Exploring New Frontiers

For psychiatrists John R. Stein ’91 and his wife, Sara Kulleseid, doctoring abroad seemed like a perfect opportunity to work, play, and travel all at the same time. So in 2000, they signed up for temporary jobs in Auckland, New Zealand. "Living and working there, we were able to immerse ourselves in the life" of the country, says Stein, of New Jersey. "There was no language barrier, and the work we did was very social, so we interacted with a lot of nurses and other doctors, and got to know the culture."

Such assignments are known in the medical community as "locum tenens." They can run anywhere from six months to several years in foreign countries and throughout the United States. Stein worked through Global Medical Staffing Ltd., in Salt Lake City, which also places physicians in Australia.

Locum tenens jobs attract three primary groups of doctors, says Alan Lakomski, the company’s chief operating officer: those fresh out of training and looking for international experiences before settling into a practice; mid-career practitioners seeking a break from their practice, or a wholesale job change in a different healthcare setting; and those near retirement who want to do some good, travel, and experience a different part of the world. "We’ve also had people who have stayed in jobs abroad for many years," Lakomski says. Locum tenens opportunities also exist for non-doctors; one of the largest placement services, CompHealth, also recruits nurses, physician assistants, pharmacists, rehabilitation and respiratory therapists, and laboratory technicians.

Frustration with aspects of the American healthcare system—specifically managed care and crippling medical malpractice premiums—has led to increased participation in locum tenens opportunities in recent years, says Pamela McKemie, senior vice president of LocumTenens.com, which places anesthetists, psychiatrists, and radiologists nationwide. "One of our marketing tools is, ‘Let us take care of the business—you take care of the patients,’" she says, "which is very appealing to doctors."

LocumTenens.com typically takes care of all the background checks, credentialing, and other paperwork (50 to 75 administrative steps are required to place a doctor in a new post), and provides medical malpractice insurance, housing, transportation, and salaries that are "competitive with national standards," McKemie says. International locum tenens work tends to pay less, though all the services above are also provided to participants.

Stein says their Auckland home "was the nicest place I’ve ever lived since I left my parents’ house," The couple returned to the United States after six months. "Had it not been for our ultimate consideration—to be near our families, rather than a 24-hour air journey away—we would have stayed longer," Stein says. "And I think it’s definitely something we would consider doing again in the future."