Locum Tenens After Graduation?

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doubledeuce80

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Hi All,
I will be finishing psychiatric training on July 1st and am trying to figure out creative ways to pay off my > 100k in loans as fast as possible. I'm geographically flexible (including international) and was thinking locum tenens positions might be a good way to go. I was hoping to get input from the board:

1. Has anybody on this board ever done a locum tenens position and if so, how was the experience? Anybody taken the plunge on the numerous New Zealand, Australia, and Middle-East opportunities listed online?

2. Are locum tenens positions, on average, more lucrative than what you can get starting a permanent position fresh out of training? As a point of reference, there are psych ER opportunities near me that pay $125 per/hr any shift or $163/hr 7p-7a shift (but those shifts are hard i.e. no sleep and I don't know how sustainable they are). Could I find a locum tenens position that paid more than this?

3. Any advice on reputable locum tenens staffing organizations? A google research reveals many different options.

Thanks!
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I'd like to know these answers too, even though I'm two years out.

$125 seems low no? I'm earning close to $100 per hour moonlighting.
 
I have had a good experience with locumtenens.com However, I am using them to find weekend psych ward coverage assignments.

The amount you are being offered for psych ER opportunities seems low (at least for an attending).

I think that locum tenens work is a good way of exploring the options before settling in to a full-time position. However, be aware that the agency takes a cut if you take a position somewhere that you did locums work (the cut is paid by the employer but it still comes out of $ that could have gone to you).
 
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doubledeuce80 said:
Hi All,
I will be finishing psychiatric training on July 1st and am trying to figure out creative ways to pay off my > 100k in loans as fast as possible. I'm geographically flexible (including international) and was thinking locum tenens positions might be a good way to go.
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There are lots of advertisements for jobs at $300K/year from the various locum sites. If you're geographically flexible and really motivated, doing one for one year could be enough to pay off your debt.

The overseas gigs in NZ and scandanavia pay less than domestically.
 
Typically, you're going to see locums offering 120-130/hr to start, for psych. Try to find sign-on bonus monies too or look for a job with significant student loan reimbursement.
 
Leo Aquarius said:
I'd like to know these answers too, even though I'm two years out.

$125 seems low no? I'm earning close to $100 per hour moonlighting.
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yes, but you aren't going through an agency either. Many employers looking for locums people only go through agencies, and after everything is added up the agency takes a *big* cut.

125/hr in terms of what is actually paid to the psychiatrists in locums work isn't low. But a lot of it will depend on things like whether housing was provided, mileage/travel, etc.....

Apart from this though locums work is generally crappy, high volume, and stressful(if it's a full time gig and not occasional weekend work, which I don't really consider true locums). I wouldn't want to do it.
 
With experience, you'll command more money. Particularly if you develop a reputation for excellence.
 
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michaelrack said:
I have had a good experience with locumtenens.com However, I am using them to find weekend psych ward coverage assignments.

The amount you are being offered for psych ER opportunities seems low (at least for an attending).

I think that locum tenens work is a good way of exploring the options before settling in to a full-time position. However, be aware that the agency takes a cut if you take a position somewhere that you did locums work (the cut is paid by the employer but it still comes out of $ that could have gone to you).
Click to expand...


Thanks for the feedback guys! I'm surprised, 163$/hr is the highest hourly rate I've ever seen for a psych ER job. What kind of rates do you consider good/have you received?
 
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Anyone know hourly rates for locums work in rural areas for psychiatrists?
 
Leo Aquarius said:
Anyone know hourly rates for locums work in rural areas for psychiatrists?
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the hourly rate for a position I just go in my gmail inbox 10 minutes ago in rural northwest Alabama is 110/hr....of course who knows the total they are paying the agency.
 
Thanks.
 
Does anyone know the names of the locums agencies that offer jobs in Scandinavia and the Middle East which were both mentioned above?

Anyone with experience working in the Persian Gulf area? Locums or otherwise?
 
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Trismegistus4 said:
Just got a VM from a headhunter saying I could make between $35k and $45k per month providing coverage. Any idea what the catch might be?
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It's coverage for a crack dealer?
 
