Part 4: Starting Your Locum Tenens Career

In Part 4 of Locumpedia’s No-BS Guide to Locum Tenens we’ll cover:

• The difference between a CV vs. a resume
• Writing a stellar locum tenens CV
• Interviewing for locum tenens jobs
• Licensing and credentialing
• Earning supplemental income with locum tenens

Let’s start by saying that because a locum tenens physician or clinician must meet the same standards as any of his/her peers, finding a locum tenens job really doesn’t differ that much from finding a “permanent,” full-time physician job.

Locum tenens physicians (and advanced practice clinicians) go through background, licensing, credentialing and reference checks over and over — which, essentially, requires them to be even more thorough and transparent than the clinicians whose jobs they would cover.

So, locum tenens clinicians must be uber-qualified and well-organized to pass muster with reputable locum tenens staffing firms or with licensed healthcare employers. To try locum tenens — or to become a career locum tenens physician/clinician — you must have your act together and be able to prove it.

Also, don’t expect you’re going to talk to an agency or healthcare facility recruiter one week and start the assignment the next. In The Locum Tenens Guy’s Guide to Locum Tenens, Vladimir Dzhashi, MD, advises you to ‘contact agencies or hospitals you want to work with at least 4 months before your planned start date to secure the job and finalize credentialing.’

HOWEVER, before you make a list of agencies to call immediately, you need to create a “CV” (curriculum vitae) or a resume and gather copies of all licenses and certificates that validate what’s on your CV/resume.

As we mentioned in Part 3 of our guide, pretty much every job searcher knows he/she needs a resume or a CV. There’s an ASTOUNDING number of websites, or sections of websites, designed to walk you through the process of creating one, the other or both. So, what’s the difference between a CV and a resume?

The American Medical Association (AMA) distinguishes between the two as follows: “A curriculum vitae (CV) is used by professionals in the fields of academia, medicine, teaching and research as an overview of accomplishments that are relevant to the academic realm. Accordingly, it should be updated frequently to reflect your career’s development.

“There are notable differences between a CV and a résumé, including:

• Education is always listed first on a CV.
• A CV rarely lists an objective or has a long narrative profile. If you would like to explain why you are an ideal candidate for this position, include this as part of your cover letter.
• Name-dropping is more common in a CV than in a résumé. For example, if you performed research under a certain professor, you would include his or her name and title.
• Unlike a résumé, a CV can run for 3 or more pages; however, the length of a CV alone is not what makes it successful. You should present the most relevant information in a concise, understated manner and avoid being self-congratulatory.
• A CV should be neatly organized with clear headings and distinct conceptual divisions. Experience may be divided between headings such as “Teaching” or “Research”; education may be divided between “Degrees” and “Advanced Training” or similar.
• Bulleted points are commonly used in a résumé, but less common in a CV.”

According to Indeed.com, “The differences between a resume and a CV include the document’s length, contents and purpose. You should also consider which region of the world you’re applying in and your career path when deciding which is more appropriate to use.

“Most notably, in the US a resume should be a concise and curated collection of your professional experience, skills and qualifications that are strictly relevant to the job you’re applying for. In contrast, a CV presents an in-depth history of your professional and academic credentials and accomplishments.” Some of their main differences include the following:

• “Length”
  Tailored to a specific role, a resume should be limited to one or two pages, Indeed suggests, while a CV can be longer and “more detailed, including descriptions of coursework, research, publications or presentations.”
• “Experience/Career Type”
  Indeed indicates, “CVs are mostly used to apply for academic roles or programs, grants, fellowships and research or teaching positions…Resumes are used for jobs…in the private or public sectors, often referred to as ‘industry positions,’ in contrast to academia.”
• “Geographic Location”
  Indeed’s take: ‘In regions of the world like the UK, New Zealand and parts of Europe, employers use the term “CV” to describe both types of documents and don’t use the term “resume” at all. “In South Africa, Australia and India, the terms ‘CV’ and ‘resume’ are often used interchangeably. But, in the US, a resume and CV are two distinctly different types of documents used for different purposes.”

For readers at the front of the job-seekers class, reviewing our tips for creating a resume might just put you to sleep — and maybe even prevent you from reading the second half of our ‘No-BS Guide.’ You have our permission to scroll on through this material.

