. . . but, you've got to have the right temperament and situation to get the most out of it.
I did locums for a year, straight out of residency, and it was the BEST thing I could have done. For me.
My wife was teaching overseas for a year and we weren't set on a place to settle down yet. I had a lot of job offers, but until you've really gotten out, into the work force, academic institutions are all you've known.
I was, essentially, single. I put all my stuff into storage, and was willing to go anywhere, so I cherry picked my hospitals and situations.
I worked at awesome hospitals, form tiny community based practices, to large regional centers, and learned a TON.
It was the best practice I could have had for the oral boards, because each job required me to be able to walk into a hospital, look at a list of cases for the next day, and be able to mentally run through the entire case, the issues I'd have to anticipate, and the equipment I'd want available.
I took a month off to travel to Africa, two weeks to go to a couple music festivals, another month to hit Australia and Africa again, and traveled across the US.
Can locums look bad on a C.V.? Sure, if you make it look like you couldn't get a job and HAD to do locums, but if you sell it as a time you took to experience different hospital settings and garner a greater breadth of experience, plus get over the "new attending jitters", you're rocking.
and truthfully, it makes a huge difference. No matter what practice you walk into, when it's your first step out of residency, you're going to make some rookie mistakes. It's inevitable.
I cut my teeth at the various places I did locums at, and after my first two positions, I felt solid, and when I signed on for my first job, I walked in as an attending, not a recent grad (first impressions make a big difference, especially if you're going private practice).
But, again, you've got to have the stomach for it. It's a bit nerve fraying the first week, when you're in a strange setting and feel like you're fending for your own.
Plus, you've got to learn how to pick out the bad locums gigs.
Here's the general philosophy. There's three settings that need locums:
Bad hospital: they're perpetually in need of locums, and are often hiring more than one at a time. There's inherently something wrong with this place, stay away. If you're thinking about applying to a locums gig in the middle of "fantastic large urban metropolis where everyone's already trying to work," it's probably a train wreck.
good hospital, bad location: This is the money shot. These are generally great places, but because they're more out of the way, have trouble attracting long term people to stay and staff the hospital. These can be cities of 100,000+, but still have trouble, just because of the location. They make great locums jobs, and that's where I spent most of my time.
Good Hospital, Good location: these are very rare, and usually just because someone's on maternity, disability, or extended vacation. Good hospitals in good locations never have to advertise for jobs, they've always got a line of people in waiting. If you're doing locums there, it'll likely only be temporary (but could always turn into a permanent position if they really like you).
They're few and far between though.
Agency vs doing it yourself?
If you're looking at doing it more long term or on your vacations: do it yourself.
If you're looking short term, want to take lots of trips, and don't want to worry about the organizing: get an agent.
I know someone's going to respond to this and say that locums looks like a black mark on your C.V., and to be fair, if your resume is kinda iffy then it probably will, and if your resume isn't that great, then you may struggle as a new grad with locums, so it's probably not your gig anyway.
I'd personally recommend locums to anyone graduating who has the right skills and mindset. It gives you a chance to do something they can't teach in residency, and that is learn to work in a diversity of settings, and how to practice anesthesia, not practice it just the way they did at your institution.
All I can say is, look around at all the people who've graduated a few years ahead of you and see how many of them worked themselves to the bone as part of a partnership track and are now looking for a new place because they hate their group, or the hospital, or were strung along, but didn't have the perspective at the time to realize what they were signing up for?
Locums was educational, and I banked a lot of cash too.
