Map of General Surgery locums jobs over the last 5 years

I thought I would post an interesting bit of data on our jobs that we have had for locum tenens coverage over the last 5 years. This industry and our specialty has certainly evolved quite a bit in that time. Jobs have grown but have been outpaced but surgeons looking to do locums. This map is purely from data from my organization and although this isn’t industry-wide, I expect it to generally correlate since most of the larger locums companies have jobs in the same areas.


I get a lot of questions about what are the best states to get a license in, or what states have the most jobs. I’ve always felt like Wisconsin was our best state for locums, but according to our map, North Carolina tops the list with 686. Does this mean that you should get a North Carolina license to maximize your footprint for locums? Not necessarily. Many of the jobs we have had in North Carolina are for weekend coverage needs and quite often those can be covered by someone who is a local candidate with a license in hand.

What might be more meaningful as far as telegraphing where a good state to be licensed in is jobs that go unfilled or we have a slower rate of confirmation on jobs. Obviously for any surgeon who has a pathway to getting the IMLC letter of qualification, this is the single most impactful way to maximize your locums footprint. For surgeons who do not qualify, perhaps the next best thing would be to analyze the states that have a lower ratio of surgeons to jobs, or as mentioned above states that have a higher rate of jobs that go unfilled.

Wisconsin is a state that I proactively got a lot of surgeons a license in, and we still have a large amount of jobs in the state that don’t get filled with local surgeons, but each job we get in this state gets a high amount of candidates. States that come to mind that would be good to get a license in if you don’t have a pathway to the IMLC would be New Mexico, Arkansas and Alaska. These states are non-IMLC meaning those who have the letter of qualification would have no advantage and we do get jobs in these states that go unfilled. States like Texas, California, New York and Florida have a lot of demand from surgeons to work in these states but are full of candidates with licenses in hand.

I like to say that proactive licensing is a bit like what they say in the stock market, ‘past performance does not equal future results’. Locums is extremely cyclical and can be hard to predict where the next jobs will be. My top tips for people looking to do locums (in the context of state licenses) would be to utilize the IMLC compact license if you have a pathway, and if not, have at least 3 licenses in states where the ratio of jobs and licensed surgeons is reasonable. Feel free to contact me at or 801.930.3661 for more information on license strategy.


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