What is it like as a locum optometrist in Australia? Moving from town to town, organising placements, and collaborating with unfamiliar GPs and ophthalmologists? Insight speaks to those on the road.
Pre-2010, before the optometry profession in Australia moved to a national registration system, anyone wanting to work interstate as a locum had to be registered with the relevant authority in each state they worked. Consequently, they paid multiple registration fees, with the employer usually picking up the bill.
When national registration with the Optometry Board of Australia was established – and state-registration abolished – locums had greater freedom to work across the country under one registration.
And with the Trans-Tasman mutual recognition in place between Australia and New Zealand, optometrists can locum abroad too. But it is still a costly exercise to register across both country, as well as acquire additional professional indemnity insurance.
In the years since 2010, locum-specific services have grown, while communication between practices requiring a locum and optometrists seeking short-term positions has blossomed.
One such service was established in 2002 has more than 2,000 locum candidates registered across Australia and New Zealand. Corporates like Specsavers and OPSM also facilitate locum placements for their own stores.
Over the next three pages, Insight sits down with a new generation of locums, discussing what drew them to experience the highs and lows of a nomadic career.
ARRIVE AS A STRANGER, LEAVE AS A LOCAL
ALINTA SOUTHAM-ROGERS, an early career optometrist who began working as a locum last year, is splitting her time between work and travel while on a road trip around Australia.
“I’m locuming only 50% of the time – the rest of my time is devoted to travelling,” Ms Alinta Southam- Rogers explains as lives out of a 4WD in tropical North Queensland.
The now-locum optometrist graduated from University of New South Wales in 2015 and held a full-time position at EyeQ Optometrists in Ulladulla for five years and EyeQ Vincentia for one year until she and her partner decided on travelling around Australia.
“I started locuming in January 2021. My partner and I always planned to do this trip and we went ahead, despite COVID, because when I make a plan, I stick to it. The ability to combine work and travel was one of the reasons why I chose this profession in the first place,” Southam- Rogers says.
Throughout the year, they travelled and worked up and down the East Coast, in Queensland and New South Wales, managing to dodge the numerous lockdowns and subsequent border closures. She spent one lockdown beachfront on North Stradbroke Island.
Southam-Rogers liaises with several locum services to secure work while on the road, preferring to line-up placements to match her physical location.
“Friends who have locumed have gone through Eyecare Recruitment, they’ve got a great reputation and can link you up with independents and corporates. They are very responsive and diligent when booking placements. I’m also registered on Specsavers locum app and OPSM’s national relief team. I probably did 20 placements last year – I’m open to everything,” she says.
“I was grateful to receive several permanent offers in several great regional practices, some of whom have been without a full-time optometrist for many months.”
“As a graduate, I was really fortunate to secure a full-time job in a regional practice where I was exposed to a lot of pathology and diagnostic challenges.”
Southam-Rogers recalls one instance where she travelled specifically to work in a mining town she’d only heard about from a friend. She was curious about working there due to its isolation.
“I caught two flights to work in Kalgoorlie in Western Australia. I locumed at OPSM Kalgoorlie for two weeks. The practice doesn’t have a regular optometrist on staff – they rely on locums all-year-round,” Southam-Rogers says.
“The patients and support staff appreciated having me there. I was the only optometrist there for those two weeks, but I work on my own all the time, so I’m accustomed to it and not daunted by it.”
Southam-Rogers says she is wellversed in managing complex cases independently, having spent five years working in Ulladulla.
“I made a calculated decision to begin my career in a regional practice, and I had an excellent mentor in Tony Ireland at EyeQ Optometrists Ulladulla,” she says.
“As a graduate, I was really fortunate to secure a full-time job in a regional practice where I was exposed to a lot of pathology and diagnostic challenges in my first five years in the profession. That has given me confidence and skills in managing complexities and co-morbidities, so I was well prepared to take on the position of sole optometrist in Kalgoorlie,” she says.
One of the more challenging cases Southam-Rogers recalls during her short stint in Kalgoorlie involved managing a patient with a retinal detachment.
“Diagnosis was relatively easy but being 12 hours from Perth, managing what happened next was more challenging,” she says. “Kalgoorlie only has a visiting ophthalmologist every three months, with the Lions Eye Institute van.”
Southam-Rogers had to liaise with Royal Perth Hospital to arrange the patient’s transport, giving them the option to fly or drive the 597km. The patient opted to drive.
Another experience she enjoyed during her first year of locuming involved testing children’s vision at a school in Northern Rivers in NSW. It was organised by self-employed optometrist Ms Andrea Eliastam, owner of Mobileyes Optometry Australia, providing mobile optometry services to schools, aged care and corporates.
“Andrea and I tested almost 900 kids at the school, which took four weeks. I really valued the fact you test a broad spectrum of children when you go to them, rather than only testing the ones who present to you in a practice setting. I found it really rewarding, identifying those who needed further treatment, and it honed my binocular skills,” she says.
Southam-Rogers says one of the things she values most about locuming is experiencing new locations around Australia.
“When you arrive for a new placement, you’re a stranger to the practice and the town but you always leave with new friends and a better understanding of that particular town and its community.”
‘I LEARNT A LOT ABOUT MYSELF WHILE WORKING AS A LOCUM’
After successfully locuming in Australia for several years, Aucklander HALA AL-GELAN has now returned to New Zealand where she is once again seeking this style of optometric work.
New Zealand native Ms Hala Al-Gelan graduated from The University of Auckland in 2012 and moved to Australia the following year, first working at George Nasser Optometrist in Greenacre, NSW, before joining Bupa Optical as a mobile optometrist in NSW and ACT.
“I worked with Bupa for a year and then decided to do something different,” Al-Gelan says, gravitating towards locuming for the travel opportunities.
