slartibartfast

Should you locum or not? your guarandamnteed guide

42 posts in this topic

Ive been doing locum work since the last 2 years. Will go over as many related issues as possible in this thread. Give you as much of an overview as possible.

My reasoning for doing locums.

I was unhappy with my life - coming home, watching TV, going to sleep and back again the next day.

I realised I didnt leave my beautiful life in India to come here and live a hermit's existence. A groundhog day life of work-home-tv-net-eat-sleep and weekend warrior living.

I also didnt see the life ahead as very fulfilling - I saw consultants walking around with that haunted look in their eyes and didnt really want to see myself there.

Realised that I didnt really know what I was signing up for when I joined medschool i.e. at an age where I wasnt old enough to legally drink, smoke or shag. And they expected me/us to make decisions about the rest of our lives till 65.

But really - it was the groundhog existence. I thought I could save money and go on holiday.

Well, that didnt happen.

I fell into the same trap I always had been in. Dropped down in overdraft no matter how much I earned.

Sure, money was put into investments. But thats when I realised a little something - people doing locums just had (massively) bigger debts. Before a 12K car or a second house was an extravagance, but now it was almost a necessity.

I put the money into a business in India. Didnt go too well, but that was because of ineptitude rather than anything else.

But getting back to the point - my locum buddies bought fancy cars, fancy gadgets, and invested in property.

But they were still massively in debt. And some were actually spending less money on themselves than when they were earning substantive salaries. Of course, with the substantive salaries the system takes away 11 months of your pay (From january to june - I work for the government (30-40% income tax, 11% NI, and council tax)(conservative estimate here) July-mid september - I work for the bank (2.5 months salary is a very conservative estimate for a normal mortgage) two weeks in september for my pension (two weeks salary is a conservative estimate for a years pension)

Oct-mid nov - i)GMC (medical registration), BMA (doctors union), MDU (defence union), RCPSYCH (royal college registrations) all circa 400 quid on average ii)car/motorcycle insurance, gas, tax, loan iii)utilities i.e. gas, electricity, water, broadband, tv, cable, phone two weeks in nov - to pay for 6 weeks of holiday. so at the end of the day, I found I had 45 minutes of my daily income that I could actually decide where to spend. And being very generous on this side of the fence too - max 1.5 hours a day that I worked for myself. And more often than not this was pissed down a nightclub toilet.)

So yes, in a system that takes away 11 months of your payslip.

Lessons learnt since then:

Locum work pays more. but expenses shoot up even more than that.

Other people's chase for more money is never ending.

BUT.

I wanted to be free. So why am I still working 2 years later - its because Im still trying to get more gold coins.

I havent really saved much money - but enough to have a modest 1,2 or 3 years of holiday.

LOCUMS DRYING UP..

fuck that. You will notice locums drying up when they offload people in locum agencies. I still havent seen anything like that happening.

You will see locums drying up, when career locums leave their jobs and get back into substantive posts.

You will see locums drying up when there are less than 3-4 jobs to choose from with every job you start.

So dont worry about there being no locums. People doing locums dont even go a single day in between jobs - thats how easy it is to find jobs.

Is it worth the money? ahh.. only a wise man asks that question.

Because really, it isnt about the money. If you do feel it is the money, then you have a big car, big gadgets and tie your self worth in with how much you own. RIcher people then become happier or more satisfied than you. And poorer people the other way around.

this is what you are signing up for -

You cant mess around in any job - you make a mistake youre out.

You cant afford not to get along with people.

you have to keep travelling all the time.

You live without broadband, without tv (beautiful things actually) and living out of suitcases at times.

Living away from family, friends in a small town away from everyone else.

SO.. in a mad chase for money.. what you have actually got is more debts, more travel, less time with family, and a non existent social life.

And ALL of this in what are probably the most important years of your life NOT to have all this.

chasing money is a trap that has side effects that arent very nice.

On the flip side - do you want money? and for what.

if you do want money - decide if its worth sacrificing social life, sex, being away from family, away from kids, travelling, living alone in some BnB in the boondocks, just waiting for the next days work.

And seriously, do you really want money that bad. If you do - do understand what that says about you.

On the flip side, there are some who have ideas of working (like I did) and moving out. But we get caught in the trap.

Inconsistent saving, indiscriminate spending, and still doing locums years after that.

So if you have a money save and leave plan - make an arbitrary figure in your head - stick to it, and jump when you have hit it.

Dont stay stuck in an unhealthy lifestyle - no family, no kids, no nookie, no lifestyle, no broadband, and a hundred little things you take for granted like access to a printer or scanner, a full wardrobe, washing machine etc etc etc.

