SINCE 7 June 2020 – mid COVID-19 pandemic – I have consistently and regularly been working for one health service as a locum medical officer.

My shifts between 12 October 2020 and 26 March 2021 were a 7 days on/7 days off roster, at times with additional shifts during my off week (usually on short notice) as the health service was struggling with a staffing shortfall.

The health service I work for as a locum is located a few hours’ drive from the capital city, and locums like myself often have to cross state borders to get to the workplace. We are accommodated in town and away from our usual residence and family during the course of the locum, either because of on-call requirements and/or physical distance between the place of work and our usual residence and family (in my case, both). The longest stint saw me away from home for almost an entire month from 26 June to 20 July 2020.

My duties as a locum medical officer include assessing, treating and managing patients presenting to an acute hospital, including presentations to the emergency department (ED). Throughout the pandemic, my work included assessing suspected COVID-19 patients.

Despite doing the same job as my non-locum peers and being exposed to the same risks as my non-locum peers, as a locum I do not enjoy the same benefits: I have not been issued a work identification nor an access swipe card despite repeatedly requesting one. I have been told by medical administrators that they don’t issue these to locums. When I am on-call and am called back to the hospital after hours, I have to ring the doorbell and wait in the cold and the dark for a member of staff to let me in, despite being called back in to attend presumably time-critical emergencies.

There is no job security as there is no guarantee of shifts in the already short periodic contract measured in weeks, and I have booked shifts cancelled by the hospital. There is no sick or medical leave, no annual leave, and no access to the COVID-19 leave that my non-locum peers have.

Because I have to cross state borders to get to work, during the pandemic it was not unheard of that locums have been refused passage across state borders as various lockdowns occurred. This effectively rendered the locum stuck, either unable to go home or see family or unable to go to work (locums generally do not get paid if they do not go to work).

At the height of the pandemic and state border closures, the mood at work could often be described as bleak, fear often palpable especially when it came to assessing and treating suspected COVID-19 patients. Yet frontline health care workers like myself, locums or otherwise, continued to make silent sacrifices to provide health services and to serve communities experiencing a shortage of medical staff, well aware of the risks of doing a job as a frontline health care worker and constantly reminded by media reports of colleagues becoming unwell and testing positive for COVID-19.

As Australia rolls out the country’s COVID-19 vaccination scheme, there is some optimism now in the mood at work. Internal email correspondence from managers on 19 February 2021 stated:

“Staff in our Phase 1a priority group will start receiving the … vaccine from Monday. This group includes those at highest risk of exposure to COVID-19-positive patients [eg, EDs] … Staff identified to receive the COVID-19 vaccination in Phase 1a will be contacted directly in the coming weeks and informed about how, when and where they will be able to get vaccinated. You will receive a personal invitation to register.”

I continue to wait patiently to be “identified to receive the COVID-19 vaccination” and to be “contacted directly”.

By early March 2021, I saw my non-locum medical peers who are doing the same job working in the same health service at the same acute hospital and in the same ED being offered and receiving a COVID-19 vaccine. Conversation with other colleagues at that time – nurses, paramedics, and the ward clerk – suggested that they had received a COVID-19 vaccine.

The initial optimism in late February has turned to disappointment and a loss of confidence in the government.

Locum medical officers like myself make silent sacrifices as we travel to work to provide health services in communities experiencing a shortage of medical staff. At the time of writing (27 April 2021), I continue to put in shifts to continue to work as a locum medical officer at the same acute hospital doing the same job as I have been throughout the pandemic since June 2020, but without an offer, invitation or the ability to obtain a COVID-19 vaccine for myself.

My experience so far leads me to conclude the following:

Australia’s roll-out of the COVID-19 vaccination, ostensibly in priority groups “consistent with guidance from the World Health Organization,” is in theory only; inequity and a “naked display of privilege” exist akin to that reported at elite health services overseas in terms of who gets offered a vaccine and who does not, who has the know-how to be able to obtain a vaccine and who cannot.

As a frontline health care worker I am yet to be offered a COVID-19 vaccine and do not have the ability to obtain one, while at the same time the media reports that select groups have been given “priority access” (the words “out of the queue” have also been used).

