How to Become a Locum Tenens Physician

By Cory Kleinschmidt

2026-07-21

Getting started as a locum tenens physician is largely about completing the right steps in the right order. Three things stand between you and your first opportunity: a CV built for a fast skim, your state medical licenses and facility credentialing. Sequence them right and starting locums is straightforward.

Of the three, licensing is almost always the longest lead time, so it sets your realistic start date. You can move fast on your CV and your interviews. A new state license runs on a medical board’s clock, not yours. So start licensing first and treat everything else as scheduling.

What You Need to Start

You need three things: a CV that survives a fast skim, at least one active and unrestricted state medical license (often several) and facility credentialing that checks out. Licensing is the long pole, so it decides your start date.

Build the CV and open the licensing on the same day. The CV you can finish quickly. A new license or a fresh credentialing packet you can’t rush past someone else’s process, which is exactly why you begin it before you have an opportunity in hand.

Licensing is the long pole. The physicians who start fastest treat everything else as scheduling.

Build a CV That Survives a Fast Skim

A recruiter or clinical manager skims your CV in seconds, so structure beats prose. A physician CV is a complete professional record, from education through publications. It’s expected to run several pages. The job is to let a reviewer find what they need at a glance.

Format it for scanning:

• One simple sans-serif font at 11 to 12 points.
• Reverse-chronological order with clear, consistent headings.
• Saved as a PDF, named LastName-FirstName so it files cleanly.

Order the sections the way reviewers read them:

1. Name and contact information
2. Education, medical school through fellowship
3. Licensure, states and status
4. Board certification status
5. Professional experience
6. Committees and memberships
7. Honors, awards and affiliations
8. Publications and presentations

Three rules that trip people up:

• List every locum placement. You can show two or three representative facilities on the CV itself, but you have to disclose every facility in your credentialing paperwork.
• Never paper over a gap longer than about three months. Explain it briefly in your cover letter instead. A hidden gap looks worse than an explained one.
• Keep the CV current at all times. Locum opportunities move fast. The physician who can send an updated CV the same day gets presented first.

The Interview Is Two Conversations, Not One

You’ll talk to your recruiter first, then the facility. The recruiter learns your background, specialty and preferences, packages your CV into a presentation and submits it. Expect a facility to respond in about a week, sometimes two. If it passes, a good recruiter brings back the reason and moves to the next opening.

If there’s interest, you speak with the facility’s clinical manager, sometimes the medical director. It usually runs 20 minutes to an hour and is mostly about fit, adaptability and logistics, not a hard clinical grilling.

Interview the agency while it interviews you. Before you commit, ask:

• Do you have an in-house licensing team that coordinates primary-source verification?
• Who pays for licensing and credentialing costs?
• What’s your experience with my specialty and the state boards involved?
• How reliable is payroll and how quickly do locums get paid?

Ask the facility the questions that reveal the opportunity:

• Why do you have this staffing gap right now?
• What’s the patient population, volume and call expectation?
• Which EHR do you use?
• What are the responsibilities and onboarding support?

Then confirm the start date, schedule, responsibilities and next steps. Get what you agreed to in writing. Your recruiter handles the agency-side vetting covered in the agencies chapter.

Get Licensed: One State First, Then Multi-State

Every locum physician needs the same foundation: an active, unrestricted state medical license. Behind that license sit the credentials a board and a facility will verify: an MD or DO degree, passing USMLE or COMLEX scores, completed ACGME- or AOA-accredited residency and current ABMS or AOABOS board certification.

Board certification isn’t always required to hold a state license, but facilities increasingly expect it, and it’s one of the eligibility criteria for the Compact below, per the IMLCC (eligibility criteria). Keep that distinction in mind: expected by facilities, required by the IMLC, not universal for licensure itself.

Do You Need a DEA Registration in Every State?

Generally yes. You need a DEA registration to prescribe controlled substances. A registration is tied to a physical location, so you need a separate one for each state where you’ll prescribe, per the DEA (registration rules). Factor that time and cost in early. Exact requirements vary, so confirm for your states.

