Your First Locum Assignment: What Actually Happens
You've made the decision to try locum tenens — whether to explore a new specialty setting, pay down student loans faster, or simply reclaim some schedule flexibility. But between signing on with a staffing partner and showing up to your first shift, there's a process most first-timers aren't fully prepared for.
This post walks you through what to expect at each stage, from credentialing to check-in, so there are no surprises on day one.
The Onboarding Process
Onboarding is the most document-heavy phase of any locum assignment, and it typically begins four to twelve weeks before your start date depending on the facility and state.
Credentialing and privileging is the first major hurdle. The facility will verify your medical license, DEA number, board certifications, malpractice history, and references. Some states require a separate license, so if you're crossing state lines you'll need to initiate that application early — often before you even have a confirmed assignment.
Once credentialing clears, you'll complete facility-specific compliance requirements: HIPAA training, infection control modules, electronic health record orientation, and sometimes a brief clinical competency assessment. These vary widely by organization; some facilities handle onboarding entirely online while others require an in-person orientation day.
Expect to gather and submit:
- Active medical license for the assignment state
- DEA registration
- Board certification certificates
- Malpractice insurance certificates and claims history (if any)
- Immunization records and TB test results
- BLS/ACLS/ATLS certifications as required by specialty
- Professional references (typically two to three)
If credentialing bottlenecks are a concern — and they often are — it's worth understanding the five most common credentialing delays and how to get ahead of them before they push your start date.
Understanding Your Contract
Locum contracts are shorter and more flexible than traditional employment agreements, but they still carry terms worth reading carefully before you sign.
Key contract elements to review:
- Assignment length and schedule — Contracts specify the exact dates, weekly hours, and shift structure. Some are open-ended with rolling extensions; others are fixed-term. Clarify whether shifts can be changed at facility request.
- Compensation structure — Most locum clinicians are paid an hourly rate or a day rate. Rates vary significantly by specialty, geography, and urgency of need. For a realistic look at what to expect, see our breakdown of what locum physicians actually earn.
- Malpractice coverage — Confirm whether the coverage is occurrence-based or claims-made. If it's claims-made, ask whether tail coverage is included or if you're responsible for it after the assignment ends.
- Exclusivity and moonlighting clauses — Some contracts restrict you from working independently with the same facility or in the same market during or after your placement. Understand the scope before agreeing.
- Cancellation terms — Review the notice period required by both sides. A facility that can cancel a shift with 24 hours' notice without penalty creates financial uncertainty for you; negotiating a minimum notice window is reasonable.
If anything is unclear, ask your staffing representative to explain it before you sign. This is especially important for first-timers who haven't encountered locum contract language before.
Travel and Housing: What's Typically Covered
One of the more attractive aspects of locum work is that travel and housing costs are almost always covered by the agency or the facility — but the specifics vary.
Airfare or mileage reimbursement is standard for assignments that require travel beyond a defined radius (commonly 50 miles from your home). If you're driving, expect either a per-mile reimbursement or a flat travel stipend. If you're flying, the agency typically books or reimburses coach-class airfare.
Housing is usually provided through one of two arrangements: the agency books a furnished corporate apartment or extended-stay hotel on your behalf, or they provide a housing stipend and let you arrange your own accommodations. Furnished housing is common for assignments longer than two weeks; stipends are more typical for shorter stints or in markets where the agency has existing arrangements.
Rental car or transportation is generally covered for inter-city assignments where you'll need a vehicle to commute. For urban placements with accessible transit, coverage may differ.
One practical tip: always confirm the housing address and confirm the rental car reservation at least a week before arrival. Logistical snags — a double-booked apartment, a reservation under the wrong name — are more common than they should be, and arriving tired after a cross-country flight to find a housing issue is a rough way to start.
What the First Week Actually Looks Like
Most clinicians describe the first week of a locum assignment as a mix of productive adaptation and mild disorientation. You're learning a new EHR, a new layout, new staff names, and new workflows — all simultaneously while seeing patients.
A few things that help:
- Arrive early on your first shift. Give yourself extra time to find parking, badge access, and your workstation. Facilities vary enormously in how organized their locum onboarding is.
- Ask about the unwritten rules early. Who's the go-to for supply questions? Where do labs get routed? Which attending should you loop in for escalations? These aren't in any orientation packet.
- Be adaptable on EHR workflows. You may have a preferred charting style, but locum positions aren't the place to fight for it. Adapt to the local system quickly and adjust your templates later if needed.
- Introduce yourself to the core team. Nurses, MAs, and front desk staff can make your assignment significantly easier or harder depending on the relationship you build early.
Most experienced locum clinicians say the second week is dramatically smoother than the first. The learning curve is real, but short.
How Rediworks Streamlines the Experience
The administrative overhead of locum work — credentialing paperwork, contract management, housing logistics — is where most frustration accumulates for first-timers. Rediworks is built to compress that overhead.
Our platform centralizes your credentialing documents so they're ready to submit the moment an assignment matches, rather than gathering paperwork from scratch each time. Contract terms are presented in plain language with flagged clauses so you know what you're signing. And our team coordinates housing and travel logistics directly, so you're not managing airline bookings alongside a clinical schedule.
For clinicians who are newer to locum work, we also provide direct support throughout the onboarding process — not just a portal and a phone number. If you want a fuller picture of what the locum tenens model looks like before your first assignment, our complete guide for clinicians considering locum work covers the broader landscape: specialties, markets, compensation structures, and licensing considerations.
Ready to Start?
Your first locum assignment comes with a learning curve — that's expected. But with the right preparation and a staffing partner who handles the logistics, the transition from uncertainty to confidence happens faster than most clinicians expect.
The goal isn't just to fill a shift. It's to give you an experience worth repeating.