And all for money.

If you are doing locums - do them for the right reasons - dont expect that you will be spending more or afford more once you get the money. Most people I know spend money on investments(like that BMW M3 or second house in India) and get into deeper debts. and as a result spend as much as they were always spending or even less than that (as they are now saving for the future).

and this is what I have seen happening.

So what do you do.

If youre happy in your substantive job, and have family - Id say stick to it. NHS salaries are pretty decent for a decent lifestyle, and most people reading this will have double incomes - so a lot easier.

If your unhappy - then find out what you are unhappy about and what you can change about it. If you cant change much then will option B really make you happy. Will option B, without family, love, sex, less expenditures (you wont believe how often this happens) and no steady roof over your head make you happy.

and if you are leaving to make money - are you leaving for all the right reasons - and what is your plan. Stick to it. Seriously, stick to the plan and dont keep extending it for reason after silly reason - like we always do.

earn enough money, and if the plan was to jump after X GBP then Jump.

Dont fall into the standard trap of buying biggie gadgets, buying bigger houses, being invested in big money lifestyle but actually end up spending less money on themselvs than they ever did.

If you want to earn buckets of money - and are okay with losing out on Lifestyle, then go right ahead. Dont expect to have your cake and eat it too - very few people are able to i.e. lifestyle and moolah.

So in summary.

Locums arent drying up. Its the fear and greed inherent in the system that makes your fear jumping.

Do it for the right reasons.

So in summary - should you locum or not?

really all it boils down is family. If youre single - then its a brilliant stop gap option.

If not - and theres a family you want to meet often - then maybe locums arent for you.

Or if you have a short term money making then shoot and scoot plan - then go for it. But dont up expenses. I think thats the key, not upping unnecessary expenses just because you have money in the bank.

Of course, having said all that - do understand that there are some resourceful people who do locums in their home city, live with family and have been in the same job for months.

At the end of the day - its pros and cons.

I hope Ive gone over what the pros and cons are, what happens when people start locuming, common errors and what to do about them.

if you have any doubts or queries - then drop me a question on this thread and I or anyone else in the field will help you.

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Yup exactomundo and that nice streak just keeps bubbling up in you.

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Look, at the end of the day why someone starts locuming depends upon their circumstances and their choices. Locuming doesn't give one job security, but thats why locums get paid more. You say its because you were disillusioned with your life, in my case it was trying to stay near where my wife got a job. Reasons may be different, end result is that it is very enticing to be "free". Whether one is actually free ( and of what) is debatable. I have tried to work near my home and bar around 10 months in 3 years have managed to do that. So I may have compromised on the money a bit at times but have been lucky in getting 6-9 months jobs mostly. Have to formulate rest of my thoughts.....

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Im summary - and this is my opinion.

Do locums if its a short term option and you want to leave after (for whatever reason).

Do locums if you are okay with staying away from family, and losing out on a lifestyle.

Locums as a long term option if you have family - unless you can manage to stay close to home like flak - is inadvisable. Its just an empty chase for all the wrong stuff i.e. money, gadgets and phallic symbols.

Scarcity of locums, locums drying up, fear of not getting jobs, taxation issues, IR35 etc etc shouldnt enter the decision making algorithm because they dont really factor into the equation.

also.. another good or brilliant reason to do locums would be - plugging out of the substantive runaround and a lot of the associated negatives.

If I want to leave my job right now - i can walk out the door, book a plane ticket to anywhere in the world and not have to work again for another couple of years.

Edited by slartibartfast

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Slarti is it only psych that you don't like or the whole medicine? curiosity

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so why are you sounding so cheesed off? :)

Am I?!! I'm not, really! Not about the locum part. More the medicine as a whole part maybe, cause I want to do other things and cant seem to break away.

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Normally people who do locums always moan and indirectly discourage others...but themselves still persist to do locums..

This post is good..gives clear pros and cons

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Ive been doing locum work since the last 2 years. Will go over as many related issues as possible in this thread. Give you as much of an overview as possible.

My reasoning for doing locums.

I was unhappy with my life - coming home, watching TV, going to sleep and back again the next day.

I realised I didnt leave my beautiful life in India to come here and live a hermit's existence. A groundhog day life of work-home-tv-net-eat-sleep and weekend warrior living.

I also didnt see the life ahead as very fulfilling - I saw consultants walking around with that haunted look in their eyes and didnt really want to see myself there.

Realised that I didnt really know what I was signing up for when I joined medschool i.e. at an age where I wasnt old enough to legally drink, smoke or shag. And they expected me/us to make decisions about the rest of our lives till 65.

But really - it was the groundhog existence. I thought I could save money and go on holiday.

