Pros:

  • Opportunity to experience wide range of specialties
  • Autonomy – you pick what shifts you want to do, and you can leave placements that are making you unhappy or where you feel unsupported
  • Convenience – your shifts are found for you, offered to you by email, and booked in for you by the agency. All you need to do is turn up!
  • The agency communicates with the trust and chases them up for you
  • Complete flexibility – you can pick up shifts weekly or you can book longer term placements
  • Weekly pay (usually) and better rates!

Cons:

  • Lack of clinical or education supervision (particularly noticeable during these pandemic times!)
  • Being “the locum” on shifts and the judgement you sometimes receive from colleagues
  • Phone calls from the agency at weekends/on days off – but this can be alleviated by blocking the phone numbers!
  • Less structure and support for portfolio, CPD and appraisals
  • I had to pay for my appraisals

My experience as an F3/F4/F5 with HCL Doctors:

I am currently still working as a locum in (technically) my F5 year! I have been working as a locum with HCL Doctors since I finished FY2 in August 2018. I did this because as an F2 I had no idea which specialty I was going to apply for.

I think that the most important point I want to make about doing at least an F3 year and in particular doing this through a locum agency, is that it gives you such a wide range of opportunity to experience different areas of medicine.  These could be areas that you would never have considered or had the chance to experience through foundation training.

I was one of the many who had no Intensive Care or Anaesthetics posts during my foundation years. A career in these specialties had never occurred to me. In April of my F3 year with HCL Doctors, I was offered a four-month full time post as a locum in Intensive Care at Nottingham University Hospitals, which meant I had the same rota and responsibilities as the Junior Clinical Fellows.

This meant I went from being a locum F3 to wearing a “Critical Care Doctor” lanyard and putting in central lines! For this I am incredibly grateful as I have now discovered a love for Anaesthetics and Intensive Care Medicine. This would not have happened for me, directionless as I was at the time, had it not been for the fact that I was working for an agency who were able to offer me a range of different posts.

Since my first four-month post in ITU I’ve been able to get a further five-month and another two-month post with them, still as a locum. I love it so much that I’m now finally ending my time as an agency locum to take a (proper!) Junior Clinical Fellow post with ITU, and I’m applying for Anaesthetics training this year. I would never have had this career direction if it weren’t for my time as a locum. I still can’t believe how lucky I’ve been to have the experience I’ve had working in ITU.

Other specialties I’ve worked in as a locum include Neuro-Rehabilitation (mostly patients who have been discharged from long stays on ITU) and Haematology (where I worked on the Bone Marrow Transplant unit), both of which I loved and wouldn’t have had any experience in otherwise. The agency has also provided an easy way to access ED shifts which are always available.

 I have to say that my experience with HCL Doctors as a locum agency has been wholly positive. They have been my sole agency and source of shifts for two years and four months now, and not once have I been short of shifts. I have been fully autonomous in choosing which shifts I want to do, and when I’ve been unhappy in a placement the agency has helped me to move placements without any trouble. I’ve had one agent, Michelle, who has been my go-to for any problems and who has sent me all the shifts and posts they have available. She’s always contactable by phone and she’s accommodating and friendly.

I joined the agency by simply phoning HCL. I chose HCL because they get prioritised for shifts with NUH, which was where I wanted to work. I spoke with one of the agents and explained that I was an F2 who wanted to start doing locum work as an F3. The agent then set up a remote face to face meeting for them to check my ID etc, for which they travelled to Boston, Lincolnshire to meet me where I was working at Pilgrim Hospital. The whole process was very easy for me and once my DBS had come back I was good to go – they had ED shifts available for me from the very next day.

With regards to appraisal, I have been keeping a portfolio with MEDSU for which HCL pays the £30/month subscription as long as you work >1000 hours/year (which you most likely will). Appraisal with MEDSU then costs around £230.

The most important negative I would say that I have experienced as an agency locum is the lack of senior clinical support and supervision. There have been times when I would have gone to my educational or clinical supervisor to discuss problems or issues (particularly safety issues identified at work) where I have had to figure out who to turn to, which at times can be difficult. This has been particularly evident to me since the pandemic has happened, being without a senior who has a responsibility to check in on you does feel quite lonely and unsupported after a while.

I’m also aware that were anything to ever happen with a serious incident at work, that there would be much less support from senior medical staff in coroner’s court as an agency locum than if I were a trainee or in a trust grade position.

I wouldn’t trade my last two-and-a-bit years’ experience for anything, but I am very much looking forward to having some senior support again in my new job.

In summary, I would recommend doing an F3 year to anyone and everyone, unless you know for sure what you want to do and just want to get through training as quickly as possible. But for those who are unsure about what direction to take themselves in or who wouldn’t know what specialties to apply for trust grade F3 roles in, working through an agency is a great way to discover new specialties! It is flexible and well paid, and the agency takes the burden of the organisation of your shifts and communicating with the trust. As long as you have the organisational skills to keep yourself up to date with your portfolio, CPDs and appraisals, I think it’s a great option and I’d do it again if I had to go back and make the same decision.

Article written by Dr. Amy Fitch 26/11/20