VA Locum Tenens: What Contract Physicians Should Know Before Signing

Locum tenens work at a VA medical center can be one of the most rewarding assignments a physician takes on. The schedules are often predictable, the pay is competitive, and the patients are the men and women who served this country.

But a VA contract isn’t quite like a locum assignment at a private hospital. It runs through the federal system, with its own rules for licensing, credentialing, oversight, and day-to-day work. Physicians who understand those differences up front tend to start faster and enjoy the work more. Those who don’t can find themselves surprised by requirements they didn’t see coming.

Here’s what to know before you sign.

How VA Locum Tenens Works

At a private hospital, a locum physician is usually placed by an agency that contracts directly with the facility. At the VA, the structure has an extra layer.

The Department of Veterans Affairs buys clinical services through federal contracts. A staffing company, often working with partners, holds or supports that contract and recruits physicians to perform the work on-site at the VA medical center. You deliver care inside the VA, as part of its clinical team, but you aren’t a VA employee.

That distinction matters in practical ways:

• Your work is defined by the contract. Each VA contract spells out the services required, the schedule, coverage expectations, and performance standards. Your assignment is shaped by those terms.
• Oversight runs on two tracks. Clinically, you’ll typically report to the facility’s Chief of Staff or service chief. Contractually, the work is monitored by a Contracting Officer’s Representative (COR), the VA official responsible for making sure the contract is performed as written.
• Your time is documented. VA contracts commonly require providers to sign in and out of every shift, because hours are reconciled against invoices. It’s routine, but it’s not optional.

Licensing: A Detail Many Physicians Miss

Here’s something that catches physicians off guard. VA employees benefit from a federal rule that allows them to practice at any VA facility with a valid license from any state. Many physicians assume the same applies to VA contractors.

It doesn’t, at least not automatically. The federal rule that governs VA professionals’ authority to practice across state lines specifically excludes contractors, because they aren’t VA employees.

For contract physicians, licensing requirements are set by the contract itself. Some VA contracts accept a full, unrestricted license from any U.S. state; others may require a license in the state where the facility is located. Before you commit, confirm exactly what license the contract requires, so you don’t discover a gap during credentialing.

Credentialing and Privileging: Plan for It

No physician sees a single VA patient until they’re fully credentialed and privileged. For contract providers, the rules are explicit: under VHA Directive 1100.20, credentialing must be completed before a contract provider is even scheduled.

VA credentialing is thorough. It runs through VetPro, the VA’s electronic credentialing system, and requires primary source verification, meaning the VA verifies your licenses, education, training, and certifications directly with the issuing institutions rather than relying on copies. Physicians are also enrolled in the National Practitioner Data Bank’s Continuous Query program, which monitors for new reports on an ongoing basis.

Privileging comes next: the facility grants approval for the specific procedures and services you’re permitted to perform, based on your training and demonstrated competence.

Expect to provide:

• A current CV in month/year format, with no unexplained gaps
• Your medical license information
• Board certification or eligibility documentation
• Current DEA registration and NPI
• Education, training, residency, and fellowship details, plus professional references
• BLS, ACLS, or other certifications required for your specialty
• Immunization and occupational health records

The single most common cause of delay is an incomplete or inconsistent file: a gap in the CV, a missing document, or dates that don’t match across records. A staffing partner that knows the VA process can catch those issues before your file is submitted, which can make a meaningful difference in your start date.

Other Federal Requirements to Expect

Beyond credentialing, federal contracts come with requirements that private locum assignments usually don’t. Depending on the contract, these can include:

• Background screening and facility access. Expect fingerprinting and a background investigation to receive the credentials that give you access to the facility and its systems.
• Mandatory training. VA requires annual training on topics like information security, privacy and HIPAA, and workplace conduct. It’s typically completed online.
• Federal program eligibility. Providers can’t be excluded from federal healthcare programs, and must meet E-Verify and employment eligibility requirements.
• Conflict-of-interest rules. Contract providers are generally prohibited from referring VA patients to their own or affiliated private practices.
• Immunizations. VA facilities follow CDC and VA infection-control requirements, including TB screening and required vaccinations.

None of these are unusual for federal work, but it helps to know they’re coming so they don’t slow down your start.

The Electronic Health Record Is in Transition

If you’ve never worked at a VA, the health record system may be new to you. Most VA facilities use the VA’s long-standing electronic record system. But the VA is in the middle of a major transition to a new Oracle-based Federal EHR. After a pause of several years, the rollout resumed in 2026, with deployments in Michigan and more sites scheduled in Ohio, Kentucky, Indiana, and Alaska. The VA plans to bring the new system to all of its roughly 170 medical centers by 2031.

It’s worth asking which system your facility uses, and whether a transition is scheduled during your contract. A go-live during your assignment can temporarily slow workflows while staff adapt.

Schedule, Call, and Pay: Get Specifics in Writing

VA locum assignments vary widely. Some are full-time, Monday through Friday. Others are part-time, such as three set weekdays. Some include on-call and call-back rotations with defined response times, for example responding to calls within 15 minutes and arriving on-site within an hour. Others require no call at all.

Before signing, make sure you know:

• The exact days and hours, and whether alternate schedules can be approved
• Whether call is required, how often, and what response times are expected
• The length of the contract and whether it can be extended
• The hourly rate, and how hours are documented and paid

Pay is often a deciding factor. For a detailed look at how VA contract rates compare to staff salaries, see our breakdown of VA radiologist pay.

Know the Engagement Structure Before You Commit

Every contract is different. Employment classification, professional liability requirements, credentialing responsibilities, and other contractual obligations depend on the specific position and contract. The most important step before signing is simply asking: what exactly is this engagement, and what am I responsible for?

A good staffing partner will answer that clearly, in writing, before you commit, not after you’ve started.

Your Pre-Signing Checklist

Before you sign a VA locum tenens contract, confirm:

1. Licensing: Which state license does this contract require?
2. Credentialing: Who manages it, and what documents do you need now?
3. Schedule and call: Exact days, hours, and call expectations
4. Duration: Contract length and extension options
5. Pay: Hourly rate and how hours are documented
6. Engagement structure: Classification and contractual obligations
7. Reporting: Who you report to clinically, and who the COR is
8. Systems: Which EHR the facility uses, and any upcoming transitions
9. Start date: A realistic timeline from signed contract to first shift

Why Physicians Choose VA Locum Work

For all the requirements, physicians keep coming back to VA contract work for the same reasons: defined commitments, schedules that often beat private-sector call burdens, competitive hourly pay, and the chance to practice inside one of the largest health systems in the country.

And then there’s the mission. VA patients are veterans, many carrying the physical and psychological weight of their service. Physicians who work in VA settings often say that’s what makes the work worth it. With the VA reporting severe physician shortages at 97% of its facilities, the need has rarely been greater.

Current VA Physician Openings

Summit Operations Group is a service-disabled veteran-owned staffing company that places physicians in locum tenens and contract roles at VA medical centers nationwide. Our current openings include interventional radiology in Brooklyn and Syracuse, NY, and San Antonio, TX, and diagnostic radiology in Atlanta, GA. We’ll walk you through the licensing, credentialing, schedule, and pay for each opportunity before you commit.

View current openings → · Learn about locum tenens physician staffing →

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