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Career quandary: Should I move from locum work to a salaried GP role?

James Truswell, director at Menlo Park, answers a locum GP's dilemma over whether to go permanent.

James Trusswell, director, Menlo Park

Question: I’ve been working as a locum GP for the last two years as I was attracted to the higher pay and increased flexibility over when and how I work. However, I’m starting to realise some drawbacks - I’m not getting any input into my training and development, and I don’t feel fully part of the practices where I work. Should I look for a permanent position or what should I do?

James Truswell says…

Whilst you may have enjoyed the perks of locuming, it sounds like you’ve also started to realise what you’ve been missing out on. There is no reason for a practice to invest in a locum’s training, whereas if you were a salaried GP you would indeed have a practice that cares about you and invests in your long term career development.

Being a locum can be isolating - you’re typically on the move, you don’t have your own room to work from and you lack routine and familiarity. You’re probably known as ‘the locum’. As a permanent GP the practice staff would know you by name and you would feel much more part of a team. 

Most people enter medicine because they want to provide continuity of care, which is important to patients and your own job satisfaction. Who would you prefer to have looking after your family - an unfamiliar locum or a doctor you know and trust?

In terms of pay, you need to consider the overall package. Consider the value of six weeks annual leave, one week study leave, sick pay, indemnity pay and maternity/paternity pay that you’re not getting as a locum. Many locums enjoy the life of a salaried GP but with higher locum rates. However, changing IR35 legislation means HMRC is cracking down on this and it’s making many locums switch to salaried roles.

Locuming is often perceived to be a more flexible option but many tell me they don’t take much leave because they see it as lost money. This isn’t great for your health, productivity or work/life balance. More and more salaried roles are in fact offering flexible working options too so it’s worth exploring these. 

The experience you would gain as a permanent GP, such as home visits, paperwork, bloods and results analysis, is more likely to future proof your career than locum work is. Many locums risk becoming unemployable if the market turns from the current GP shortage. So whatever road you decide to pursue I would urge you to assess the impact on your long term career.

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