Let the rest of the class be forewarned: we’re about to quote “freelance healthcare writers” whose work ‘should not be construed as coming from, or representing the views of, the New England Journal of Medicine or the Massachusetts Medical Society.’ (However, we found the material, “produced by freelance healthcare writers as an advertising service of the publishing division of the Massachusetts Medical Society,” here — and we think it’s pretty good advice.)

Complete, Simple, Succinct

The subhead for an article published in the New England Journal of Medicine’s online Career Center summarizes the CV-writing task effectively: “Simple format, brevity and absolute accuracy — and avoiding including extraneous details — are musts.”

Seasoned healthcare journalist Bonnie Darves begins her well-researched advice observing, “Physician residents and fellows who start writing their curriculum vitae (CV) usually approach the task expecting it will be a straightforward matter of letting the world know where they’ve been and what they’ve done, in a document that is about three pages in length.”

Darves notes that, while this is about right theoretically, “many young physicians, especially those about to launch their first job search(es), quickly find themselves sweating the details,” about how to create “a document that sets them apart from the crowd.”

Recruiters and hiring physicians tend to appreciate a bit of “fretting about getting it right,” Darves says, since they see too many CVs in which candidates fail to proof or polish, or to accurately convey important accomplishments.

“Ideally, everything that is on your work calendar should be on your CV, and there should be a brief description and timeline of those roles or assignments,” an administrator with the Indiana University School of Medicine told Darves. In his experience, many applicants leave out differentiating details like committee work, quality-improvement-initiative involvement, medical student teaching or mentoring, or even assistance on a hospital IT project.

While residents usually include their research work, they tend to omit “quasi-extracurricular activities,” that demonstrate their willingness to go above and beyond what’s required, the administrator told Darves.

Format: KISS

Polishing, proofing and producing a CV that makes the cut doesn’t conflict with ‘keep(ing) it simple, stupid (KISS).’

Darves says the CV should be composed “in a simple sans serif font and an easily readable font size — at least 11 or 12 points — and physicians should stick to a single font and size, and a very simple presentation format,” Darves writes. She quotes the IU med school administrator as admonishing candidates to “remember this isn’t an art contest.”

Echoing that sentiment, a health system recruiter told Darves that what she termed “a busy CV (e.g., one with graphics)” can even raise suspicion the candidate is trying to hide performance issues or other problems.

Experts with whom Darves spoke recommended residents use “a decent-quality paper stock — something slightly heavier than 20 lb. bond copier paper — but nothing dense, elaborate or textured” when preparing hard copies of their CVs to hand out at conferences or job fairs.

Content: Honest and Tight

More importantly, Darves’ research confirms what we guessed: most medical training programs can recommend CV templates for physicians seeking structural guidance. For those seeking an initial practice opportunity, she suggests the following content and ordering of information:

• Name and contact information
• Education — undergraduate through internships, residencies, and fellowships — including specific clinical roles and any leadership roles
• Licensure (status of applications planned or underway, if any)
• Board certification or status
• Professional experience (medicine-related only), including procedure and patient volumes as applicable to the specialty, along with administrative roles or duties
• Activities and committee memberships, including roles and brief descriptions of associated accomplishments
• Honors, awards, and professional affiliations
• Publications and presentations

Careers by Kevin MD.com offers similar advice, noting: “Although a CV generally contains more information than a standard resume, the keys to a successful CV are still brevity and a stellar list of accomplishments.”

In a February 2, 2019, article on KevinMD.com writer Eve Harris offers a list of CV content in a slightly different order than Darves suggests. “After contact information,” she says, “a physician’s CV should include

• Education (school name, school location, degree earned, graduation dates)
• Academic Honors/Activities/Leadership Positions
• Research
• Internships/Clinics/Residencies/Fellowships (employer name, employer location, specialty area, dates)
• Practice Experience (name of practice/hospital, location, title, type of practice, brief description)
• Specialty Area
• Publications
• Presentations
• Professional Memberships
• Licensure/Board Certification
• Other Work Experience (employer name, employer location, title, dates of employment, brief job description)
• Professional Awards/Honors
• Language Skills

“Also, if you’re a foreign medical graduate, list your citizenship/visa status. Being forthcoming shows a potential employer that you are honest and, if necessary, ready to make the visa process as smooth as possible for them,” Harris writes.

