up my residency and starting fellowship, but I am stuck in this cycle of not being able to save much with rent/loans and medical/dental bills because I only earn 40k after taxes. If my 17 year old car breaks down, I am ****ed. After 11 years of post secondary education and training, I want to actually earn money. How does locum tenems work logistically? It is possible to do something like that in fellowship (e.g. on weekends where I don't have call)

Cheers
You can moonlight in residency and fellowship if your program director signs off on it. If you do it enough, moonlighting plus fellowship salary should clear about 100K. If you can’t live on that... you need to reassess your priorities.
 
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If you want to make money 1) why did u do peds
2) why are u doing a peds fellowship
3) yes u can moonlight during fellowship on the weekend and potentially make some money

You think you're gonna have enough time to moonlight as a fellow your first year? If you're doing a fellowship that'll make you more moolah (cards, PICU, NICU) you're probably gonna be zonked out when you're not on service. Peds ED might be the only one where you'd actually have time to moonlight first year.

Also, what he said, why did you do a peds fellowship if you're that desperate for money? Go work as a hospitalist for a couple years, make enough money to buy a car that's not 17 years old and then do fellowship like tons of other people do...
 
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I am finishing up my residency and starting fellowship, but I am stuck in this cycle of not being able to save much with rent/loans and medical/dental bills because I only earn 40k after taxes. If my 17 year old car breaks down, I am ****ed. After 11 years of post secondary education and training, I want to actually earn money. How does locum tenems work logistically? It is possible to do something like that in fellowship (e.g. on weekends where I don't have call)

Cheers

If you have a non-training license in the state in which you wish to work, then you can moonlight but only with the permission of your PD and assuming your fellowship is ACGME the moonlighting cannot violate work hours. This generally means moonlighting only when on research months but this does depend on your field and how much call it involves.

Most fellows moonlight within their own program, covering for example when a spot "resident" is needed for a variety of reasons. Doing outside work, as would usually be involved in a locum tenems job is less common and leads to issues related to malpractice coverage (usually covered by the sponsoring group) as well as conflicts if you are working at a competing institution. Regardless, this is something that needs some honest discussion with your PD about as well as a close look at your contract.
 
If you want to make money 1) why did u do peds
2) why are u doing a peds fellowship
3) yes u can moonlight during fellowship on the weekend and potentially make some money

Shucks, can I play this one? Even though I'm not the OP?

1. I like caring for kids more than adults. By a lot. There's plenty of money to be made and the job market is very secure for nearly all pediatricians and specialists. There are a few exceptions.
2. I did neonatology, look it up, fellowship adds to our salary considerably, although of course doing academics cuts that down.
3. With approval and a license of course. And "potentially"? I would hope that no one is moonlighting for free!
 
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Shucks, can I play this one? Even though I'm not the OP?

1. I like caring for kids more than adults. By a lot. There's plenty of money to be made and the job market is very secure for nearly all pediatricians and specialists. There are a few exceptions.
2. I did neonatology, look it up, fellowship adds to our salary considerably, although of course doing academics cuts that down.
3. With approval and a license of course. And "potentially"? I would hope that no one is moonlighting for free!

How much more do you make with fellowship? Let’s say general peds is making 200k what’s a neonatologist making these days?
 
How much more do you make with fellowship? Let’s say general peds is making 200k what’s a neonatologist making these days?

As per 2018 MGMA, in Midwest neonatology made in excess of 350k
 
So most other people have taken the "yes it's possible" answer off the table.

The bigger question is how are you going to actually do it.

Some hospital systems may actually have Gen Peds urgent care or hospitalist shifts available - which would likely be the easiest as you wouldn't have to travel and your program director is likely aware that their fellows have this opportunity. Credentialing should be easier, though depending on set up you might run into a small bit of wonkiness with your paychecks (hopefully not if this is a common thing for people to do).

If that's not an option, you'll need to find a company that will scout opportunities for you. Google "locum tenens general pediatrics" or "locum tenens job boards" and you'll come across a ton of different companies. When I was coming out of fellowship, I actually found a website (that I don't remember the name of now) where I put my name/info in and received calls from easily a dozen different locums companies with opportunities - some actually called me within hours of posting my info. You should do your due diligence though on companies though to figure out who is well regarded. (Personally, my favorite was CompHealth, but there are lots of options). You'll find that some of the recruiters just feel "off" and others don't follow up in a way that is useful.

Don't let recruiters bully you into positions that don't fit for you - whether it's location, hours, or payment rates. If there is some aspect that you don't want to do, be firm and clear (for example, as a PICU attending, when I was doing locums, I refused to do newborn nursery jobs, one company lied to me telling me it was a "pediatric hospitalist" spot and I ended up in a gig seeing nothing older than 72 hours). Whether it's supervising residents, taking calls, or certain volume, remember that they need you more than you need them. Also, if they come in below your expected pay rate, ask them to go back to the site to see if there is any wiggle room in the dollar amount.

If you are willing to travel out of state, make the locums companies handle all of your fees - whether it's an additional DEA number, state licenses, etc - you should not spend money on things to make you presentable. The only instances I can think where that would be worthwhile would be if you have an interest in doing work in a state that is notoriously slow for licensing (eg California or Texas, among others). Like if your parents live in Texas and you knew that you could just head home for a spot of time and do some sidework, then having that state license already would increase your opportunities. Many states that have a robust locums market actually have mechanisms in place to fast track licensing (Indiana is incredibly fast from personal experience).

Lastly, 100% do not tried to sidestep your fellowship director. Nothing good will come of it if your fellowship director doesn't feel like they can trust you. If they refuse initially, speak with them directly and lay out why you need this opportunity and show how it won't affect your work as a fellow.
 
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