From First Call to First Case: What to Expect from a High-Quality Locum Assignment 

By Jim Tobin, Recruiter at Altamar Physician Services 

For physicians considering a locum assignment, the time between your first conversation with a recruiter and your first case can involve quite a few steps behind the scenes. Credentialing, facility review, travel coordination, scheduling, and other administrative details all have to come together before you can walk into the facility and start practicing. 

The timeline can also vary considerably. Some physicians may be ready to work within days through emergency privileges, while others may wait several months for facility credentialing. Understanding what happens during each stage can make the process easier to navigate and help you know what questions to ask along the way. 

So, what really happens between that first phone call and your first case? 

From First Call to First Case: The Key Steps 

A locum assignment involves several stages before you begin practicing. Here’s a quick overview of what to expect: 

• Initial conversation: Discuss your clinical background, preferences, availability, and goals with your recruiter. 

• Opportunity matching: Explore assignments that align with your experience, schedule, location preferences, and clinical comfort level. 

• Credentialing: Complete the documentation and application steps needed for internal and facility review. 

• Facility approval: Wait for the hospital or surgical center to complete its credentialing process, which may take days or several months. 

• Pre-assignment preparation: Coordinate your start date, travel, timesheets, and payroll details. 

• First case: Begin your assignment with the necessary approvals and arrangements in place. 

The timeline varies by assignment, especially based on facility credentialing and your availability. Understanding each step can help you know what to expect and where delays may occur. 

Step 1: The First Conversation Sets the Foundation 

The process starts with a conversation about you, your practice, and what you want from a locum assignment. 

A recruiter needs to understand more than your specialty and where you hold a license. They may ask what your typical day looks like, what types of cases you perform, which cases you do not perform, whether you take call, where you have practiced previously, and what your availability looks like. 

Open-ended questions can make this conversation more productive. When you describe your typical practice, you may naturally provide answers to several questions at once, giving the recruiter a better understanding of your clinical experience and preferences. 

This is also when expectations should be established. A thorough conversation may take around 30 minutes, particularly if you are discussing your experience, reviewing documents, and walking through the credentialing process. 

It is reasonable to ask questions at this stage, too. How long could credentialing take? What information will you need to provide? When might you hear about opportunities? Which parts of the timeline depend on the facility? 

Getting clear answers early can prevent confusion later.

Step 2: Finding a Locum Assignment That Fits 

Once your recruiter understands your background and preferences, the search for an appropriate opportunity can begin. 

This is where the details from the first conversation become important. A potential assignment might be in the right location but have a schedule you do not want. Another might offer the right clinical environment but require cases outside your comfort zone. 

There is rarely a perfect match across every category. A strong fit means finding an opportunity that aligns with the priorities that matter most to you. 

Your recruiter may also ask about personal considerations, such as whether you have family or friends in certain areas. These details can help shape the search. 

If an opportunity does not appear to be a good match, you should expect your recruiter to explain why. You can then decide whether you want to explore it further. The decision to accept or decline an assignment remains yours.

Step 3: Credentialing Gets Underway 

Once you decide to pursue an opportunity, credentialing becomes a major part of the behind-the-scenes process. 

Internal credentialing can take up to about a month depending on your background and the information that needs to be verified. The credentialing team will gather the initial documents required to begin the process, then work on collecting additional documentation and completing the necessary applications. 

In some cases, credentialing can begin before a specific assignment is secured. This can be helpful because having your credentials organized ahead of time means less administrative work needs to happen after an opportunity becomes available. 

The process may involve gathering information related to your education, training, work history, licenses, certifications, and other professional records. The exact requirements can vary based on your background and the facility. 

This is one reason it helps to respond promptly when the credentialing team requests documentation. A missing document or incomplete application can create additional delays. 

Step 4: Facility Credentialing Determines the Next Part of the Timeline 

Internal credentialing is only one piece of the process. The hospital or surgical center must also review and approve you before you can begin practicing there. 

Facility credentialing timelines can vary dramatically. 

