When you move to Australia as a UK junior doctor, you have to take a permanent job first and are not eligible for locum work. 

But, after a year, it’s possible to leave that job but remain in Australia as a locum doctor. Much like locuming in the UK, this gives you flexibility and control over time, the freedom to travel and significantly increased pay.

In this article, we chat with Dr Oliver Riley. He, after a year of working in General Medicine and Emergency Medicine in Brisbane, has transitioned to life as a locum doctor in Australia.

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🌏  What prompted you to make the move out to Australia?

I moved out to Brisbane in November 2020. I’d finished my FY2 and wasn’t ready to start a training programme, so I had two real options; locum and travel or work abroad. I decided that working abroad was a more unique opportunity that I may not get again and offered the opportunity to work in a different healthcare environment.

🇦🇺  Where did you work when you moved out?

I worked at The Prince Charles Hospital in North Brisbane. It has a busy emergency department, General medicine, general surgery, pediatrics, orthopedics and ICU and specializes in cardiothoracic and cardiology.

🤔  For those that aren’t aware, why can’t you locum from day one in Australia?

All overseas doctors moving to Australia will start off on Provisional Registration with AHPRA, barring some Consultants using the Specialist pathway

This provides up to 12 months of Registration to allow supervised practice in Australia. This registration level is comparable to being provisionally registered with the GMC during your FY1 year. You have to work supervised under a named supervisor in a named job at all times, so you cannot work as a locum under Provisional Registration.

After 47 weeks of full-time supervised practice under Provisional Registration, you can then apply for General Registration. Once this has been approved, you are eligible to start locuming.

👉  You can read more about AHPRA’s registration types and their differences here. 👈

🌴  Did you consider taking another permanent job after your first contract, or did you know you wanted to locum?

I did consider staying at the hospital because I really enjoyed it there and had a good rapport with my colleagues. However, I thought locuming would provide a new and exciting opportunity to travel and earn more money doing similar work already.

Generally, people either decide after receiving their full AHPRA to step up to a PHO (Principal house officer) role, basically a junior registrar, or locum. Stepping up to a more senior role offers more training and experience but as I do not want to pursue a career in emergency medicine I decided locuming was better suited to me and what I wanted.

🇬🇧  Had you locumed in the NHS before moving to Australia?

Yes, I locumed through the Staff Bank at the last hospital I worked at before travelling out to Australia, in A&E at the Royal United Hospital, Bath.

💰  What were the main benefits of locuming that you were weighing up? 

These are very similar to the trade-offs that you’d look at if you were considering locum work in the UK vs a permanent job such as a fellowship. Messly has written a guide on that here which breaks down the pros and cons.

Here are the benefits that I’ve experienced in Australia:

👉  Flexibility - The ability to choose when and how much you work is one of the biggest selling points of locum life. Having a less-packed work schedule and more free time is especially important in Australia, when your time in the country might be limited if you think you’ll come back to the UK at some point. 
👉  Travel - It’s allowed me to explore Tasmania’s greenery and Queensland’s beaches, as part of locum assignments and in my time off between locum work.
👉  Variety of clinical environments - I have worked in contemporary COVID virtual wards and various emergency departments, providing a real mixture of clinical scenarios. These experiences are useful additions to my CV.
👉  Pay - Pay rates in Australia are already higher than in the NHS, but you take this up another level again when you locum. It’s also common to have your flights and accommodation covered too, so financially, this is a highly fortuitous position. We break down the pay in a later question.

👎  What downsides have you experienced?

There are some downsides…

You don’t tend to worry about finding work as there is a lot of work going on, but it can be competitive to get good jobs ie in desirable places. You also don't have sick pay or Annual leave, so I’ve been more conscious of getting COVID etc, when I'm locuming as I won't be entitled to any sick pay. Sometimes you can negotiate this into your contract, especially if you’re working on COVID wards etc.

There’s also a lack of continuity, always feeling like the work newbie and having to get your head around yet another IT healthcare system, which can be draining.

It might not be for everyone or a long-term career, but for me, the financial and travel opportunities that locum life brings provide an amazing opportunity to see Australia and work in new and exciting healthcare settings.

🩺  How did you go about finding work? Are you locuming with an agency?

I spoke to a few doctors who were already locuming and with different agencies to get a feel for things. 

Locum work out here in Australia is pretty much all through agencies, so it’s a case of choosing the right one for you.

From my own experience and a lot of friends who have already gone through the locum life, many agencies might have similar work.

There is some variability, however, in the quality of service, the minimum number of shifts they want you to work per month and what referral bonus they offer. 

