Life as a locum registrar

Life as a locum registrar
Photo by Ante Hamersmit / Unsplash

TLDR: Reasons I'm not applying to ST4 right now

  • I love my job
  • I'm happy with where I am in my career
  • I want more time with my children while they're young
  • The role of consultant anaesthetist in the NHS doesn't look all that appealing right now
  • I enjoy having a sense of 'things still to accomplish' that I can delay to later in my life
  • I want to support my partner's career
  • I'd like to bring home more than £21 per hour to my kids

A conversation I've had rather a lot recently

"So you must be nearly done with CT3 now right?"

"Yes, my contract finished last week."

"Ah well done! So have you applied for a training number?"


" what's your plan? SIM fellow? Trust grade job?"

"Nope - just this."


"Pretty much!"


Having worked at 80% less than full time equivalent since halfway through CT1, I found myself drifting through to the end of my CT3 year at the beginning of February, after which I was cast adrift into the middle earth between core and higher specialty training.

After many months of much deliberation, asking other trainees and consultants for their insights and experiences, I had made the decision not to apply for a training number or a trust grade post, and instead went full mercenary - Hello Larry Locum.

Here's a run through of the reasons why I've made this choice, and what it currently looks and feels like, for anyone who is considering doing the same.

After a few months I'll come back and update with how it's all going, and how things appear with a bit of hindsight.

Why I'm not applying to ST4

Well, not right now at least.

I'm an anaesthetic registrar, father to multiple small children and partner to another doctor.

  • I have no spare money
  • I have no spare time
  • I'm seriously happy

I love my job.

So much so that I'd do it for free, but maybe not quite as often.

Everything I had ever imagined as a fifteen year old thinking about applying for medicine? I've made it!

That's not intended as an arrogant brag about how spectacularly marvellous I am - far from it - it's simply a reflection on the fact that it's very easy to get so engrossed in the process of 'career progression' and climbing the ladder toward consultancy that we fail to pause and take stock of just how far we've come.

We lose sight of why we applied to medicine in the first place.

I wanted to help people feel better, to use science to make cool stuff happen with the human body, work with my hands and feel like I'd done a good day's work, and earn enough money to do the stuff I like doing.

I do all this already as a junior anaesthetic registrar, so as far as teenage me is concerned - mission accomplished.

  • I put needles in people's spinal fluid and remove pain within seconds
  • I drift strangers into unconsciousness with ridiculously powerful drugs
  • I get to use all my scientific knowledge of biology, chemistry and physics every day to help people get better
Teenage me would be proud.

I've reached a stage in my training where I have enough autonomy and responsibility as an anaesthetist to work in the way that I enjoy, but also the right amount of senior support and supervision when I need it to not lie awake at night stressing.

Having heard the conversations between consultants in the variety of departments I've worked in - it doesn't sound all that much fun right now

  • Increasing bureaucracy and management control
  • Lack of staff
  • Lack of beds
  • Increasing complaints
  • Their own financial and political issues

I'm sure there are many wonderful perks to being a consultant, but all I've been hearing for the last three years are a lot of disgruntled voices complaining about things that aren't going to change by the time I get there if I went into higher specialty training right now.

I'm sure in the future I will want more responsibility and the ability to do things 'my way', but for now, the current set up suits me just fine.