Travel Log: Livin' La Vida Locum
Where have all the faculty gone?
Locum: a doctor who does the job of another doctor who is sick or on vacation
I just wrapped up the first week of my third locum block at Auburn this year, and I have three more weeks on the road before I’m back home. I’m on track for ten weeks at AU alone this year, which is in striking distance of some full-time faculty’s clinic commitments. Even for someone who enjoys travel it gets tiring and lonely to be on the move constantly.
Fortunately, my wife drove up with one of our dogs Jack for a long weekend to celebrate her birthday. We had a wonderful time seeing some old friends and eating at our favorite restaurants. It was also a reminder of how much the town has changed since we left. It’s grown massively in size, with high-rise luxury apartments blocking views of the smaller historic buildings. Numerous friends and faculty have departed—for jobs at other schools, for retirement, some due to illness or death. Some of our favorite haunts shuttered due to COVID. Our old house is owned by strangers and the neighborhood has changed. The place we love and miss is actually a moment in time; we can re-visit the physical space, but not the bygone era.
I do love the day-to-day work at these institutions and feel energized by the complex tertiary referral cases. The residents are enthusiastic and super knowledgeable, keeping me on my toes with the latest research. Every block I learn updated terminology and new factoids. I’ve even gotten a chance to co-author some conference presentations that may turn into case reports in the future, which is very gratifying.
Help Wanted
I will be discussing the details of why I am locuming full-time in an upcoming post. What I want to talk about today is why there is such an opportunity for locum work at vet schools in the first place.
This year I am booked at Auburn, Ohio State, UGA, and NC State, most of those for multiple blocks. There are several other schools advertising for relief help on our professional list-serv, too. And these are just the open positions; many schools that require locum coverage are able to fill those blocks through connections outside of nationwide calls.
Why do schools need locums? The reasons vary. Sometimes, it’s due to maternity leave, sabbaticals, unexpected family care events, or overlapping vacations. Overall, though, the main reason is these schools are short-staffed without enough faculty to cover those gaps that inevitably arise. Locums get paid a premium rate higher than typical professors, so universities would only entertain this option as a last resort.
All of the schools I’ve been to above had or have open clinical pathologist faculty searches this year. In addition, there are currently six other schools with open CP faculty postings, and I know of several that will probably be listing positions in the near future. Keep in mind, there are only ~30 vet schools in the US, and not all of them have clinical pathology labs or residencies. This means that roughly 1/3 of the veterinary colleges are currently short-staffed in my field!
This is not just limited to my specific niche in pathology, either. Vet schools everywhere are desperate for neurologists, cardiologists, surgeons, and everything in between. Some schools are barely-staffed by a skeleton crew and fighting to stay open.
These trends also apply to the private sector, with a rise in relief/locum general practice vets, and a critical shortage of ER vets (that pre-dated the pandemic, but was significantly exacerbated by it) leading to astronomical pay rates for contractor coverage. I’ve heard stories about burned out vets who quit their full-time job, then go back to work relief for their old clinic making double the money for fewer shifts. What strange economic times we live in…
Where are the missing faculty, and why are they leaving?
Most go into private practice. Unlike other academics, DVMs (like MDs and other healthcare providers) can walk down the street into a booming labor market outside the ivory tower. The pay is often much higher, the schedules can be lighter, and there are less of those hellacious responsibilities like sitting on interminable admissions or disciplinary committees. Most have excellent job security without worrying about promotion and tenure hurdles. This Inside Higher Ed article sums it up:
“Talk to anyone who works at a college or university and they will say that their department is understaffed. The big secret of academic work is that academics, at all levels and positions, work all the time. Much of the night and weekend work is driven by the competitiveness of the field and the love of the work. But much of the reason people in higher education work so many hours is that they do more than one job. The work of higher education jobs does not stop when a colleague retires or leaves for another institution or industry.”
We are also seeing demographics at play, with a large crop of baby boomers reaching retirement age. This trend probably accelerated as the COVID-19 pandemic put huge pressure on healthcare workers, including at university vet hospitals, and those who could afford to retire or quit increasingly chose to do so.
This wouldn’t be as serious of a problem if those departing academia were being replaced by new blood. However, fewer and fewer residents today are interested in an academic career. I know because I talk with them daily. Many cite similar concerns:
Not wanting to pursue a PhD (+/- post-doc) on top of 11+ years in undergrad, vet school, and then residency. Adding even more training to this is untenable for people with six-figure student loan debt and/or wanting to start a family
A desire to focus on one or two areas of excellence like service and teaching, but feeling pressured into high research FTE %
Fear about not being able to make research productivity quotas for tenure when they have to balance working in the hospital on top of teaching and everything else. (In addition to time constraints, having any sizable clinical service component can hurt one’s chances of major grant funding like an R01)
Not wanting to be on call nights and/or weekends/holidays
Witnessing stressed/toxic and burned-out faculty members during their residency. Lack of strong role models can lead young trainees to conclude universities are a terrible place to work
I don’t pretend to have all of the answers. In a lot of ways, locums have it easier than the full-time faculty who have to wear ten different hats at a time for less money. I also realize there are complicated economic and demographic forces at work that make fixing this situation an uphill battle.
It does seem like universities are going to have to start embracing change to reverse their fortunes. At some point there is going to have to be a recognition that veterinarians (especially residency-trained specialists) who have to work weeks a month in the teaching hospital can’t be treated the same as a “naked” PhD researcher in terms of grant and publication metrics for promotion and tenure. Some schools are already—finally—starting to embrace clinical-track positions instead of stubbornly sticking to traditional tenure-track roles. More flexible scheduling and part-time positions could work for some people who need to take care of children or elderly parents. Hybrid faculty roles shared by vet colleges and companies could provide a sustainable way forward that is mutually beneficial.
As for me, all I can personally do is try to be the best mentor I can when I visit different schools and encourage them to give academia a chance. I try to nurture any resident interest in teaching and research. I make sure they are aware of the excellent health and retirement benefits most universities offer, as well as programs for student debt relief like Public Service Loan Forgiveness. Finally, as someone who has worked as both full-time faculty and in the private sector, I can speak to the fact that the grass is not always greener outside the university!
This is fascinating. In my field, faculty feel much more trapped--but if, as you say, we could just walk down the street and get a job elsewhere, I think many would.