Well, that didnt happen.

I fell into the same trap I always had been in. Dropped down in overdraft no matter how much I earned.

Sure, money was put into investments. But thats when I realised a little something - people doing locums just had (massively) bigger debts. Before a 12K car or a second house was an extravagance, but now it was almost a necessity.

I put the money into a business in India. Didnt go too well, but that was because of ineptitude rather than anything else.

But getting back to the point - my locum buddies bought fancy cars, fancy gadgets, and invested in property.

But they were still massively in debt. And some were actually spending less money on themselves than when they were earning substantive salaries. Of course, with the substantive salaries the system takes away 11 months of your pay (From january to june - I work for the government (30-40% income tax, 11% NI, and council tax)(conservative estimate here) July-mid september - I work for the bank (2.5 months salary is a very conservative estimate for a normal mortgage) two weeks in september for my pension (two weeks salary is a conservative estimate for a years pension)

Oct-mid nov - i)GMC (medical registration), BMA (doctors union), MDU (defence union), RCPSYCH (royal college registrations) all circa 400 quid on average ii)car/motorcycle insurance, gas, tax, loan iii)utilities i.e. gas, electricity, water, broadband, tv, cable, phone two weeks in nov - to pay for 6 weeks of holiday. so at the end of the day, I found I had 45 minutes of my daily income that I could actually decide where to spend. And being very generous on this side of the fence too - max 1.5 hours a day that I worked for myself. And more often than not this was pissed down a nightclub toilet.)

So yes, in a system that takes away 11 months of your payslip.

Lessons learnt since then:

Locum work pays more. but expenses shoot up even more than that.

Other people's chase for more money is never ending.

BUT.

I wanted to be free. So why am I still working 2 years later - its because Im still trying to get more gold coins.

I havent really saved much money - but enough to have a modest 1,2 or 3 years of holiday.

LOCUMS DRYING UP..

fuck that. You will notice locums drying up when they offload people in locum agencies. I still havent seen anything like that happening.

You will see locums drying up, when career locums leave their jobs and get back into substantive posts.

You will see locums drying up when there are less than 3-4 jobs to choose from with every job you start.

So dont worry about there being no locums. People doing locums dont even go a single day in between jobs - thats how easy it is to find jobs.

Is it worth the money? ahh.. only a wise man asks that question.

Because really, it isnt about the money. If you do feel it is the money, then you have a big car, big gadgets and tie your self worth in with how much you own. RIcher people then become happier or more satisfied than you. And poorer people the other way around.

this is what you are signing up for -

You cant mess around in any job - you make a mistake youre out.

You cant afford not to get along with people.

you have to keep travelling all the time.

You live without broadband, without tv (beautiful things actually) and living out of suitcases at times.

Living away from family, friends in a small town away from everyone else.

SO.. in a mad chase for money.. what you have actually got is more debts, more travel, less time with family, and a non existent social life.

And ALL of this in what are probably the most important years of your life NOT to have all this.

chasing money is a trap that has side effects that arent very nice.

On the flip side - do you want money? and for what.

if you do want money - decide if its worth sacrificing social life, sex, being away from family, away from kids, travelling, living alone in some BnB in the boondocks, just waiting for the next days work.

And seriously, do you really want money that bad. If you do - do understand what that says about you.

On the flip side, there are some who have ideas of working (like I did) and moving out. But we get caught in the trap.

Inconsistent saving, indiscriminate spending, and still doing locums years after that.

So if you have a money save and leave plan - make an arbitrary figure in your head - stick to it, and jump when you have hit it.

Dont stay stuck in an unhealthy lifestyle - no family, no kids, no nookie, no lifestyle, no broadband, and a hundred little things you take for granted like access to a printer or scanner, a full wardrobe, washing machine etc etc etc.

And all for money.

If you are doing locums - do them for the right reasons - dont expect that you will be spending more or afford more once you get the money. Most people I know spend money on investments(like that BMW M3 or second house in India) and get into deeper debts. and as a result spend as much as they were always spending or even less than that (as they are now saving for the future).

and this is what I have seen happening.

So what do you do.

If youre happy in your substantive job, and have family - Id say stick to it. NHS salaries are pretty decent for a decent lifestyle, and most people reading this will have double incomes - so a lot easier.

If your unhappy - then find out what you are unhappy about and what you can change about it. If you cant change much then will option B really make you happy. Will option B, without family, love, sex, less expenditures (you wont believe how often this happens) and no steady roof over your head make you happy.

and if you are leaving to make money - are you leaving for all the right reasons - and what is your plan. Stick to it. Seriously, stick to the plan and dont keep extending it for reason after silly reason - like we always do.

earn enough money, and if the plan was to jump after X GBP then Jump.

