Note to patients and caregivers: This post is intended for fellow medical oncologists who may be considering alternative career paths, particularly locum tenens work. While my usual audience consists of patients and caregivers, this article is specifically written for healthcare professionals who may be feeling burnt out or contemplating a change.
For 14 years, I was deeply entrenched in my role as a Cutaneous/Connective Tissue Medical Oncologist, balancing patient care with the administrative burdens and clinical trials of a busy practice. Like many physicians, I had invested years into building my career, only to find myself at a crossroads— frustrated with a variety of specific issues. I submitted my 90 days resignation without securing another position. I did not even interview at another hospital prior to my resignation. I was respectful and appreciative of the 14 years at my old hospital—it was a good chapter, and I certainly remember all the good times. Practicing in a permanent position, heavily involved in clinical research and working in a multidisciplinary team, made me a better oncologist, and for that, I am deeply grateful. But yes, I resigned without a backup plan. I did not secure another position or even interview—who does that!
I was fortunate to learn early in my career “never love the hospital—it will never love me back”. Fortunately, I was in a position where this transition was financially feasible. We had paid off all our student loans, auto loans, and other debts, leaving only a small mortgage payment. This financial freedom allowed us to take trips to Iceland, Japan, a week long cruise with my boys, New York with my wife alone, and now Puerto Rico with the family this weekend, with a whole summer of travel planned for the family. I took a deliberate pause to reevaluate my career and, more importantly, my life. This break allowed me to spend invaluable time with my family—my wife, two daughters, and two sons—traveling and reconnecting without the constraints of an overbearing schedule.
But stepping away from clinical medicine didn’t mean I wanted to leave the field entirely. My journey into locum tenens work was both an eye-opening and rewarding transition. Locum work offered flexibility, additional financial income, and an opportunity to continue practicing the medicine I love on my own terms. Rather than being tied to a single practice or hospital, I found myself with the ability to work part-time, select contracts that aligned with my preferences, and even prioritize locations that exclusively used Epic—avoiding the frustration of learning a new EMR system.
Through networking and extensive research, I connected with reliable locum agencies such as Hayes Locum and Weatherby, working closely with specific recruiters who genuinely understood my needs. With their guidance, I secured a position in Montana, working two weeks on and two weeks off. The financial compensation alone on a part-time basis easily surpassed my earnings from full-time practice, all while giving me the freedom to travel, explore other professional interests, and spend quality time with my family. And the patients, fully aware that Im not their permanent doctor, are so incredibly grateful!
Beyond locums, I intentially delved into multiple non-clinical opportunities, including medical malpractice consulting, workers’ compensation reviews, and disability/life insurance case evaluations. Attending multiple oncology and non-oncology conferences, including SEAK—an organization that hosts annual conferences by physicians for physicians exploring non-clinical careers—broadened my perspective. This experience introduced me to a myriad of alternative career options for physicians looking to either completely transition from clinical medicine or add supplementary income streams. Additionally, we doubled down on real estate, acquiring another medical office building, and are in discussions about potentially opening a medical franchise. Other remote work, such as medical file reviews, speaking, blogging, and even delving into paid medical informatics, has allowed me to maintain flexibility and work on my own terms. Even more rewarding is the opportunity to continue working alongside two of my former nurses, who now collaborate with me on these unique patient cases remotely and via video meets. It’s a refreshing change from clinical medicine, and they are also compensated per case, making it a win-win for all of us. In fact, I accept cases only if they are available to help review. The camaraderie remains, and it’s been a joy to continue working with them in this new capacity.
While locum tenens has been an incredibly fulfilling experience, it’s important to acknowledge its drawbacks. Frequent travel can be exhausting, and adapting to new clinical environments requires flexibility. Moreover, locum doesn’t offer the continuity of care that a permanent position provides—you may initiate a treatment plan but won’t always see it through. Kinda like shift work. For those deeply invested in long-term patient relationships, this aspect may be challenging. Additionally, locum work can sometimes come with inconsistent work availability (shockingly I had one week seeing no patients but still being compensated just to be there), lack of employer-provided benefits such as health insurance or retirement plans, and the administrative burden of managing independent contractor status, including taxes and licensing requirements across multiple states. And certainly the worst part is the time away from family which I reframe as time for personal growth! Initially my wife was not so happy about it, however over time, I feel we became much more intentional and proactive with our time together and with the kids compared to the routine of everyday permanent work. The old saying distance does make the heart grow fonder. That said, I travel first class and stay at really nice extended-stay hotels. Obtaining additional life, disability, health, dental insurance, solo 401k accounts is easy and these are pre-tax write off against 1099 income which doesn’t compare to W2 income if we’re comparing apples to apples. Yes, it gets cold in Montana, but half the time, blue sunny skies, 30-40 degrees—manageable with just a jacket. Having auto-start to warm up the car is a nice perk, and I have to admit, you haven’t lived until you’ve driven a Mustang on the ice!
On the logistical side, the locum agency covers malpractice insurance, assists with licensing, and arranges flights, hotels, and car rentals. The entire itinerary is planned ahead of time, including designated time off—just communicate your preferences from the start, and they’ll ensure your schedule aligns with your needs. Moving forward, I will be transitioning to a more structured closer to home schedule, working Monday to Wednesday while having Thursdays to Sundays off for three weeks at a time, followed by a one-week call in West Virginia. This flexibility continues to make locum work an ideal choice for maintaining balance while enjoying clinical oncology.
Despite these challenges, locum tenens has given me the opportunity to recalibrate my life. I’ve been able to focus on intellectual, social, physical, and spiritual growth in ways that were previously neglected. I even learned to cook some dishes and play pickle ball for the first time (prefer to still play old-men basketball until I screw up a joint)! The choice to do locums is entirely up to me—I can opt out with a 60-90 day notice and explore other opportunities as they become available. I am not obligated to work with just one locum company; I have the freedom to work with several and have developed good, honest relationships with some incredible folks who genuinely care about my well-being. Yes, their interest is in me working locums long-term, but that’s a good thing—our interests align because they want to see me extremely happy and fulfilled in my career. I do well, they do well. With plans to continue traveling, this career shift has been one of the most rewarding decisions I’ve made.
For medical oncologists feeling trapped in their current roles, locum work offers a viable and lucrative alternative. Whether you’re looking to take a break, address burnout, or explore other professional avenues, locum tenens provides the flexibility to design a career that fits your personal and professional goals. Don’t get me wrong—I do plan to return to a permanent position, specifically back to dedicated clinical research. I miss knowing my patients long-term, the collaborative environment with my colleagues, focusing on a specific disease and working closely with industry partners. At some point, I will announce my return and where I will be for the long term, and I look forward to directorship of my own section in the future. Until then, I am thoroughly enjoying my time exploring new opportunities, and it is reassuring to know that there are so many paths available. Locum work will always be there as a flexible, rewarding option. It offers stability, ease, and the ability to adapt to my schedule while still allowing me to do what I love. If you’re considering this path, I’m happy to connect and share my experiences further. The possibilities are vast, and the rewards can be personally immense.
About the author
Dr. Sajeve Thomas is a distinguished medical professional and a compassionate guide in the field of oncology. With over a decade of dedicated experience as a board-certified medical oncologist/internal medicine specialist, Dr. Thomas has become a trusted expert in the treatment of melanoma, sarcoma, and gastrointestinal conditions. He brings a wealth of expertise to the complex and challenging world of oncology.
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