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Trismegistus4 said:
Just got a VM from a headhunter saying I could make between $35k and $45k per month providing coverage. Any idea what the catch might be?
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for something like that, there isn't a catch....there are catches. My guess(and almost certainly two apply):

1) realistically, it doesn't pay anything close to that. I get emails all the time with big salary figures in the title, and when you call the money is never that. Sort of like how it's also harder for stay at home moms to make 8500/month working 15 hrs a week at home, despite what the ads on tv say:)

2) it's work that isn't ethical and possibly illegal

3) the pace you are expected to work is not humane for you or patients.

these are undesirable positions for a reason people.
 
vistaril said:
these are undesirable positions for a reason people.
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I agree with this.

Every now and then, a great opportunity comes up at a location. You tell your old program director, old residency-mates, and colleagues you respect and it likely fills that way. If an amazing-paying job has to be filled by a headhunter who is making honest-to-god cold calls, that's not a good sign.
 
notdeadyet said:
I agree with this.

Every now and then, a great opportunity comes up at a location. You tell your old program director, old residency-mates, and colleagues you respect and it likely fills that way.
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agreed, but the great opportunity is likely great(which is a relative word in mh today) not because of the salary but because of the clinical potential within the job. And the non grindhouse feel. And not the fact that it is great because of the pay.
 
nancysinatra said:
Does anyone know the names of the locums agencies that offer jobs in Scandinavia and the Middle East which were both mentioned above?

Anyone with experience working in the Persian Gulf area? Locums or otherwise?
Click to expand...

I've been looking into a Qatar position for addiction psychiatrists on locum tenens.com and recruiter is hermann medical staffing germany. haven't heard back about specifics yet, but will post when I do
 
michaelrack said:
certainly possible, but you will be working a lot of hours, event if your hourly rate is in the $150-$175 range with extra $ for call.
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Even so, I'm having trouble imaging how a psychiatrist could generate enough revenue to justify paying him that much.

daru1 said:
Rural Pennsylvania is 135-165
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For what? Inpatient, outpatient, ER?
 
Trismegistus4 said:
Even so, I'm having trouble imaging how a psychiatrist could generate enough revenue to justify paying him that much.

?
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Inpt psych units can't operate without a psychiatrist covering, and may be willing to supplement a psychiatrist's pay with money from bed fees, room charges, labs, etc.
 
Trismegistus4 said:
Even so, I'm having trouble imaging how a psychiatrist could generate enough revenue to justify paying him that much.
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you need to imagine harder......you could easily get to 40 rvu's covering a bunch(think 25+) of inpatient beds if there are a few discharges per day, 4 admissions per day, etc.....it wouldn't resemble quality work in any way(some would say it wouldn't be ethical or honest), but you could do it.....

of course the internist taking that same approach and doing in hospital work could easily hit 75 rvus or some insane number like that.
 
Ethics and honesty aside, there is something appealing about the idea of taking one of these horrible-but-high-paying jobs for like 6 months just to get all my loans paid off. Probably not enough that I would actually do it, but something nonetheless.

On a somewhat different note, one of the possibilities of locum tenens that appeals to me, if I'm still unencumbered by a wife and family when I graduate, and thus don't have a particular need to maximize my income, is the prospect of taking large chunks of time off. E.g, working 6-8 week gigs interspersed with periods of 3-4 weeks in between not working. Anyone ever seen this done or have any thoughts on the feasibility of this?
 
Trismegistus4 said:
Ethics and honesty aside, there is something appealing about the idea of taking one of these horrible-but-high-paying jobs for like 6 months just to get all my loans paid off. Probably not enough that I would actually do it, but something nonetheless.

On a somewhat different note, one of the possibilities of locum tenens that appeals to me, if I'm still unencumbered by a wife and family when I graduate, and thus don't have a particular need to maximize my income, is the prospect of taking large chunks of time off. E.g, working 6-8 week gigs interspersed with periods of 3-4 weeks in between not working. Anyone ever seen this done or have any thoughts on the feasibility of this?
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are you in psych? I cant speak for locums work in other fields, but in psych you aren't going to get rich with locums. Simply because the hours tend to be fairly limited(usually 8/day) and so much of your hourly rage is going to the tenems company.

I contacted them all......comphealth, barton, onyx, locumtenems.com. etc.....rates paid(1099) to the board certified psychs start at around 100/hr, cap at pretty much 140/150, and the average was around 115...again, that was after the company got their cut. You have to consider that. Also, these jobs are typically NOT GOOD jobs.
 
vistaril said:
are you in psych? I cant speak for locums work in other fields, but in psych you aren't going to get rich with locums. Simply because the hours tend to be fairly limited(usually 8/day) and so much of your hourly rage is going to the tenems company.