State-by-state licensing is the slow part. Each state board runs its own process on its own timeline, which is why licensing sets your start date and why the Compact matters so much.

The Interstate Medical Licensure Compact (IMLC), Explained

If you plan to work in more than one state, the Interstate Medical Licensure Compact is the fast lane to multiple licenses. It’s a physician-only pathway that lets qualified MDs and DOs get licensed in participating states through one application, instead of running each state’s process from scratch.

It’s a shortcut, not a single national license. Each state still issues its own license. The Compact just speeds up how they do it.

What the Compact Covers

The Compact spans 44 member states and 2 US territories through 59 participating medical boards, information current as of July 31, 2026, per the Interstate Medical Licensure Compact Commission (member states).

Who Qualifies for the IMLC

About 80% of US physicians meet the eligibility criteria, per the IMLCC (eligibility criteria). You qualify if you hold a full, unrestricted license in a member state you name as your State of Principal License (SPL) and you meet all of the following:

• An SPL anchor in that state: your primary residence, at least 25% of your practice, your employer or your federal tax home.
• A degree from an LCME-accredited medical school, or an equivalently listed school.
• Completed ACGME- or AOA-accredited residency.
• Passed each component of the USMLE or COMLEX-USA in no more than three attempts. The Canadian LMCC does not qualify.
• Current ABMS or AOABOS board certification.
• No disciplinary actions, controlled-substance actions, criminal history or active investigations.

How the IMLC Works

1. Designate your SPL and confirm one anchor above.
2. File one application, pay the fee and submit fingerprints for a background check.
3. Your SPL issues a Letter of Qualification (LOQ) confirming you meet the Compact’s requirements.
4. Choose the member states you want to practice in. Each issues its own license through expedited information-sharing.

You can’t get licenses through the Compact without the LOQ, so it’s the step to start first, per the IMLCC (how it works).

What the IMLC Costs

The Compact’s participation fee is a one-time $700, paid to the Commission, per the IMLCC (what it costs). Each state’s license fee is separate, set by that state’s board and varies widely by state and license type.

Locum opportunities are frequently multi-state. Licensing is usually the longest lead time in the whole process. The Compact compresses it, which is why the physicians who move fastest start their LOQ before they have an opportunity in hand. The Compact is a physician pathway. Advanced practice clinicians license on separate tracks, covered in their own guides.

Locum Tenens Credentialing: What It Checks and How to Speed It Up

Credentialing is how a facility confirms you are who your CV says you are. It typically takes about 30 to 90 days. It’s primary-source verification of your identity, training, licenses and history, which means the agency or facility contacts the original issuers directly, your medical school, residency, boards and prior hospitals, rather than taking copies at face value.

The documents you’ll need:

• Medical school diploma and proof of residency and fellowship training
• Board certifications
• Active state medical licenses and DEA registration
• Life-support certifications such as ACLS
• Name-change documentation, if applicable
• Foreign medical graduates add ECFMG certification plus visa or permanent-resident documentation

Facilities also require current immunization and testing records, commonly Hepatitis B, MMR, varicella and Tdap, plus annual influenza and a current TB screen. Exact requirements vary by facility, per the CDC (healthcare personnel vaccines).

Line up references who respond fast. A slow reference is one of the most common causes of delay, so tell yours to expect the call.

Disclose everything. Report every licensure sanction and malpractice claim in full. Make sure your application matches your CV exactly. Credentialing teams have to investigate any discrepancy, even a two-month difference in dates. Unexplained mismatches stall the file.

Your credentials don’t carry over. Your internal credentialing with an agency is generally good for about two years. Every new facility runs its own credentialing on top of it, so expect a fresh packet for each opportunity.

You control the clock more than you think, by keeping your documents current and digital, lining up fast references, staying current on immunizations and answering the credentialing team the same day they reach out.

You Don’t Have to Quit Your Job to Start

Many physicians start locum tenens part-time, alongside a full-time role, to test the model before committing. It’s a low-risk way to add income and see whether locums fits your life, though it still takes a few months of licensing and scheduling lead time. Plan the licensing first, then layer opportunities around your existing schedule.

Go Deeper

Up: The No-BS Guide to locum tenens.