"After 11 years in training I realized that once I had control over my schedule, I wanted to do medical relief work. Since I started working locum tenens assignments I have been to Haiti four times—every other month."

Cecily W., MD, a fellowship-trained critical care and trauma surgeon, did her first medical relief mission to Haiti during her residency. She returned with a Salvation Army team right after Haiti suffered a 7.0 magnitude earthquake in January 2010.

That's when Cecily began looking for a job that would support her relief work. "I need to work enough to fund my trips," she says. She evaluated several jobs and accepted one that promised a specific number of shifts per year, which, she assumed, could be grouped together to give her blocks of time to work in Haiti. Unfortunately it did not work out that way and she was only able to make it to Haiti twice that year.

"They don't teach you this in residency," she says. "You are not thinking about how to negotiate for a workable, flexible schedule. You are only thinking about getting a job.

"Even if your goal is a permanent job, it makes sense to use locum tenens to test the fit before signing a contract," she suggests. "It's like a long, two-way interview, and you get paid for it."

Going forward, Cecily sees herself working one or two locum tenens assignments in a given month, and then spending a month in Haiti or another country that needs her services. She leads teams for New Reality International (www.newrealityinternational.org), a non-profit organization based in Nashville.

"My VISTA scheduler, Denise, is good about picking assignments that fit me. She has a better feel for my needs than other agencies, and that is smart in this business," she says.

From Maine to Kansas to Washington, Cecily says she has loved every group she has worked with. And the feelings have been mutual. Every location she has staffed as a locum tenens has offered her a permanent job.

"I went into medicine because I wanted to do everything—travel, practice, save the world," she says. Her long-term goal is to set up international medical relief programs with more continuity, where, for example, surgeons and medical personnel rotate through on a more regular basis. "The goal is to get these places to the point where they don't need you anymore," she concludes.

Cecily W., MD,
Critical Care and Trauma Surgeon

"Joining a small group practice is like a marriage. Having the opportunity to work in the practice as a locum tenens physician gave me the chance to observe my future partner and for him to observe my skills and style. That's an important part of establishing a successful partnership."

Although this "marriage" was not even on the radar when board-certified OBGYN Michael L. decided to semi-retire in early 2010 and travel the country as a locum tenens physician.

"My wife and I had never seen the Grand Canyon, so we figured we would start out with short assignments in the West. But one of the first assignments VISTA offered to me was in Maine. They described it as, 'A short assignment until the hospital is able to recruit.' We figured, why not?" he remembers.

There was just one other OB in the practice and the two hit it off instantly. "He is a great doctor with a great personality. In no time, he offered me the job permanently," says Michael. The answer was, "No thank you, we really want to do this locum tenens thing.

"But as we left we looked around and thought that this would be a really great place to live," he says. The town's population is about 7000; there is no expressway; the food is fresh and healthy; the people are active and hard working; Penobscot Bay and Blue Hill will take your breath away. The couple returned for repeat assignments. "And they tried to recruit me, again. And again. Throughout the summer.

"Finally," Michael says, "we decided that maybe this was providence. Maybe this was opportunity knocking and we'd be wrong to ignore it. Maybe it was time to pack up and leave Kentucky for a part of the country where we had never in our wildest dreams thought of living.

"In 30 years, I have never been as happy practicing medicine as I have this past year in Belfast, Maine," he concludes. "It has truly been a return to all the reasons I wanted to become a doctor.

"It's not easy to cut the ties to your long-time practice," Michael says, "But I have no reservations recommending locum tenens and VISTA.

"The first person I contacted at VISTA was Betsy. She was so warm and confident." Michael says he was a bit surprised, but ultimately reassured, by the depth of VISTA's credentials review process. Some of the colleagues VISTA contacted as references on his behalf mentioned that they were impressed with the knowledge and specificity of the skills-assessment questions asked. "Once I was ready to go everything was handled in a timely manner—travel arrangements, cars, accommodations," he says.

Michael says that, to be perfectly honest, he's a bit envious of the locum tenens doctors he works with now, "because they get to run around the country doing this." He recalls two older colleagues who retired and worked locum tenens assignments for nearly 10 years. "Both say it is the highlight of their careers."

Michael L., MD,
OBGYN

"My scheduler, Janel, must have died laughing at me the first time around; I asked so many crazy questions. But if she was laughing she never showed it. There is someone to help you with everything when you work with VISTA," says Swati S., MD, MPH, a board certified OBGYN who has worked with VISTA since 2009.

After 10 years in a group practice, where Swati watched her income shrink despite being on call virtually every night—and after Hurricane Katrina destroyed the group's office in New Orleans' Upper 9th Ward—she decided locum tenens offered the chance for a better quality of life. "I love the flexibility, the travel. I am the kind of person who relishes the challenge of testing my skills in a different arena, of thinking about how medicine should be practiced. Locum tenens is never boring.

"Especially in rural areas, patients appreciate access to care. They like their doctors and they are happy that their doctor gets a vacation because I am here," she says. She's had permanent job offers just about everywhere she has worked, which is gratifying, but not part of her plans. She has guest rooms to paint, volunteer trips to plan, holidays to spend with family, and a lot more traveling to do.

"My mother says I am a different person since I started working as a locum tenens," she continues. "I just laugh and tell her it's because I get more sleep these days, but she thinks it is something more.

"Now I would say, 'If you are ready for adventure, interested in flexibility and variety, want to feel good about covering for a physician who really needs a break...come along for the ride!'"

Swati S., MD, MPH
OBGYN

"I think that coming here has added 20 years to my career. Unless you have experienced it, I don't think you can really understand what being in a kind, relaxed place is like. The hospital is great and I really like the people I work with. I am so grateful to VISTA for your help in making it happen!"

Jennifer R., MD, a board certified emergency medicine physician, worked in busy EDs in California, New Mexico, and Nevada for more than 15 years before contacting VISTA about international locum tenens work. She accepted a year-long locum tenens placement in Invercargill, New Zealand in 2009, re-upped for another year in 2010, and has now decided to stay permanently. With an assist from VISTA scheduling associate Ciara Baber, Jennifer has extend her visa, and she has applied for vocational registration with the Australasian College of Emergency Medicine. Now she is busy helping her new hospital establish an emergency medicine training program and trying to recruit additional US doctors to work in New Zealand.

"I would love to see more US trained doctors come here and get to re-experience what medicine is supposed to be," she says. "The entire hospital is on a first-name basis. The nurses finally call me Jennifer! It is fun to talk to docs from all over the world and hear differences in how medicine is practiced. There is a wonderful spirit of collegiality here."

Jennifer is also astounded by the relaxed schedule and generous time off. "I feel like I have had lots of time off and have travelled extensively this last year, but I currently have 300 hours of paid time off to use. And I just got another 240 deposited in my leave account as I have had my year anniversary! The reimbursement package as initially explained does not in any way portray how much time off you actually get."

Putting that time to good use, Jennifer, her husband, Greg, and their two Akitas, Miko and Katana, have visited the Catlins, Lake Wanaka, Arrowtown, and Te Anau. Greg is an outdoorsman and fly fishes, plays golf, and got to ski more than 30 times at eight different ski fields last year. Jennifer loves to cook and revels in the fresh ingredients and healthy options.

Jennifer R., MD
Emergency Medicine