Locum practice by recent family medicine graduates.

OBJECTIVE

To explore the demographic characteristics of recent Alberta family medicine residency graduates choosing locum practice, as well as their reasons for choosing and leaving locum practice and the frustrations and rewards of locum placements.

DESIGN

Web-based and mailed cross-sectional survey and interviews.

SETTING

The family medicine residency training programs at the University of Calgary and the University of Alberta.

PARTICIPANTS

A total of 152 graduates who had completed family medicine training between 2001 and 2005, inclusive, and who had either done locums in the past or were doing locums at the time of the survey. Interviews were conducted with a subsample of this group (n = 10).

MAIN OUTCOME MEASURES

Duration of locum practice, reasons for choosing and leaving locum practice, and frustrations and rewards of locum practice.

RESULTS

Of the 377 graduates surveyed, 242 (64.2%) responded. Among the respondents, 155 (64.0%) had in the past practised or were at the time practising as locum physicians (complete data were available for 152 respondents). Most (71.7%) had arranged locum placements independently. The average duration of a locum placement was 9.1 months. Female and younger family physicians were more likely to practise as locum tenentes. The most common reason for doing a locum placement was as a practice exploration to increase experience or competence (46.7%). The primary reason for leaving locum practice was to settle into permanent practice (52.1%); interview data revealed that this reflected a desire for stability, a desire for continuity with patients, personal life changes, financial considerations, and the end of a perceived need for exploration. Locum tenentes were frustrated with negotiating locum contracts, low patient volumes, lack of patient continuity, and working with difficult staff. Rewards of locum practice included flexibility and freedom in practice, gaining experience, and the rewards that come from seeing patients. In total, 44.6% of family medicine graduates joined practices in which they had done locum placements.

CONCLUSION

Locum practice is a common early career choice for Alberta family medicine graduates. The most common reason for doing a locum placement was to gain experience, not to delay commitment. Locum practice tends to appeal more to female and younger family physicians. Rewards of locum practice were also cited as reasons for participation. Locum tenentes tend to be frustrated with the business aspects of arranging placements and with the generally low patient volumes. Long-term recruitment efforts by community physicians should be initiated within the first week of locum engagement.