Introduction
Over the last ten years, the number of foundation doctors choosing to progress straight into speciality training has dropped dramatically. This has been put down to many reasons, but ultimately, it represents a new cultural norm that has developed over the last decade. In my experience, those going straight into training from FY2 are now the minority. I felt an FY3 was a good chance to take a step off the treadmill I feel I’ve been on since deciding to apply for medical school back in 2012. Having not taken a gap year before university and not being 100% sure about what speciality I wanted to pursue, taking some time out of training after FY2 felt like a natural break. My biggest uncertainty was what to do with this year.
Why I chose locuming?
There are a plethora of opportunities you can take as an FY3, and it can feel quite overwhelming deciding what to do with this valuable time. For me, going to work abroad somewhere like Australia had always been a consideration, but COVID rather put a spanner in the works there. I considered applying for a junior clinical fellow (JCF) or clinical teaching fellow (CTF) job, but for me, a big part of taking an FY3 was to enjoy the flexibility that comes when your life is not dictated by a rota, term dates or exams. Having worked in central London during COVID, I also felt I had maybe earned myself a bit of time off?! Being a medic means you are constantly bombarded by portfolio deadlines, points for applications, and constantly feeling like you have to think two steps ahead for how your CV should look when you apply for a registrar job in 5 years. The fear factor of being told how competitive a speciality or a deanery is and seeing your peers taking exams you haven’t even heard of yet can mean making the decision just to have a ‘year out’ actually quite a daunting one.
For me, deciding to locum full time was the right thing, but there are pros and cons, as with everything in life. See below for a summary of the main pros and cons I have come across.
Pros of locuming
Flexibility
Probably the biggest pro to being a full-time locum is the lack of rota and, therefore complete flexibility with your time – you pick and choose when and where you want to work. For me, that has meant no night shifts or weekends and plenty of holidays
Salary
Locum rates are higher than trainee/fellow post rates – this means you don’t have to work as much to still earn the same as others working full time. It also means it’s a good time to put some extra cash into your savings or just treat yourself!
Career planning
Taking an FY3, in general, gives you time to think more carefully about which speciality you want to go into. Being a locum provides you with the chance to pick up shifts in different areas to increase your experience. It also means you can work in specialities/departments that you did not get a rotation in during your foundation years
Change of location
Being a locum means you can also work hospital in any town or city. It can allow you to explore completely new areas or move to somewhere you’ve always wanted to live but might not have secured an F1/2 job there.
Cons of locuming
Budgeting
Whilst mainly a pro as you can earn significantly more as a locum, there is also the consideration that you have no guaranteed paycheck each month so you do have to plan ahead with your shifts to make sure you will earn the amount you need for your budget (rent, bills, etc). Budgeting itself can also be difficult as you tend to get paid weekly, and the amount may differ each week depending on the number of shifts you have worked and at what rate. There is also the added mystery of tax codes to contend with. These can be confusing at the best of times, but when you’re being paid weekly and most likely from different trusts, this can make it hard to figure out what tax code you should be on and, therefore, how much you will take home each week
Sick pay
There is no guaranteed sick pay, so if you become unwell and have to cancel shifts, this means you most likely will not get paid. This is particularly relevant at the moment with COVID and potential isolation periods
Lack of continuity
Some locum posts are for a few weeks or even months at a time. However, many shifts can be picked up on an ad-hoc basis, and you may therefore miss the sense of having your own team/base. There is also the chance you could be working in completely new hospitals, finding the right ward or even just logging into the computer a challenge. However, a lot of people locum in hospitals they have already worked in or join locum agencies who can help with some of these issues.
Final Words
Working as a full-time locum isn’t for everyone but for me, the pros far outweigh the cons. It is not something to do forever necessarily, but if you’re looking for a bit of a break post foundation years, I would highly recommend considering it.