All dated entries should be reverse-chronologically listed (from present to past) in a month/year format. Darves’ sources agreed physicians should be prepared to explain any gap of more than three months in a cover letter or conversation; they should never attempt to cover up a gap.

One medical-group CEO told Darves of a candidate who spent a year working in an emergency room before starting medical school and another who took a year off during his training to care for his dying mother. “Most of the time, it’s just a matter of letting people know why there’s a gap,” the executive said.

Darves’ NEJM Career Center article offers a good discussion of what to include, or possibly exclude, in a physician CV. To the extent possible, tailoring contents (like opening statements, hobbies or personal interests) and cover letters to a desired employer’s expectations is optimal.

“Sources agreed that physicians should keep to the standard ordering of information while attempting to position potentially distinguishing details (like special awards or recognition) on the first page, if possible,” Darves writes. Also, the experts with whom she spoke generally agreed that the following information generally should not be included on the physician CV, under most circumstances:

• Birthdates, Social Security numbers, and any other official identification number.
• Marital status.
• References. (Including references before they’ve been requested can make it look like you’re trying too hard.)
• Extensive publication details — stick to title, journal name, publication date and author name(s).
• Conference attendance, unless you spoke at the event.

Sweat the Details

“The CV should be crisp, clean, and clearly written — no grammar or spelling errors — but also succinct,” a human resources administrator with the Southern California Permanente Medical Group (SCPMG) advised Darves. As of the article’s writing, SCPMG employed more than 9,000 physicians and its physician recruiters received more than 4,000 CVs a year.

Suggestions for ensuring your CV makes the screener’s cut include:

• Proof, proof, proof — and, if possible, have someone else review your CV before submitting it. When applying for a posted position, be sure your CV and, especially your cover letter, clearly relate to the desired position.
• “Pay attention to seemingly minor formatting details that, if not handled properly, could frustrate potential readers who review scores of CVs as part of their job,” Darves writes. For example, a footer including a page number and the physician’s name should appear on each page.
• Think of the receiver when naming your CV file: hiring managers suggest file names with the physician’s last name, then first name (and maybe the submission date).
• Save your CV in PDF format. While not ‘bullet-proof,’ it’s a deterrent to someone’s altering your document along the way.

Pass the 6-Second Test

In her early-2019 post, “11 Resume Tips to Keep Your Application From Getting Passed Over,” The Fit Careerist (and former recruiter) Corrie Alexander says the average read time per resume is 6 seconds.

“Hiring managers typically sort through hundreds of resumes per position. It’s overwhelming to say the least,” Alexander writes. “To carefully peruse each one is simply out of the question. That’s why the average read time per resume is 6 seconds.”

In its Guide to Practicing Locum Tenens, LocumTenens.com offers a short checklist for preparing an eye-catching CV — presumably one that passes the 6-second test:

• Make the first page of your CV the essentials at a glance.
• List your permanent and locum tenens employment history.
• List the month/year of all your locum tenens jobs.
• Keep the information about your licenses current.
• List areas of specialization.
• Save the information about research, publishing and poster presentations until the end.
• Spell-check!

The Locum Tenens Guy’s Guide to Locum Tenens offers a bit more insight into listing any locum tenens experience on your resume: You can list either the agencies you work with or the hospitals/facilities to which those agencies have sent you.

“However, if you’ve worked at too many facilities, again either mention an agency or pick two to three hospitals where you spent the most time and include them in your CV,” Dr, Dzhashi advises. “Just keep in mind if you are completing credentialing or licensing paperwork, you’ll have to list EVERY hospital/facility where you’ve ever worked.”

Find a model CV from the ACP (American College of Physicians) here. For a list of what should be included in a CV and other AMA tips, click here. If you’re a medical resident preparing to enter the job market, find what news writer Brendan Murphy calls “CV-Writing 101” advice here.

If you’re still with us after all that tedious CV/resume ‘how-to’ business, NOW we’re ready to begin your pursuit of a locum tenens job — or any type of physician job, if we’re honest — in earnest.

A) The Facilitator

If you’re going the agency route, first comes the ‘get-to-know-you’ interview with a locum tenens agency recruiter — one with a firm you’ve researched enough to know you’d be comfortable working with.

