“I’m aware that I’m my own boss, and I really like that”

Before I started locuming...

I worked at Manchester Royal Eye Hospital, where I had completed my pre-reg, for three months. I was in that transition period from being newly qualified, and was gaining more confidence. It was great to have very knowledgeable colleagues around to ask any questions while I was starting to become more independent. 

At weekends, I shadowed my colleagues at their practices, so I could get the gist of what to do, and see different scenarios that may come along – how to manage a dilation that they hadn’t planned for, for example. It was really helpful to gain some confidence and build my routine. I worked at the hospital and shadowed at the weekend until February 2023.

My next experience was untraditional, in the sense that I was actually working in the TV and film sector. We were putting prosthetic contact lenses in the actor’s eyes, which was fun. It took up a lot of time, though. I did that from March to June. That was a completely different experience. Honestly, I hadn’t even known it was something within our field. I was doing that during the week, and at the weekends I was starting to pick up locum work, because I realised I needed to become more confident and get outside my comfort zone.

It was a good transition, because I had the time in the week to take my mind off it, and then at the weekend I’d really be focusing on locuming and getting my head around the routine sight tests. When the film and TV season finished, I went into full-time locuming.

Of course, when I was first locuming, I was a bit slower. I warned my employer that this would be the case, and they were supportive of it. I was grateful for that.
I had done a community placement, with Specsavers in Sale, when I was doing my pre-reg. All those experiences had really helped me gain some confidence to think, ‘yes, I can do this, I can go straight into it.’

When I started locuming, I wish I had known...

That anywhere you go, a routine sight test is going to be a routine sight test, and you’ll know how to do it. Really, the biggest challenge is knowing how to use the systems: knowing when to enter results, when to click print – details like that. Once you get your head around that and know what you’re doing, you can relax and stop feeling like you’re in over your head with the different places that you’re working at.

I realised this when...

I started working for both multiple and independent practices. Working at the independents, we were using completely different systems. That’s when I realised that I was going through the same process, it was just different buttons that I was clicking. That’s what really made me confident: knowing that I knew what I was doing, even via different systems.

Anywhere you go, a routine sight test is going to be a routine sight test, and you’ll know how to do it

I made the decision to become a locum because...

Of the flexibility. For someone in my situation, with family overseas, your general 20 days of annual leave doesn’t always work. Flights could be expensive, and you want to spend as much time as you can out there. Flexibility was one of the main reasons, alongside the fact that I could have time for myself.

I realised once I’d started locuming that, actually, I was working more rather than less, so I could bulk up my days and then take longer breaks. I’m aware that I’m my own boss, and I really like that. I can choose when to work and when not to work. When you’re employed you might be a bit limited. You may not always get the days off that you want, depending on your practice. This way, I’m able to take long breaks if I ever need them, and I can really plan my days ahead. I think it has helped me to become more organised, too.

On my first day of locuming...

I was nervous, of course. But I told myself that I had got this. I was shadowing so many people at that point. I was like, ‘You know what, you know the system. You’ve done it before.’ Really, it’s just about getting yourself into a routine.

I also wanted to prove myself, especially coming from a hospital setting, which is completely different from routine sight testing. But after two or three sights tests, I got the flow of it.

My biggest challenge as a locum is...

Getting to know each practice, their systems, and the little things, like where they keep the records that need to be taken into the sight test. What is their system for post-checks – who do we give that to? I like to go in early, to get ahead of it and ask as many questions as possible.

When you’re working as a resident, you’re comfortable. You know exactly what’s going on. But as a locum, you have all these questions. I think practices are aware of this, and some are very organised, so that’s helpful.

As a locum, I have adapted my day by...

Doing lots of research. If I’m working in a different area, I would look up their Local Optical Committee, to see different referral pathways. London is quite different to Kent, which could be very different to Berkshire.

My biggest worry is knowing where to refer people. It’s hard to keep track of your patients, and that’s quite a big challenge. You’ll refer someone, but you won’t know what happens to them afterwards, which is the downside of locuming. But it’s just about making sure you send them to the right place at the right time, through whatever system they have. I’ve adapted by asking lots of questions, and doing as much research as I can.

Practices can make life easier for locums by...

Being more organised. I’m really impressed with some practices. They’ll have a printout with information on what to do, where to refer, what the system is. They go through everything you need to know, in one little cheat sheet. That’s really helpful.

Of course, it depends on how many clinics are running, but having someone there who you can go to for questions is useful too.

My favourite thing about being a locum is...

Flexibility, again. It allows me to control my schedule. Also, I like the fact that I can work at different settings all the time. I don’t drive, so I’m usually taking the train. Every day is a new journey, a new experience, and a new adventure. I like that I'm in different settings, getting to know different people, in different areas.

Every day is a new journey, a new experience, and a new adventure

My advice for people who are new to locuming is...

Be brave. It takes that extra step to go out your comfort zone, and that’s what locuming is. It’s being comfortable with not being comfortable.

It’s not just the work that can be different. It’s the fact that you may not have steady income. You need to be quite comfortable with that as well, and just get ahead of it as much as you can. My biggest advice is to get out of your comfort zone and know what to expect in terms of being confident with yourself, and knowing that you can do the sight test – you’re just in a different setting.

My last word on locuming is...

Know what you’re worth. Don't let people bring you down. You are the clinician at the end of the day, so set boundaries based on that.