See the world the locum way

By her mid-50s, Claire Arment started to think about retiring. But the California FP wanted to end her career with a flourish rather than a slow fade. So she signed up with Global Medical Staffing, a Murray, UT-based agency that places physicians in locum tenens positions in Australia, New Zealand, and, occasionally, the United Kingdom, the South Pacific, and the Caribbean. Under Global Medical's aegis, Arment spent almost six months providing vacation and CME coverage for physicians in Queensland, Australia.

Arment, who returned to San Diego in January, stopped in Tahiti on her way to Queensland and in Fiji on her way back. While in Australia she toured the picturesque coastal town of Innisfail, saw Carnarvon Gorge (a popular tourist destination similar to the Grand Canyon), went diving on the Great Barrier Reef, and drove the Great Ocean Road, a stunning stretch of coastline southwest of Melbourne.

Physicians who opt to do locum work thousands of miles from home aren't easily categorized, says Alan Lakomski, Global Medical's chief operating officer. Some, like Arment, want to cap off their medical career with something different and challenging. Others are only a year or two removed from residency and are looking for an out-of-the ordinary job before settling down to full-time practice.

Locum tenens physicians generally sign on for six months or a year, but many extend their stays, says Abby Grayzel, international division manager for Vista Staffing Solutions, a Salt Lake City-based company that places locums in the US, Australia, and New Zealand.

Overall, it's a "back to basics" interlude: Most locums abroad serve in sparsely populated areas, and house calls are the norm. But it's far from a Doctors Without Borders volunteer stint in a Third World country. While working as a physician abroad isn't likely to fatten your bank account, locums rarely have to pay for more than food, clothing, and entertainment-housing, utilities, use of a car, and practice overhead expenses are part of the package.

Have we stirred your interest? If so, read on for more about the locum abroad experience, as managed by Global Medical Staffing and Vista, the major US-based firms that handle international locum placements. (You can find even more details about locums tenens work both at home and abroad at http://www.locumlife.com, the website of our sister publication LocumLife magazine.)

What's the application process?

Candidates for Global Medical Staffing slots fill out an application and submit their CV. After reviewing both for gaps in training or work experience, the agency phones five references who have worked with the physician during the last year. "We check to see that the doctor is licensed and require a certificate of good standing from the body with which he or she is registered to practice medicine," says Robert W. Stringham, Global Medical's president.

Physicians who clear those hurdles are invited to select from several opportunities within their specialty. If the practice that the doctor prefers is impressed with his CV and other credentials, Global Medical sets up a teleconference. "Everyone wants to make sure that it's a good fit," Stringham notes.

Vista's credentialing process requires six phone references and three written letters of recommendation, and the company also verifies applicants' education, training, hospital and clinical privileges, board certification, and state licenses. "We spend quite a bit of time talking to doctors to understand their motivation for wanting an international assignment and to ascertain their interpersonal skills, flexibility, and adaptability," says Grayzel. "They also have to complete an application and our 'scope of practice' form to determine the best skill match among the placement opportunities."

Vista applicants then participate in a teleconference that includes representatives from the hospital or private practice of choice.