For my F3 year I worked in A&E at Liverpool University Hospitals NHS Foundation Trust. This is the Trust I worked for to complete my Foundation Training and I just picked up ad hoc locum shifts. This was initially organised via liaising with medical staffing directly and then the Trust changed to booking shift via an App.
I have no regrets about taking an F3 year and am currently taking an F4 year.

The advantages I experienced of working as an F3 as opposed to in a training post include:
    Flexibility to choose my own hours – I found I was more motivated to go to work knowing that I had chosen to be there
    Control over my schedule – enabled me to take advantage of other opportunities to strengthen my portfolio for specialty applications (i.e. completed a PGCert in Medical Education)
    Travel opportunities – I spent 2 months backpacking in Australia prior to COVID which I would not otherwise have had the opportunity to do, were I in training.
    Salary – I earned more than I did in F2 even though I didn’t work for 2/12 whilst I travelled. This enabled me to both fund my travels & save money for a house deposit  

The disadvantages I experienced of taking an F3 year:
–    Uncertainty of ad hoc work could be stressful – I did not secure a guaranteed job prior to F2 finishing so the lead up to August was stressful as I didn’t know if I was going to be able to earn enough to support myself. To try and plan for this, I ended up doing a lot of bank shifts in my last few months of F2 so that I could still afford to pay my bills if I didn’t get many locum shifts! (Thankfully, the worst month I had was working only 9 shifts and with that, I basically earned what I was earning per month in F2)
–    No sick pay / Paid annual leave working as a locum. Thankfully I have not been affected by this myself but a know friends who did not get paid at all whilst having to self-isolate due to COVID.
–    No formal ARCP process – although not having to complete a portfolio was very nice in some respects, as I could focus my efforts on other things, but I have no formal ‘evidence’ authorised by a senior, of what I have been doing, the competencies I have gained and my learning during my locum career. (I did originally get assigned an ‘educational supervisor’ for my work in A&E but this was cancelled because of COVID pressures.)  
–    More difficult to get a mortgage due to not having a guaranteed income

Things I wish I knew before I started:
•    There are loads of shifts available – especially if you don’t mind what you do/picking up ad hoc shifts. I think this is even more relevant now because of COVID. There will always be people going off sick with COVID/self-isolating so I imagine there may be an even bigger demand for doctors to fill in rota gaps
•    Locum agencies can do a lot of the hard work for you and may be in a position to negotiate better terms on your behalf so it may be worth considering using them (i.e.  ID medical, A&E agency)
•    There are a number of Apps where you can book shifts (i.e. Locum’s nest, Patchwork, Locate a locum)
•    You may not be able to get your ‘dream job’ as a locum – I tried for over 18 months (from November of F2 until September F4) to get a locum post in my chosen specialty but no jobs came up. Therefore, I worked in A&E as I felt I would gain breadth of experience, confidence managing acutely unwell patients and exposure to clinical presentations related to my chosen specialty. I believe working in A&E for a year has also made me a better clinician overall which is applicable to any specialty.

Article written by Dr. Sarah Winfield