I contacted them all......comphealth, barton, onyx, locumtenems.com. etc.....rates paid(1099) to the board certified psychs start at around 100/hr, cap at pretty much 140/150, and the average was around 115...again, that was after the company got their cut. You have to consider that. Also, these jobs are typically NOT GOOD jobs.
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Sheesh, give it a rest, will ya? I don't post here often, but I'm beginning to understand other posters' exasperation with you. Who said anything about getting rich? I specifically said that if I don't have a wife and family I don't particularly need to earn a lot of money. What exactly do you think you're accomplishing posting this crap in every thread without even bothering to notice whether it's relevant?
 
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vistaril said:
are you in psych? I cant speak for locums work in other fields, but in psych you aren't going to get rich with locums. Simply because the hours tend to be fairly limited(usually 8/day) and so much of your hourly rage is going to the tenems company.

I contacted them all......comphealth, barton, onyx, locumtenems.com. etc.....rates paid(1099) to the board certified psychs start at around 100/hr, cap at pretty much 140/150, and the average was around 115...
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If those are the best jobs you're able to find, that's just pitiful....

Trismegistus4- You will find some coverage gigs that last weeks, but most of the advertised locum tenens gigs that pay well are looking for longer commitments. You can definitely negotiate a 6 month contract, and many have done just that. This is particularly true for the high paying/desperate jobs. You will find that many of them are in either undesirable locales or are very busy (neither of which is too bad a gig for someone looking to put their nose down and work off their debt as quickly as possible). You can find many jobs for well over $200K advertised and many have opportunities for extra coverage. Even in desirable locations, you will get some great gigs (though I presume there might be competition for it). I just talked with someone about one for $280K/year in coastal northern california. The catch is that it's a 50 hour/week job that many folks wouldn't want to work, but if you wanted to just plow away and burn off debt for a year, it would be quite do-able.

Don't get scared off by vistaril. I don't know why he's finding 1099 gigs for $100/hour but you can double that in other places moonlighting, for chrissake. I have only seen weeks-long locum gigs through the grapevine, though (e.g.: word-of-mouth of folks looking for someone). I'm sure they exist, but might not be as easy as setting up something for 6 months.
 
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There are plenty of locum jobs that pay lower/hr but includes call when you may be sleeping. One I've seen is covering admits, problems, and up to 10 follow-ups on a 150 bed facility. $4800 for 48 hours call. A psych doc I know there also rounds on other patients making an additional 2k the same weekend. That's $6600 in 2 days.

Another is at a 60 bed facility where your pay is tied to how busy it is. It pays for a nice call room, food, and probably about $2500/48 hours. Much less busy and can involve lots of down time, hitting the movie theatre, etc.

If you mix enough of these gigs together, you can explore a bunch of cities and get paid a decent rate to do so. I wouldn't say many gigs are of a great hourly rate, but i could see the appeal.
 
notdeadyet said:
Don't get scared off by vistaril. I don't know why he's finding 1099 gigs for $100/hour but you can double that in other places moonlighting, for chrissake. I have only seen weeks-long locum gigs through the grapevine, though (e.g.: word-of-mouth of folks looking for someone). I'm sure they exist, but might not be as easy as setting up something for 6 months.
Click to expand...

I had a 1099 gig as a medical student that paid $150-$200/hr, depending on how hard you worked. While he enjoys his pessimism, I'll enjoy the opportunity and leave it for him to find alternate reasons why good paying gigs exist.
 
notdeadyet said:
Trismegistus4- You will find some coverage gigs that last weeks, but most of the advertised locum tenens gigs that pay well are looking for longer commitments. You can definitely negotiate a 6 month contract, and many have done just that. This is particularly true for the high paying/desperate jobs. You will find that many of them are in either undesirable locales or are very busy (neither of which is too bad a gig for someone looking to put their nose down and work off their debt as quickly as possible). You can find many jobs for well over $200K advertised and many have opportunities for extra coverage. Even in desirable locations, you will get some great gigs (though I presume there might be competition for it). I just talked with someone about one for $280K/year in coastal northern california. The catch is that it's a 50 hour/week job that many folks wouldn't want to work, but if you wanted to just plow away and burn off debt for a year, it would be quite do-able.
Click to expand...

