Key Points
- Your first locum tenens assignment should align with your career goals, whether you’re seeking flexibility, additional income, new clinical experiences, or a better work-life balance.
- Evaluating the clinical environment, onboarding process, and level of support can help ensure your first assignment builds confidence rather than creating unnecessary stress.
- Success in locums goes beyond patient care. Understanding 1099 contractor responsibilities, benefits planning, and operational expectations is essential before accepting an assignment.
- Asking thoughtful questions about contracts, scheduling, malpractice coverage, and site expectations helps clinicians make informed decisions and find assignments that fit their needs.
Starting your first locum tenens assignment is exciting, but it can also feel overwhelming. Whether you’re a physician or an advanced practitioner, your first experience with locums can shape how you feel about this work long-term.
You may feel confident clinically, but navigating new sites, new systems, and independent contractor logistics can still feel unfamiliar. That’s completely normal.
Before you say yes, it helps to pause and ask the right personal questions about your goals, your comfort level, and how prepared you feel for the realities of locums work. These questions aren’t meant to slow you down. They’re meant to help you move forward with confidence, clarity, and the right support.
Below are key questions to ask yourself, along with prompts you can bring to your recruiter to make sure your first locums assignment is a good fit.
Why am I choosing locum tenens right now?
Before focusing on any specific assignment, it’s worth getting clear on your “why.” Locum tenens work can look very different depending on where you are in your career. It may offer flexibility between roles, exposure to new clinical environments, geographic freedom, additional income, or a way to explore practice settings before committing long-term.
Early career clinicians come to locums for many reasons. None of them are wrong, especially at a stage when you’re still learning what kind of work and lifestyle suit you best.
Questions to ask yourself.
- What do I want out of locums at this stage of my career?
- Am I prioritizing flexibility, income, location, experience, or recovery from burnout?
- What would make my first assignment feel like a success?
Your first locums assignment doesn’t need to be your “forever” role. It just needs to support where you are right now.
Questions to bring your recruiter.
- Based on my goals and experience level, what types of assignments should we focus on?
- What regions match what I’m trying to accomplish?
What clinical environment will help me succeed?
Your first locums assignment should stretch you, not overwhelm you. Even strong clinicians can feel challenged when everything is new at once.
Questions to ask yourself.
- Do I feel more confident in fast-paced, high-acuity settings or steadier, more predictable environments?
- How much autonomy am I comfortable with on day one?
- Do I want a broad scope of practice, or something closer to what I’ve done recently?
It’s okay to choose a first assignment that feels “easier.” Confidence builds quickly once you’ve done this once.
Questions to bring to your recruiter.
- What does a typical day look actually like at this site?
- How does the facility usually utilize locums clinicians?
How much structure and support do I need?
Every clinician adapts differently to new environments, systems, and teams. Early career clinicians often benefit from more clarity up front.
Questions to ask yourself.
- Do I do best with formal onboarding, or am I comfortable jumping in quickly?
- How important is it to have a clear point of contact on site?
- What level of clinical and operational support do I need to feel confident?
Your first assignment is not the time to test your limits unnecessarily. It’s the time to build confidence and rhythm.
Questions to bring to your recruiter.
- What kind of onboarding or orientation is provided?
- Who will be my go-to person during the first few shifts?
- How familiar is the site with working with locums?
Am I comfortable with the level of operational complexity?
Locums work often means navigating new systems alongside clinical care. That exposure can also be an advantage. Learning how different organizations operate, document, and deliver care can build adaptability and confidence that carries into future permanent roles.
Questions to ask yourself.
- Am I comfortable learning a new EMR quickly?
- How much administrative complexity can I manage while maintaining quality and safety?
- Do I feel okay asking questions on site?
Questions to bring to your recruiter.
- Which EMR is used, and is training provided?
- What are the documentation expectations?
- How are consults, referrals, and support services handled?
Am I financially ready to be a 1099 contractor?
This is one of the biggest adjustments for first–time locums clinicians, and one of the easiest to underestimate.
Questions to ask yourself.
- Am I prepared to manage my own taxes without employer withholding?
- Do I understand that I may need to make quarterly estimated tax payments?
- Am I ready to track income, expenses, and work by state?
Financial realities to be aware of.
- Locum tenens clinicians are typically classified as 1099 independent contractors.
- Taxes are generally paid through periodic estimated payments, which may be quarterly.
- Contractors are responsible for their own federal, state, and local taxes, including applicable self-employment taxes.
- Working in multiple states may require filing tax returns in more than one jurisdiction.
Questions to bring to your recruiter.
- Which states will I be working in so I can track income correctly?
- What expenses are covered by the assignment versus my responsibility?
This article provides general information related to locum tenens. It is not intended as legal or tax advice. Please consult with a professional tax advisor or accountant to receive advice specific to your circumstances.
Get answers before your first assignment.
Do I have a plan for benefits I used to get automatically?
Benefits and coverage details are some of the most common and most important questions for clinicians new to locums, because these protections often look different than they do in employed roles. As a locums clinician, many benefits shift from employer–provided to self–managed.
Questions to ask yourself.
- How will I handle health insurance during this assignment?
- Do I have a plan for retirement contributions without an employer plan?
- Have I budgeted for gaps between assignments?
Common options clinicians explore include:
- Coverage through a spouse or partner.
- COBRA after leaving a full-time role.
- Marketplace or professional association health plans.
- Retirement options like an Individual Retirement Account (IRA) or a Simplified Employee Pension (SEP) account.
Questions to bring to your recruiter.
- Is malpractice insurance included, and does it include tail coverage?
- What travel or lodging support is provided?
Do I understand the contract, and am I comfortable with the risk?
Your contract outlines the terms and conditions of your assignment, including responsibilities, expectations, and key rights.
Questions to ask yourself.
- What would I do if the assignment were canceled?
- How much flexibility do I need if personal circumstances change?
- Which terms would make me uneasy?
Questions to bring to your recruiter.
- What is the cancellation policy on both sides?
- What happens if the scope or schedule changes?
- Who should I contact if something doesn’t match expectations?
Final Thought for Early Career Clinicians
You don’t need to have everything figured out to start locums. You just need the right questions, and a recruiter who’s willing to talk them through with you. Thoughtful questions aren’t a sign of hesitation. They’re a sign you’re taking ownership of your career. A good recruiter won’t rush these conversations. They’ll welcome them. The right questions help them advocate for you more effectively.
Get clarity on fit, expectations, and next steps before you commit.