Dont fall into the standard trap of buying biggie gadgets, buying bigger houses, being invested in big money lifestyle but actually end up spending less money on themselvs than they ever did.

If you want to earn buckets of money - and are okay with losing out on Lifestyle, then go right ahead. Dont expect to have your cake and eat it too - very few people are able to i.e. lifestyle and moolah.

So in summary.

Locums arent drying up. Its the fear and greed inherent in the system that makes your fear jumping.

Do it for the right reasons.

So in summary - should you locum or not?

really all it boils down is family. If youre single - then its a brilliant stop gap option.

If not - and theres a family you want to meet often - then maybe locums arent for you.

Or if you have a short term money making then shoot and scoot plan - then go for it. But dont up expenses. I think thats the key, not upping unnecessary expenses just because you have money in the bank.

Of course, having said all that - do understand that there are some resourceful people who do locums in their home city, live with family and have been in the same job for months.

At the end of the day - its pros and cons.

I hope Ive gone over what the pros and cons are, what happens when people start locuming, common errors and what to do about them.

if you have any doubts or queries - then drop me a question on this thread and I or anyone else in the field will help you.

Thanks for this honest and open posting..

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Well said Slaarti,

Could you advice me on how I will account for any extra income generated from locums, MHA work?

I prefer to keep my NHS job and do some weekend locums with MHA to top up the meagre income.

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Fascinating to read slarti's analysis, Agree with all he has said, just to add locum options are becoming less , further away from the base, not as financially attractive and without on calls. So in the bigger picture a substantive job has become attractive by comparison with a locum job and not by itself!

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Cage - Still love psychiatry bro. Used to think it was the best job in the world until a couple of weeks ago. Now, a little guilt and shame is reducing a little bit of the love. :)

Flak - you can manifest anything you want. how limiting a belief for a rocking cool dude like you to think youre locked in. thats a real shame. there are other ways.

sure - the reason people doing locums discourage others is because they feel locums are difficult to get and dont want their patch of grass getting any more crowded. also dont want other people to earn more money. heck, even my best friends doing locums have given me crap at times about posting on SEC about doing locums.

but the secret here, for them and for everyone else is that there is massive massive abundance out there. and the way to make the best use of the abundance is to give abundantly and wish the best for other people. whether it is for them to earn more money, get laid more, find love etc etc. You wish the best for your fellow man, and treat your fellow man (who is the universe who is also God) well, you will have gifts showered upon you. whatever you wish for. be good to the universe around you, and the universe around you will be brilliant to you. :)

optimist, cobra - thanks for the kind word. :)

Eu - do locums and MHA work and make a list of expenses - make sure you declare them as you dont want Inland revenue chewing your dartos in a couple of years time.

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Now now, don't start "poor you". Seriously though-yeah in the last few years haven't listened to the ol'ticker as much. The reason I don't encourage/discourage others is that it should be one's own decision knowing the pros and cons. Neutrality is not a cop out everyone.

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I must be very lucky. I've been locuming for over 3 years with no gaps in employment and always within commutable distance of my house!

Viva locums!!

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.......if you do want money - decide if its worth sacrificing social life, sex, being away from family, away from kids, travelling, living alone in some BnB in the boondocks, just waiting for the next days work..........

Not sure what you meant by this.With no kids and no wife I have had soo much sex and ten over ten social life since I started locuming.

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Just thought I'd write a new thread about reasoning for doing locums and the pros and cons. But I had a look at the old thread and not much to add.

There are still locums around. They get filled almost immediately.

The locum agencies now dictate prices as doctors will work for pretty much anything in this climate. Rates have dropped by 10-12 pounds/hour over the last year across the board (maybe not for consultants).

There are jobs going. But they do get filled pretty quickly. Sometimes within minutes.

The locum jobs available are quite difficult in terms of workload, and often club two jobs together. My last post was inpatient and crht. The one previous was 60 inpatients in a neuro setting.

These are posts that they would not be able to advertise for one person jobs.

But there are jobs. Heck, most of my locum buddies don't even have to move away from home to work.

If you're willing to travel, then it's a whole lot easier.

Sure, there is poor lifestyle, living in BnB's, not as much sex as if you were living in one place, but if working like all get out squirelling away money for a rainy day is your thing, then go for it.

But a substantial job that keeps you going from month to month is definitely not to be underestimated. And for most IMG's with double doctor income families, it's an easy option that ticks a whole lot of boxes.

I might be earning a five figure salary post tax now (doing on calls too), but I still have everything I own in a suitcase, and live simply and spend even less than I did when I was on holiday even in a substantial job.