Update: I went to the APA annual meeting last week and stopped by a few of the locums/recruiting company booths. They said that the international gigs (Australia, New Zealand) were 6 months or 1 year, but domestic gigs were a few weeks to a few months.
 
what is this 1099 gig that i see thrown around on these locum threads? Isnt that some tax form?
 
I know a moonlighting job at a county hospital of a really horrible part of a really desirable city that pays $200 an hour for psych ER coverage.

Vis is wrong. I scope out job listings myself on occasion and have called in the past. Full time jobs in major metros for fresh grads now start >$200k. This is also pushing up academic salaries. $150+ per hour for weekend more typical for inpatient coverage/psych ER. If you want to pay off 100k of debt, which is actually below average, I don't think there's a significant advantage to 100% locum.

The other thing to look is public facilities. I know in my area prisons and state hospitals are often looking for overnight/weekend coverage, and pay higher than expected rates. However, they usually want a known item rather than hire out, because it can be a shock if you've never worked in that environment. If you have, however, the gig can be very sweet depending on the person. For example, at some state hospitals, you cover 30-50 patients, but, each only has to be seen once a month, and on average there's one admission per month. You can imagine what kind of work day those folks have.

Finally, a new thing that's getting bigger is telepsych. I was at APA a few years ago and there are agencies now specifically for nursing homes/rural, etc. do a quick search and you'll find them, but they want a # of hours commitment per month. Also pays around $150 an hour as far as I know. One could imagine a life of working 20 hours a week living on a tropical island...
 
asdf123g said:
what is this 1099 gig that i see thrown around on these locum threads? Isnt that some tax form?
Click to expand...
Yes. A 1099 gig is contractor work (as opposed to a W-2 job, which is salary).

1099 doesn't withhold taxes or benefits, so it should command a higher pay than the salary for comparable W-2 work.

With 1099's higher pay, you need to carve out money for health insurance, retirement, vacations, etc. You have some advantages in writing off expenses, since you are functioning as your own business.

For many folks, the ideal is often a mix of W-2 (for the stability and benefits) and at least a little 1099 (for the write-offs).
 
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sluox said:
I know a moonlighting job at a county hospital of a really horrible part of a really desirable city that pays $200 an hour for psych ER coverage.

Vis is wrong. I scope out job listings myself on occasion and have called in the past. Full time jobs in major metros for fresh grads now start >$200k. This is also pushing up academic salaries. $150+ per hour for weekend more typical for inpatient coverage/psych ER. If you want to pay off 100k of debt, which is actually below average, I don't think there's a significant advantage to 100% locum.

The other thing to look is public facilities. I know in my area prisons and state hospitals are often looking for overnight/weekend coverage, and pay higher than expected rates. However, they usually want a known item rather than hire out, because it can be a shock if you've never worked in that environment. If you have, however, the gig can be very sweet depending on the person. For example, at some state hospitals, you cover 30-50 patients, but, each only has to be seen once a month, and on average there's one admission per month. You can imagine what kind of work day those folks have.

Finally, a new thing that's getting bigger is telepsych. I was at APA a few years ago and there are agencies now specifically for nursing homes/rural, etc. do a quick search and you'll find them, but they want a # of hours commitment per month. Also pays around $150 an hour as far as I know. One could imagine a life of working 20 hours a week living on a tropical island...
Click to expand...

How are people not fighting tooth and nail for these tele psych jobs? 150/hr to work from home? Are they super competitive to land?
 
sluox said:
I know a moonlighting job at a county hospital of a really horrible part of a really desirable city that pays $200 an hour for psych ER coverage.

Vis is wrong. I scope out job listings myself on occasion and have called in the past. Full time jobs in major metros for fresh grads now start >$200k. This is also pushing up academic salaries. $150+ per hour for weekend more typical for inpatient coverage/psych ER. If you want to pay off 100k of debt, which is actually below average, I don't think there's a significant advantage to 100% locum.

The other thing to look is public facilities. I know in my area prisons and state hospitals are often looking for overnight/weekend coverage, and pay higher than expected rates. However, they usually want a known item rather than hire out, because it can be a shock if you've never worked in that environment. If you have, however, the gig can be very sweet depending on the person. For example, at some state hospitals, you cover 30-50 patients, but, each only has to be seen once a month, and on average there's one admission per month. You can imagine what kind of work day those folks have.