It’s likely a solid recruiter will have lots of questions on topics like your background, skills and experience; what interests you about locum tenens work or about a particular position; how much you know about the locum tenens industry and your comfort level with it, etc.

“The recruiter must determine if you’re a good fit…and if you’d work well with [the agency’s] current healthcare clients,” NEXTlocums suggests.

The Ohio-based firm offers some sage advice for interviewing in today’s digital age:

“It’s sometimes hard to whittle out quiet moments. Carve out time and a quiet location for your phone interview. Do not multitask. Lack of concentration can be viewed as apathy, which will quickly sink an interview.”

So don’t take the locum tenens agency recruiter’s (or the client’s) interview call in the cafeteria line, in-between patient consultations, or while you’re driving, okay?

Do Your Homework

FOCUS, yes. But also remember the locum tenens proposition is a two-way street. It’s just as much an assessment opportunity for you as it is for the interviewer. In either case, you need to think ahead just a bit.

“Before your interview, determine what are your ‘would-likes,’ ‘’must-haves’ and ‘absolutely-nots’ for your next location and position. Set your own requirements and expectations,” NEXTlocums advises. “Be honest and open about your job preferences and deal-breakers. This will reinforce your job dedication, and it’s the best way to ensure you are placed in your ideal job.”

In a blog post from late July 2020, Vista Staffing Solutions compares working through a staffing agency with having “a partner by your side every step of the way.” To ensure you identify a firm that will facilitate your proceeding smoothly through the potential roadblocks ahead, the Utah-based firm offers three qualifying questions:

1. Does Your Staffing Agency Have an In-House Licensing Team? Can they coordinate primary-source credential verification — “including licenses, privileges, education/training, certifications, professional liability insurance coverage and more? Will they be there if you run into any issues?”
2. Does Your Staffing Agency Cover the Costs of Licensing and Credentialing? Well-established agencies (like Vista) will cover most of the costs of licensing and credentialing for any assignment worked through said agency.
3. Does Your Staffing Agency Have Experience and Established Relationships? Look for an agency with strong state-medical-board relationships and credentialing team members who understand, and keep up-to-date with, the application-review process. Your agency team should coordinate with you, state medical boards and healthcare employers to deliver accurate paperwork and timely documentation.

Processes differ slightly from one agency to another, but once your agency recruiter has a pretty good sense of who you are and what you want from locum tenens, it’s time for the recruiter to identify the positions and places where the assistance you can provide are needed.

Then he or she will “submit your CV and a cover sheet highlighting your accomplishments and availability (aka, “marketing you”) to those facilities in what’s called a ‘presentation.’ You commit to working at the first facility that accepts you for the position, and you should hear back within six business days (although some larger facilities can take up to two weeks to respond),” according to a blog post by the locum tenens industry’s largest agency, CompHealth.

“If you’re confirmed for the assignment, your recruiter will go over all the details and help you begin the licensing and credentialing process,” CompHealth notes. “If you don’t get the job, your recruiter will share the client’s feedback with you (if provided)” and move on to the next opportunity.

B) The Gatekeeper

Often an interview with a clinical manager at the hiring facility takes place either before or while licensing and credentialing get underway. “A locum tenens interview is an opportunity to sell yourself to the hiring facility or practice,” writes Debra Wood, RN, for Locum Leaders. “There are usually multiple candidates being interviewed, and successful candidates must make a good impression.

“ ‘We always try to implement an interview as part of the locum process,’ says Andrea Randle, director of recruitment for advanced practice and CRNA at Locum Leaders. She adds that ‘most locum interviews will last from 20 minutes to an hour. Sometimes, interviews include a two-step process, with the specialty lead and the medical director.’ ”

Both Wood and Randle encourage you to highlight how your training and experience align with the assignment in question. “ ‘Hiring authorities often [also] want to know about team skills, bedside manners and adaptability, while some might ask what the candidate does for fun,’ ” Randle says.

For more interview insight, check out 5 Interview Questions Facilities Should Ask Every Locum (courtesy of Barton Associates). For a comprehensive interview-prep article that includes topics interviewing locum tenens candidates should be prepared to talk about, visit LocumTenens.com’s Four Steps to a Stellar Interview Performance.

For some big-picture and behavioral Physician Interview Questions and Answers (geared more toward interviewing for a permanent/full-time physician job, but solid advice nonetheless), go to CompHealth’s blog here.

