The realities of working as an NHS locum Doctor.

Date: 30th April 2024Average Read Time: 3 mins

I quit working as a full-time Doctor after I completed my Foundation Training (FY1/FY2). 


There were a number of reasons why I made this decision which included.... 


I didn’t know which specialty I wanted to apply to. I was exhausted (& burnt out) after working through the pandemic. I really wanted to spend more time working on the business I started with my brother. 


I started working as a locum Doctor in A&E on BANK (i.e. employed directly by a trust).


I’ve continued to do this ever since. This is what I’ve learnt about life as a locum doctor...

1. You get to pick the shifts you work until there aren’t (m)any to pick from....

As a locum Doctor you have the flexibility to pick which shifts you work but you don’t always have the option to choose when those shifts will be. From my experience, locum staff are often needed over the weekends & holiday periods. You will need to be prepared to work these days if you want work. Similarly, there have been times when there aren’t any locums required.... You need to be prepared to choose from whatever shifts may (or may not be) available. 

2. You will be paid an hourly rate but you wont be guaranteed any hours.

A lot of Doctors consider working as a locum as there is the potential to earn a higher income; however, as a locum you are not guaranteed any hours. The amount you earn is determined by the amount you can work. This depends on how many shifts are available for you to work & which of those you can work. As a result of this, I’ve found that my income will vary significantly from one month to the next. This is something you really need to consider if you have certain outgoings each month! It might be that you need to consider additional income streams alongside the work you do as a locum. 

3. You will gain some benefits and you will lose others...

You won’t have to fight with HR to take annual leave as a locum Doctor which is a significant benefit (I remember how hard it was to find shift swaps for that pesky Wednesday mid-holiday) but you lose others. For example, you will unlikely be entitled to any sick pay, maternity leave or teaching grants. There are a few schemes available for sick pay & maternity leave but it’s very dependent on your circumstances. I personally find the flexibility I’ve gained by working as a locum outweighs the benefits I’ve lost but they are important things to consider.

4. You get to work anywhere but you might not feel like you’re working with anyone.

It’s exciting as a locum as you can work in different departments (depending on your experience) and in different hospitals. This exposure to different teams & patient populations can be really stimulating. However, this nomadic way of working can be isolating if you aren’t working in the same departments for very long. I’ve not experienced this personally, as I have worked in the same department for a number of years & really do feel part of the team but I can imagine it’s harder to form these relationships if you’re moving around frequently. 

As with any career decision, there are positives & negatives to working as a locum which will be unique to you. 


I decided to work as a locum doctor as this option aligned best with my career values, my goals & my circumstances. 


It’s not the only option though...


There are lots of different ways you can adjust your career as a doctor, especially when it comes to reducing your hours.


I think it’s important that we talk more about these different career paths as medics...


You don’t have to quit!


Did you know? I've written a guide which outlines the steps which helped me to decide what I needed to do to change my career as a doctor to better suit me. It will help anyone who is questioning their career, especially those who are considering different career options or looking for ways in which they can adapt their existing medical career to suit them. You can read more about it here. 

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