Finally, a new thing that's getting bigger is telepsych. I was at APA a few years ago and there are agencies now specifically for nursing homes/rural, etc. do a quick search and you'll find them, but they want a # of hours commitment per month. Also pays around $150 an hour as far as I know. One could imagine a life of working 20 hours a week living on a tropical island...
Click to expand...

Would it be reasonable to think I could grab a job in a nice city, making at least 200k fresh out of residency AND string together tele psych and maybe a weekend locums gig? Just wondering how feasible it is for a new grad to make 300k..
 
vistaril said:
are you in psych? I cant speak for locums work in other fields, but in psych you aren't going to get rich with locums. Simply because the hours tend to be fairly limited(usually 8/day) and so much of your hourly rage is going to the tenems company.

I contacted them all......comphealth, barton, onyx, locumtenems.com. etc.....rates paid(1099) to the board certified psychs start at around 100/hr, cap at pretty much 140/150, and the average was around 115...again, that was after the company got their cut. You have to consider that. Also, these jobs are typically NOT GOOD jobs.
Click to expand...
Returned to this thread after someone "liked" my response to this, and thought I'd provide an update now that I have some experience doing locums. I can now say with even greater certainty that vistaril doesn't know what he's talking about, just makes crap up, and people should probably just put him on their ignore list. The lowest rate I have worked for is $130 an hour, and that was in the infamously saturated, [relatively] low-paying Boston-Washington corridor. And that was when I wasn't yet board certified, fresh out of residency. A "cap" at 140/150, or an average of 115, is a joke. I'm currently getting $160, and the next gig I have lined up pays $168. A more experienced psychiatrist at this place was shocked when he heard that number because it's so low; he thinks I'm a fool for accepting it and says that he refuses to work for less than $200.

Also, about the hours being limited to 8/day thing, I spoke with a recruiter at a different company who kept trying to pressure me into taking a job that entailed lots of overtime, so I could make (and of course they could make) tons of extra money. They paid a higher rate once you worked beyond 8 hours, so that kind of gig is available if you want it. She was so obsessed with me taking such a job that even after I told her I wanted to stick to 8 hours a day, she sent me a follow-up email about a different job which contained the following (I'm literally copying and pasting this from my email):

The doctor who is there now that is leaving had the following paychecks for 2 week pay periods: $27,600 $20,000 $26,050 $21,000 $24,150. He worked about 12 hours/day ​
 
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Trismegistus4 said:
Returned to this thread after someone "liked" my response to this, and thought I'd provide an update now that I have some experience doing locums. I can now say with even greater certainty that vistaril doesn't know what he's talking about, just makes crap up, and people should probably just put him on their ignore list. The lowest rate I have worked for is $130 an hour, and that was in the infamously saturated, [relatively] low-paying Boston-Washington corridor. And that was when I wasn't yet board certified, fresh out of residency. A "cap" at 140/150, or an average of 115, is a joke. I'm currently getting $160, and the next gig I have lined up pays $168. A more experienced psychiatrist at this place was shocked when he heard that number because it's so low; he thinks I'm a fool for accepting it and says that he refuses to work for less than $200.

Also, about the hours being limited to 8/day thing, I spoke with a recruiter at a different company who kept trying to pressure me into taking a job that entailed lots of overtime, so I could make (and of course they could make) tons of extra money. They paid a higher rate once you worked beyond 8 hours, so that kind of gig is available if you want it. She was so obsessed with me taking such a job that even after I told her I wanted to stick to 8 hours a day, she sent me a follow-up email about a different job which contained the following (I'm literally copying and pasting this from my email):

The doctor who is there now that is leaving had the following paychecks for 2 week pay periods: $27,600 $20,000 $26,050 $21,000 $24,150. He worked about 12 hours/day .​
Click to expand...
do you know how other specialties compare in terms of compensation for locums? Im wondering if some get better rates just based on the specialty for whatever reason that may be. Know any way I can figure to the answer to my question??
 