Ask as Well as Answer

“ ‘We stress to providers to use the phone interview as the opportunity to interview the client to make sure the potential locum assignment is going to be a good fit for both parties clinically and professionally,’ ” Randle notes. She suggests listening for anything that seems to have changed since the time locum tenens coverage was requested originally and letting your recruiter know if there’s a concern.

If your interviewer doesn’t lead with it, you should ask him or her to tell you about the facility, the community and the patient population — and whether anything about them makes the clinical situation unique. “Always ask about expectations, roles and what you would be responsible for on a daily basis,” Wood writes. “If you’re a physician, ask if you will be responsible for overseeing advanced practitioners.

“Many interviewers will ask why you’re working locums, so be prepared with a response. The candidate can also ask why the hospital is hiring a locum tenens,” Wood suggests.

Likewise, Wade (for Barton Associates) begins his 6 Questions Every Provider Should Ask During a Locum Tenens Interview with, “What’s the reason for your current staffing gap?” Wade advises, “You may not want to lead off with this question in a locum tenens interview, but it’s arguably the most important one you can ask all the same. A facility undergoing a directed restructuring may differ from one that has a physician going on vacation or LoA (leave of absence).”

He also suggests asking about the client’s electronic health/medical records solution and how happy clinical staff are with it. “You should attempt to learn which system they use, how your temporary colleagues have taken to it, and what challenges you might expect,” adding that “multi-EHR fluency is a big plus on future CVs, so don’t let an unfamiliar system scare you off.”

Now that you have a pretty good idea of what and how to prepare for a locum tenens client interview, let’s go back to Wood and Locum Leaders for two excellent pieces of client-interview-ending advice:

1.  “Randle recommends that candidates reconfirm the assignment start date, the schedule and responsibilities. Most interviews are with clinical professionals, not human resource people, so all parties need to be on the same page.”
2. “If the candidate likes what he or she hears, Randle suggests simply asking for the job” — and about the next steps in the process. “However, an interview does not obligate the candidate to accept the assignment.” Rather, it’s a chance for the clinician to assess whether the assignment is a good fit. The candidate should hear back regarding the client’s assessment within 24 to 48 hours, Wood says.

So now let’s assume that, after you’ve interviewed, the practice or facility ‘likes you’ for the assignment. Smooth sailing ahead all the way, right? Uh-hmm, not so fast.

“Your locum tenens staffing company typically covers your malpractice insurance, which is why it employs a rigorous credentialing process to verify you’re in good standing with references who can confirm your skills and your ability to perform the required procedures,” according to CompHealth.

The agency says the credentialing process typically takes 30 days. “If your assignment starts sooner than that, you’ll need to assist in any way possible to speed the process along.”

In case your feet feel a bit chilly about now, remember the awesome responsibility you took on when you decided to become a doctor (or an advanced practice healthcare provider) and know the vetting process for locum tenens practice is no more rigorous than the one to become a “permanent” employee at the healthcare facility or medical practice in question.

Moreover, CompHealth assures: “Once you’ve completed the application, your credentials are good for two years. After that point, you’ll simply need to update your work history and any other information that has changed within the past two years; there’s no need to verify your medical school and residency again.”

Nevertheless, we realize you might need a bit more assurance about the licensing and credentialing challenge to becoming a locum tenens physician or advanced practice clinician, so keep reading.

Follow the Guides

Vista Staffing Solutions’ list of licensing and credentialing tips for clinicians begins with “carving out time to get (and stay) organized.”

“Every state has a unique licensure process, and credentialing requirements vary from site to site. However, you can give yourself a tremendous head start and save time with every assignment by committing to regular organizational housekeeping; including,

• Keeping your CV and some critical documents updated. (Click here for a list of standard documents requested during the licensing and credentialing processes, as well as what to include in your CV.)
• Having complete contact information (personal phone number, email, home address, etc.) for professional references who are prepared to respond.
• Being up-to-date on your vaccinations and able to provide documentation.
• Giving yourself plenty of time to achieve licensure.
• Paying attention to licensing/credentialing application deadlines and meeting any deadlines given throughout the process.
• Ensuring all of your documents are available for digital sharing
• Keeping an eye on your email, voicemail and texts for communication and responding as quickly as possible. This will keep the processes moving as efficiently as possible.”