She locumed for three years, and says it was like being employed fulltime – there was never a shortage of placements available.
“I loved it. It required a little bit of paperwork to get set up at the beginning, to register for GST and look for an agency. They organise everything – travel, accommodation, clinics. They take care of both sides, liaising with the practices and the locums. All I needed to do was give them my availabilities,” Al-Gelan says.
“You learn to be independent and strengthen your decision-making skills. It’s a good learning curve, and I learnt a lot about myself while working as a locum.”
“I travelled everywhere, from small, one-street towns to big cities. I found everyone soon knows you in small towns, small communities. But there are drawbacks to working as a locum,” she says. “One of those is the lack of job stability and rarely do you see the same patient for follow-up. It’s also difficult to build a professional relationship with doctors and ophthalmologists because you’re only there for the short term.”
Al-Gelan says some places don’t have a resident ophthalmologist, and as the attending practitioner, she would be required to make clinical and patient co-management decisions, usually in consultation with an ophthalmologist over the phone.
“You learn to be independent, and strengthen your decision-making skills. It’s a good learning curve, and I learnt a lot about myself while working as a locum.”
Al-Gelan recalls treating a patient she would ordinarily refer.
“I was locuming in Charters Towers in Queensland, about an-hour-anda- half drive from Townsville. A male patient walked in with a foreign body in the centre of his eye which had been there for a few days – I would usually refer a case like that to the local ophthalmologist,” she recalls.
“But there wasn’t one. The patient lived alone and couldn’t drive. I called an ophthalmologist, who consented for me to remove the foreign body. The patient also gave me permission to go ahead and do it. So with their permission, I removed the foreign body, and it healed beautifully. I locumed there for a month, so I was able to see the patient for a follow-up. It was a great outcome, I was very happy, and that particular case has always stuck in my mind.”
After three nomadic years, she decided to stop locuming, opting for more certainty.
“I needed stability, so I moved to Cairns where I was offered a full-time job with Bupa Optical Queensland. Then I moved back to New Zealand in early March last year for family reasons,” she says.
Al-Gelan started locuming again, this time in New Zealand, in June 2021, using the same agency to find work.
“I was locuming in Auckland but then it went into lockdown, so I was soon travelling again, working in the South Island while Auckland was in lockdown.
“Options have been limited with travel restrictions. In recent times, working as a locum is not as easy as it used to be,” she says.
SEEKING A TREE AND SEA CHANGE
Recent graduate-turned-locum optometrist EMMA INGRAM traded a full-time position to pursue travel and test her clinical skills in a variety of settings.
When optometrist Ms Emma Ingram made the leap from full-time employment to locuming in August last year, she pictured herself across the other side of the country within months. However, COVID-related travel restrictions kept her plans on ice.
Ingram was in her first year of a science degree at The University of Melbourne when she began working as an optical assistant at Specsavers Bendigo, her hometown. This formative experience cemented her desire to pursue an optometry career.
Before committing to an optometry degree, however, Ingram spent a “gap year” working full-time at Specsavers Bendigo, providing her first insight into working as a locum, with the practice employing locums on a regular basis. After graduating with a Bachelor of Vision Science/Master of Optometry at Deakin University in 2019, she returned to Specsavers Bendigo as a full-time employee.
“I worked there for two years and that’s when I started to consider a change. In February last year, I started thinking about making the leap to become a locum and in August I made the switch.”
During the intervening months, Ingram researched her options as a locum. She was familiar with the Specsavers Recruitment Services (SRS) locum app, launched in March 2021, to simplify the way locums share their availability and accept vacancies in real time.
“One option was to remain with Specsavers, on a full-time locum salary, and locum within Specsavers network of stores as vacancies arose. Another option was to manage my own placements. I had friends and colleagues who managed their own locum work, and that appealed to me, as I wanted to experience variety in the types of places I worked – geographically and clinically,” Ingram says.
“Every time I start somewhere new, it is a bit of a stretch to adapt, but my skills are sharper because of it.”
Through word-of-mouth, she reached out to an industry specific locum service which has successfully facilitated placements for her.
“My husband – a freelance filmmaker – and I bought a caravan and were planning on travelling around Australia. I knew it would be harder for me to make interstate workplace connections from Victoria without the assistance of a recruitment service. It is ideal being able to travel and have access to national jobs at the same time,” she says.
Ingram and her husband started living in their caravan in Ballarat as they waited for the South Australian border to re-open.
“Initially, our plan was to travel and locum for two years, and eventually find a place we could settle down and start a family – in a place that suits us from a lifestyle perspective,” Ingram says.
But their plans were delayed because of border restrictions, and COVID has impacted some positions she had in the pipeline.
“I had two months of work lined up in Tasmania, but two to three days after the COVID outbreak in August 2021, it fell through. I’ve had a few other jobs like that. Government restrictions and lockdown means locums are the first to go,” she says.
“It’s really hard and makes me nervous. It has made me wonder, is this what locuming is going to be like? Will it be this volatile forever? But now I’ve had a good run of being able to see through jobs, which gives me confidence.”
Although limited in how far she’s been able to travel and work, Ingram has enjoyed the mix of places she has worked in Victoria, and says patients vary, even between regional Victorian towns like Ballarat and Portland.
“I enjoy working in different practices – independents, chains, big and small. There’s great variety, and I’m never bored. Every time I start somewhere new, it is a bit of a stretch to adapt, but my skills are sharper because of it,” she says.
“There are some skills I didn’t necessarily utilise while working full-time in the same practice day-to-day, but locuming keeps everything sharp, as you don’t know which particular skills will be needed when,” she says.
Ingram has scrapped her initial two-year plan, now that she’s tasted the locuming lifestyle.