I am also thus led to believe that in Australia there are frontline workers and then there are frontline workers. Locum medical officers are Australia’s forgotten frontline health care workers in the COVID-19 pandemic.

Who will care for us?

Dr Chee Koh is a clinical academic and a generalist who is passionate about advocacy for decency, social issues, injustice and the perils of institutional power, both within the clinical and academic context and within our society.



The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.


Locums should receive COVID-19 vaccinations like any other frontline health care worker
  • Strongly agree (96%, 105 Votes)
  • Neutral (2%, 2 Votes)
  • Agree (1%, 1 Votes)
  • Strongly disagree (1%, 1 Votes)
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Total Voters: 109

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8 thoughts on “Locum medical officers: who will care for us?

  1. Andrew Walpole says:

    Are locums employees or independent contractors?
    If employees they have employee rights and contract rights.
    If contractors rights are in the contract.
    Have the AMA advise if rates, terms, and conditions are reasonable and get the contract right before you sign on. .

  2. Anonymous says:

    No need to wait any longer for your vaccine. Fill out the vaccine declaration identifying yourself as healthcare worker and book into a vaccine hub. In Victoria, like you, I was ‘waiting to be contacted’ for vaccine in Group 1B, casual, private contractor – nurse. Arranged it myself at vaccine hub run by Austin Hospital (Repat campus) in Melbourne. Fast and efficient. I wish you all the best.

  3. Anonymous says:

    I have worked locums in the past. Overseas (10 yrs ago), the locum services contracted on behalf of the regional hospital/s in which the work was performed. Pay rates and conditions were the same as for hospital staff, though my payment was delayed. Accommodation was only paid for 1st 24 hours & despite promises to the contrary I had to find my own accommodation after this. Very stressful. Not again. In Australia, interstate accommodation was provided with air fare, but booked to arrive after dark the night prior to 1st Mon am shift, with no one on site at the accommodation & no food / breakfast available, in an unknown city. When I worked in regional Victoria, hospital or PP staff usually met the locums on arrival and ensured they were settled. This should be elementary courtesy. Time for the locum services and hospitals to make their relievers welcome AND kept safe.

  4. Growler says:

    I work as a locum in rural/remote ED around Australia. Based in a Southern capital city. On regular occasions told that I am permitted to leave the State but to freely return home as I’m not deemed an essential service (unless I stay in my home state). Add to that the unsociable shifts (nights and lates anyone? Anyone?); the nastiness of lots of non-medical staff, the occasional substandard accommodation; being away form home for days or weeks at a time etc etc and you wonder what makes it worthwhile. Then, you save someone. Or make a difference to the life of a member of a poor and/or discriminated against community and you soon change oyur mind. PS – I wouldn’t mind a payrise – the permanent staff seem to get them, but we locums are generally getting the same now as 5/6/7 years ago.

  5. Anonymous says:

    Discrimination of doctors based on ‘terms of engagement’ is probably the most menial exposition of ignorance by health systems I have ever seen! Can this be labelled a new “contractism”? Locum specialists are very high quality, highly qualified and capable doctors who form the backbone of Australian healthcare. They are excluded by contracted low quality doctors who form a collusion network within metropolitan hospitals. Hot Case for the corruption commission and ACCC here – are you listening?

  6. Dr Tony Sara says:

    Join your local union and get them to fight on your behalf. There are clear industrial and WH&S implications and your union should do what is needed here and ensure that you get vaccinated.

  7. Anonymous says:

    In this uberised world the “permanent” doctors are waging a losing battle. They diminish their stature by becoming sycophants to administration for securing their vested interests. This sort of discrimination is an admittance of their failures. They sell themselves cheap and make themselves ‘replaceable’! I am a proud Locum Intensivist for many years and have faced this vaccine inequity (not that I am in a rush to get that bungled jab of immortality!). Locums are the future of Australian healthcare. Period.

  8. Johanna muller says:

    I was also really annoyed that we are considered 1B … we travel around to provide forntline urgent locum srevices so really should have been in the first group.
    I had m,y vaccine at a privately run clinic here in Adelaide …Athelstone. Very efficient .

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