If you’re just starting to consider trying locum tenens, below is an overview of locum tenens licensing and credentialing from a seasoned healthcare writer, courtesy of Weatherby Healthcare’s Locum Tenens Tips Blog.

In her post, 10 Things To Know About Locum Tenens Credentialing, writer Anne Baye Ericksen begins, “Locum tenens is an effective strategy for healthcare facilities to fill staffing voids; however, they want assurances candidates will be well-qualified, which is why physicians, physician assistants (PAs), and nurse practitioners (NPs) undergo a thorough credentialing process. But what does that process entail?

“Here are 10 things locum tenens professionals should know about how credentialing works.

1. Primary Source Verification
   After you complete an online application, the agency must confirm your professional identity and qualifications. The credentialing team reaches out to previous employers, and to any hospitals where you hold privileges, to verify your privileges are in good standing.
2. Documentation
   • Proof of training, including residency and fellowship
   • Medical school diploma
   • Board certifications
   • DEA certification
   • Life support certifications, such as advanced cardiac life support (ACLS)
   • Medical licenses
   • Official change-of-name documentation if applicable

   Scan, email, fax or mail pictures of these documents to the credentialing team. (Hard copies aren’t usually needed.)

3. Foreign Status
   Submit  Educational Commission for Foreign Medical Graduates (ECFMG) certification, as well as proof of permanent resident status or H-1B visa.
4. Professional References
5. External Credentialing
   Once the internal credentialing team confirms your data, your agency credentialing is finalized and remains valid for two years. However, you will have to go through a separate credentialing process for each assignment at each new hospital.
6. Medical Tests
   Hospitals mandate clinicians have current vaccinations for Hepatitis B; Measles, mumps and rubella; Varicella; Tetanus, diphtheria and pertussis; and Meningococcal disease. They also require a negative tuberculosis test result within the past year
7. Medical Specialties
8. “Employment” Requirements for Physician Assistants and Nurse Practitioners
9. Full Disclosure
   Official change-of-name documentation if applicable Report all licensure sanctions or malpractice claims in detail. Also, make sure applications match your CV, because the credentialing teams have to investigate any discrepancies, even two-month differences. The process becomes much easier when you provide accurate information.
10. Clear, Timely, Communication”

For more about credentialing and licensing, and how a locum tenens agency like Weatherby Healthcare can help you, view the video How to Find a Locum Tenens Assignment.”

Okay, guessing you now understand locum tenens licensing and credentialing generally, let’s kick it up a notch: We doubt we could write a section of our No-BS Guide on locum tenens licensing with any more meat and less BS than Dr. Dzhashi’s Locum Tenens Licensing: A Complete Guide for Docs Who Can’t Stand It! So we’re not going to try.

His is a no-holds-barred guide from someone who’s been practicing medicine full-time on a locum tenens or per diem basis for seven years and counting now.

NO…Next.

Okay, seriously, “If you’re considering adding part-time hours and would rather not commit to a new full-time position, locum tenens is for you,” according to Core Medical Group.

Locum tenens physicians can quickly earn supplemental pay for filling physician shortages at other facilities, and can do so without any of the politics often associated with a full-time practice.”

Moreover, in its blog post from 8/1/2018, CompHealth shares, “Hospitalist Dr. John Thieszen started supplementing his income by working locum tenens while he was a full-time physician for the U.S. Air Force. He is now an independent contractor and continues working locum tenens with a full-time job. He describes his planning process: ‘It actually works out fantastic. As long as I can get my schedule planned out far enough in advance — three or four months in advance — then whatever time I have left, I can give to locums.’

“Instead of complicating his life, Dr. Thieszen asserts that working locums has improved his overall work/life balance. ‘Yeah, there’s extra planning that goes in, and you have to be state-credentialed or -licensed in different places, but as a whole, you also avoid a lot of the headaches that most physicians have to deal with,’ he explains. ‘When I’m at the job location, I don’t have to be doing lots of the regular hassle. It definitely contributes to a better work/life balance for me.’ ”

If there’s a will, there’s a way, as ‘they say,’ right? So, if you try locum tenens without resigning your full-time job (the one paying the bills), you’ve just moved a step closer to financial independence. CONGRATULATIONS!