Given that most agencies offer similar work opportunities etc., I chose to go with the agency that had the smallest minimum number of shifts they wanted me to work a month to give me the most flexibility.

Within an agency, there are obviously lots of different individual recruitment agents, so I went with an agent that my friends had been with before and felt they were good.

🏥  How did this process compare to finding locum work in the NHS?

My only comparison of this is working at my old hospital, where I knew the staff and rota coordinator well, so I would just email personally to pick up shifts. Whereas out in Australia, all is done through agencies.

💸  What is the pay like for locums?

The going rate for a doctor at my level (F4) is around A$120-150 per hour. At today’s exchange rate, that is £68 to £84 per hour.

It’s common to get accommodation and travel (rental car and flights) covered by the hospital too.

You negotiate the pay that you want through your locum agency recruiter. Generally, the more remote you’re willing to go, the better the pay because fewer people are willing to go there. Some people are happy going to very remote hospitals on Fly in Fly out or FIFO contracts. In contrast, others would people prefer to work in a more desirable place (like Byron Bay, for example) but accept a lower rate of pay.

Another thing about working in the public sector is that you can claim a tax-free allowance for working in the public healthcare system (called RemServe in Queensland), plus pension contributions.

🦘  When did you do your first locums? Where have you worked?

I worked at Gold Coast University Hospital as my first job on a COVID Virtual ward. Something very different, involving telehealth medicine and Specialist COVID therapies knowledge and advice. As part of my contract, they paid for an AirBnB right by the beach and it was a 10-minute commute on a tram to work which was great as I’d often get back for a sunset beach run or swim in the sea. I have worked around Brisbane at various other hospitals and in COVID fever clinics.

🥼  Is there locum work in most specialties and regions, or do you have to focus on certain areas to pick up work?

Like in the NHS, there is usually an abundance of locum work, especially in Emergency Medicine and General Medicine.

If you want to do more specialised job positions, then they can be a bit tricker, but they do exist. 

👨  What proportion of your British colleagues who moved out at a similar time are now locuming too?

I’d say around 75% of them are now locuming but that's because a lot of them are planning on coming back to the UK and so are less incentivised by a training programme or working in the public sector. 

Those looking to stay in Australia to train generally locum for a bit but obviously want to start a training programme. 

💉  Have you noticed a difference in the clinical experience, supervision etc in your time as a locum vs in your permanent job? 

As a locum, you are ultimately there as service provision, so generally, don’t attend teaching sessions that permanent staff doctors will. Likewise, with clinical teaching opportunities, permanent staff will be prioritized, e.g. doing procedures. When you start at a new place, the consultants may keep a closer eye on you to start just to make sure you’re safe/competent, and you will also want to demonstrate this to them. Once they feel confident in this, you’re treated like any other staff member in terms of responsibility/supervision. 

🌊  How are locums treated in Australia? Is that different from in the NHS?

Locuming is very much accepted as part of healthcare in Australia, and colleagues are generally grateful for you doing the job (otherwise, there wouldn’t be someone there to help them run the service etc.) - similar to the NHS from that perspective. I’d suggest that locums are more accepted as part of healthcare in Australia. 

☀️  What are your plans for the next 6-12 months?

I plan to travel a bit more whilst locuming. I have four weeks planned In Launceston in Tasmania, which will be lovely this time of year to visit and work. I would also like to do some work in West Australia and Darwin before heading back to the UK in May next year to go into a training programme, hopefully.

Do you have any other advice/things to mention?

Yes, here are my top three tips:

☝️ Having a hospital recommended by someone who’s worked there before will go a long way to making sure you’ll enjoy your time there.
☝️ It takes a while to get used to new systems, so just take your time and ask lots of questions early on.
☝️ Have a goal that your locum job is helping you achieve when you start - mine's usually a trip, and it will help you through those busy shifts!

📚 Continue Reading

🚀 This article is part of Messly's Ultimate Guide to Working in Australia. The guide covers all you need to know as a UK doctor to understand your options, research your move, find work, get registered and move out to Australia.

❓ If you are still weighing up whether a move to Australia is right for you, our article To Aus or not to Aus breaks down the pros and cons, so you can make an informed decision. Read this with Common Questions on Moving to Australia as a UK Junior Doctor.‍

🤔 Confused about how the grades work in Australia, and which roles you should be applying for? This article breaks down the grade system and explains which rolesmight be suitable for you.

💬  Read this interview with an ED doctor who has been working in Brisbane for three years. He shares the inside scoop of what it's like working day-to-day in the ED and how this compares to A&E in the NHS.

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