Some facilities may offer emergency privileges when there is an immediate need, potentially allowing a physician to begin working within a few days. Other facilities may require 90 days, 120 days, or longer to complete their process. 

The facility may also decide whether an interview is necessary. Some physicians will speak directly with the hospital or surgical center. Others may have their CV reviewed and receive an offer without an interview. 

This is an important point to keep in mind when thinking about the timeline for a locum assignment: not every part of the process is controlled by the staffing company or the physician. 

The facility’s needs, credentialing procedures, approval process, and desired start date all play a role. Your own availability matters, too. A physician may be credentialed quickly but not available to begin for several weeks or months.

Step 5: Preparing for the First Day 

Once the facility has approved you and a start date is established, attention shifts toward the practical details of getting you ready to work. 

If your start date is still several weeks away, you can expect continued communication rather than a long period of silence. Your recruiter may check in periodically to make sure your availability has not changed and provide updates as they become available. 

As the start date gets closer, additional details need to be addressed. 

Travel arrangements are typically discussed within the final 30 days before an assignment. You may also review travel limits, timesheet and payroll procedures, and what to do if there is a discrepancy. 

These may seem like minor administrative details compared with credentialing, but they are part of making sure you arrive prepared. Knowing who to contact, how travel is handled, and how your time should be submitted can eliminate unnecessary questions once you are on site.

Step 6: First Day, First Case 

After credentialing is complete, travel is arranged, and the facility has confirmed your start, you are ready to begin. 

Ideally, the administrative work fades into the background at this point. You know where you are going, when you need to be there, what your assignment involves, and who to contact if an issue comes up. 

Your first case is the point where all of those behind-the-scenes steps finally come together. 

But the process does not necessarily end there. Locum tenens assignments can come with unexpected situations. Flights can be canceled. Physicians can become sick. Schedules can change. Payroll questions can arise. 

Having a clear point of contact throughout the assignment can make it easier to address those situations when they happen.

What This Process Looks Like with Altamar 

At Altamar Physician Services, the process is designed around the physician’s time, preferences, and clinical priorities. That starts with a detailed first conversation. Rather than looking only at specialty and availability, the recruiter learns what you want from an assignment, where you want to work, what clinical environments you prefer, and the types of cases you are comfortable performing. That information helps shape the search and gives you a more personalized set of opportunities to consider.  

Once you decide to move forward, Altamar’s credentialing team handles much of the administrative work behind the scenes. Hospital applications can be lengthy, so the team collects and organizes documents, pre-fills applications, and helps with requirements such as licensing, DEA, and CSR documentation when applicable. The goal is to reduce the amount of paperwork competing with your clinical responsibilities.  

The support also extends to travel and the details surrounding your start date. Altamar can coordinate flights, hotels, and rental cars around your preferences, including frequent traveler information when applicable.  

Once you begin your locum assignment, the relationship continues. Your recruiter remains a point of contact for questions, timesheet support, travel problems, or unexpected issues at the facility. Altamar’s support teams can also become involved when a situation requires additional coordination.  

That continuity is intentional. The goal is to build a relationship where your recruiter becomes familiar with your clinical background, preferences, and assignment style over time. As that familiarity grows, future opportunities can become more targeted, while you still make the final call on which assignments you pursue.  

For a physician navigating a locum assignment, those details can make the process easier to understand and easier to manage.

A Locum Assignment Timeline Is Not One-Size-Fits-All 

There is no universal number of days between a physician’s first recruiter conversation and first case. Some placements move quickly. Others require months of credentialing and facility review. 

What you can expect is a series of distinct stages: understanding your goals, identifying a potential fit, completing credentialing, receiving facility approval, preparing for travel and onboarding, and finally arriving for your first case. 

Knowing what happens behind the scenes can help you set realistic expectations and recognize where delays may occur. 

If you are exploring a locum assignment, start by asking about the process, the likely timeline, and what will be expected from you at each stage. The right questions early on can make the path to your first case much clearer. 

Ready to explore your next locum assignment? Connect with Altamar Physician Services to discuss your goals, preferences, and available opportunities. 

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