If you want money for a rainy day, then do locums. Because you sure as hell won't be spending too much of it.

Trust me - the first few months is macbook pro, imac, ipad, iphone, dslr, bmw m3, property. Then instead of the 1-6K bills you have in a substantial job, you now have 20-80K bills.

If you skip the 20-80K bills and investments like me, then you still invest, as spending money loses its appeal, and your needs are simple.

Most people I know who are doing locums aren't really financially better off, they just have bigger bills to pay. And the ones who have paid their bigger bills, are now living simple lifestyles.

Everybody has the big tv, macbook laptop and iphone. Everybody has pretty much the same lifestyle. Okay, the interesting guys (ahem, koff koff) go on year long holidays :P. But for the most part, its the same ol same ol.

The only reason to do locums now is to squirrel money away for a rainy day. If you can manage that with your substantive post, then great stuff. If not, then some sacrifices are to be made, and depends if you are willing to make them or not.

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I've been doing locum staff grade jobs since 2008 with no gaps over 2 weeks in between jobs.

Furthermore I've always lived within commuting distance!

Who says locuming doesn't pay?!

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I've been doing locum staff grade jobs since 2008 with no gaps over 2 weeks in between jobs.

Furthermore I've always lived within commuting distance!

Who says locuming doesn't pay?!

I am very happy for you in relation to what you have stated in the above quote.

I guess what might be helpful to others here on cafe would be some advice on below points. I am on a long break from locum due to personal reasons or I would be very glad to share the info.

1. Agency bringing jobs.

2. Agency paying good rates and not exploiting doctors by giving discount to the trusts on hourly pay but pocketing their healthy commissions.

3. Ltd company rates for staff grade both from agency registered with buying solutions and those not!

4 Some info on helpfulness of agency regarding revalidation, if you choose to go with them.

I would really appreciate advice from both Frontier Psychiatrist and other locum doctors.

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I’d share my locum work experience here too, in the hope it might help others decide what they wanted to do.

Started locuming in December 2011 so have been doing this for more than a year now. Shortest was a day's work and longest is the current one, i.e. 3.5 months with possible extension. All of the jobs have been within one hour's commute from home and this is a personal choice. Longest break from work - 1 month when I wanted to and about 1 month when there was no work available that suited me.

Pros

*Freedom - love the fact that I can get up and go when I want to, sure professional courtesy and all state I should give a notice of a week-2 weeks, but still, not bound by any fussy contracts

*Pay - much much better than NHS pays - with a limited company and all (don’t really know how much of a difference it will make if I was a paye, but still think it’s worth it

*Experience- since I started, I’ve worked in Old age (mostly, for some reason lots of such jobs, both in patient and community), Forensics, Rehabilitation, EIP, PD units, and currently with CAMHS.

*Traveling- for some reason I enjoy the traveling part of my job, have gone to places normally I wouldn’t have and worked with ppl that I would have never normally

*Stress levels - as a locum what I have found is the expectations and the work load has been quite manageable, never feel over worked or over burdened with trivial things anymore

There might be a few more things I can add, but can’t think of any at present.

Cons

*Uncertainty - this is by far my biggest problem with this kind of work, very rarely has someone given me specifics about how long a job would be, it’s always "a possibility of extension" crap. Its not just this but to some extent about the job too, its always a hidden agenda somewhere when you start working, you find out that the job role is not as it was described to you in the beginning when you agreed to do the shift/shifts (maybe its just me)

*Under pay- I have found that some locum agencies con you out of the normal rate, for some reason they never stick to one pay rate and it seems to fluctuate from job to job , hence you have to haggle with them about prices at times- seems petty but I find it very uncomfortable

*Revalidation- now this is what I have found to be one of the worst things with agencies. No one seems to be helpful and the ones who offer such services want to charge you ridiculous amounts for it, one of my agencies quoted me 500 £ plus for this!!! Surely my revalidation works in their interest and in my opinion they should be offering this for free and if not that, cheaper than this.

In the end my advice,

Do what you think will work for you, but keep these things in mind before you take the plunge.

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As I said I've been doing locum work for 4 years (almost 4 1/2!)

Over this time I've worked in many different hospitals in a variety of different jobs

I honestly feel that my clinical skills have developed in such a way that wouldn't have been possible taking the more traditional routes

Also the pay is far superior - comparable to consultant pay in most cases

To be honest I'm struggling to gain motivation to get into an ST4 post!

Edited by Frontier Psychiatrist
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i agree totally FP.

unless the job market gets saturated to teh point where i cant find any work at all.....i'd rather do this than anything else :)

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