Trismegistus4 said:
She was so obsessed with me taking such a job that even after I told her I wanted to stick to 8 hours a day, she sent me a follow-up email about a different job which contained the following (I'm literally copying and pasting this from my email):

The doctor who is there now that is leaving had the following paychecks for 2 week pay periods: $27,600 $20,000 $26,050 $21,000 $24,150. He worked about 12 hours/day .​
Click to expand...

Wow.
 
surfguy84 said:
Would it be reasonable to think I could grab a job in a nice city, making at least 200k fresh out of residency AND string together tele psych and maybe a weekend locums gig? Just wondering how feasible it is for a new grad to make 300k..
Click to expand...

This happens and isn't difficult to arrange. Take an example of my colleague. He got an inpatient job for 200k, and often gets a few hours off in the PM to do outpatient in a faculty practice style office suite. He makes another 30-50k. He then works on weekends one or two weekends a month for 3-5k each for one or two day shifts. It pushes the total income close to 300k. However, averaging it out you would be working consistently 55-65hours a week, occasionally more. However, we all know weekend call at a community hospital is not particularly intense.
 
sluox said:
This happens and isn't difficult to arrange. Take an example of my colleague. He got an inpatient job for 200k, and often gets a few hours off in the PM to do outpatient in a faculty practice style office suite. He makes another 30-50k. He then works on weekends one or two weekends a month for 3-5k each for one or two day shifts. It pushes the total income close to 300k. However, averaging it out you would be working consistently 55-65hours a week, occasionally more. However, we all know weekend call at a community hospital is not particularly intense.
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Pretty low for Inpt. Saw a job as a inpt hospitalist. 7 on/7 off for 300+/yr
 
Shikima said:
Pretty low for Inpt. Saw a job as a inpt hospitalist. 7 on/7 off for 300+/yr
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yeah but his job is academic in a major desirable metro in the NE. the salary number is considered "pretty good" by everyone... the new inpt jobs this year i saw on the market in second tier hospitals in the same city (i.e. not main academic center) are in the 230k range. (lol the recruiter called me multiple times and after he gave me the numbers i was like uh, no i'm not on the market don't send anyone my CV...not interested...personally wouldn't do inpatient for <300k) saw a similar mix in Minnesota for 325k "base".

although, i'm starting to think that the facilities that are putting up a higher front investments are really looking for quality people, and therefore not everyone would be able to get these spots...not sure the "average" psych resident would be able to land a gig like that...
 
sluox said:
yeah but his job is academic in a major desirable metro in the NE. the salary number is considered "pretty good" by everyone... the new inpt jobs this year i saw on the market in second tier hospitals in the same city (i.e. not main academic center) are in the 230k range. (lol the recruiter called me multiple times and after he gave me the numbers i was like uh, no i'm not on the market don't send anyone my CV...not interested...personally wouldn't do inpatient for <300k) saw a similar mix in Minnesota for 325k "base".

although, i'm starting to think that the facilities that are putting up a higher front investments are really looking for quality people, and therefore not everyone would be able to get these spots...not sure the "average" psych resident would be able to land a gig like that...
Click to expand...

Anyone can land anything. It's a matter of patience.
 
asdf123g said:
do you know how other specialties compare in terms of compensation for locums? Im wondering if some get better rates just based on the specialty for whatever reason that may be. Know any way I can figure to the answer to my question??.
Click to expand...
Maybe start a thread in one of the other specialty forums?

NickNaylor said:
Wow..
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It was in the middle of nowhere, and like she said, the doc who made that much was averaging 12 hour days. But, if you wanted to do that kind of work to pay off student loans, or save up a massive down payment for a house or whatever, that kind of gig is available.

Also, to counter yet another bit of misinformation given by vistaril upthread, locum tenens agencies always pay for housing, a rental car, travel to/from the assignment, and malpractice insurance.
 
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Trismegistus4 said:
Maybe start a thread in one of the other specialty forums?

.
It was in the middle of nowhere, and like she said, the doc who made that much was averaging 12 hour days. But, if you wanted to do that kind of work to pay off student loans, or save up a massive down payment for a house or whatever, that kind of gig is available.

Also, to counter yet another bit of misinformation given by vistaril upthread, locum tenens agencies always pay for housing, a rental car, travel to/from the assignment, and malpractice insurance.
Click to expand...

I could live with 12 hours/day x 5 days/week for a brief amount of time for that income. If it's 6-7 days, though, that's something else altogether.
 
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