The words people use
Both countries take the term from the Latin locum tenens, "holding the place". In Canada, clinicians and organizations almost always shorten it to "locum": a family physician does locums, a hospital books a locum, a pharmacist picks up locum shifts. In the United States the full phrase "locum tenens" is far more common, particularly for physicians, and it is also the name of an industry of staffing agencies that place physicians and advanced practice clinicians in temporary assignments.
The difference in wording reflects a difference in structure. In Canada, many locum arrangements are made directly between the clinician and the practice or hospital. In the United States, a large share of physician locum tenens work is arranged through agencies. Both models exist in both countries, but the balance differs.
Licensing: provinces and territories vs states
In Canada, health professions are regulated by each province and territory. Physicians are licensed by the college of physicians and surgeons of the province or territory where they practise (for example the CPSO in Ontario or the CPSBC in British Columbia), and in some territories licensing sits with the territorial government. There is no national licence.
In the United States, physicians are licensed by state medical boards, and a licence is needed in each state where the physician practises. The Interstate Medical Licensure Compact offers an expedited pathway for eligible physicians to obtain licences in participating states, but each state still issues its own licence.
The two systems do not recognize each other's licences for practice. A Canadian licence does not authorize practice in any US state, and a US state licence does not authorize practice in any Canadian province or territory. A clinician who wants to work in the other country must meet that jurisdiction's registration requirements, and may also need immigration authorization to work there, which is a separate process.
Nurses, pharmacists and other professions
The same pattern holds beyond medicine. In Canada, registered nurses, nurse practitioners and practical nurses are regulated by provincial and territorial nursing regulators, and pharmacists by provincial and territorial pharmacy regulators. In the United States, nurses are licensed by state boards of nursing and pharmacists by state boards of pharmacy.
The United States also has a Nurse Licensure Compact that lets eligible registered and practical nurses hold one multistate licence valid in participating states. Canada has no equivalent single licence; instead, labour mobility rules under the Canadian Free Trade Agreement are intended to make it easier for a professional registered in one province or territory to become registered in another.
How locums are paid, in general terms
Payment arrangements vary widely and change over time, so treat this as background rather than a rule. In Canada, physician services are largely paid through each province's or territory's public health insurance plan. Many physicians, including locums, bill that plan for the services they provide, often on a fee-for-service basis, while others are paid through alternative arrangements such as sessional, salaried or contract models. A locum covering a community practice commonly agrees with the host practice how billings and overhead are handled. Nurses, pharmacists and many allied health professionals in locum roles are more often paid an hourly or daily rate by the organization.
In the United States, physician services are paid by a mix of private insurers, public programmes and patients. Locum tenens physicians placed through an agency are commonly paid by the agency, often as independent contractors, and the agency bills the facility. Arrangements made directly with a facility or employer also exist.
On LocuPedia, the offered rate is shown on every coverage post before a clinician applies, and the organization and the clinician agree terms and settle directly. LocuPedia does not process, collect, hold, transfer, invoice, settle or guarantee compensation between clinicians and organizations, and it takes no percentage of anyone's pay.
Liability protection
In Canada, most physicians obtain medico-legal protection through membership in the Canadian Medical Protective Association (CMPA), a not-for-profit mutual defence organization, and in many provinces a portion of the fees is reimbursed under provincial arrangements. Hospitals and clinics commonly ask a locum physician for proof of current CMPA membership or equivalent protection. Other professions have their own arrangements, and many organizations list liability protection as a requirement for the assignment.
In the United States, physicians generally carry malpractice insurance from commercial or other insurers. For locum tenens assignments, malpractice coverage is typically arranged by the staffing agency or the employing facility, and the details (including coverage for claims made after the assignment ends) are part of the contract. Clinicians in either country should confirm in writing what protection applies to each assignment.
What this means if you are searching
If you are a clinician licensed in Canada, look for work in the provinces and territories where you are registered, or plan the time to register in a new one. If you are licensed in the United States, a Canadian locum requires Canadian registration first, and the reverse is equally true.
LocuPedia's credentialing checks each credential against its issuing source: in Canada, licences are confirmed on the provincial or territorial college register, and in the United States the site describes checks against the federal NPI registry and state licence boards. Verification requirements are matched to the jurisdiction of the assignment.
A note on our name
LocuPedia is a Canadian platform and is not affiliated with Locumpedia, a US locum tenens company. The names differ by one letter. If you are looking for LocuPedia, the Canadian healthcare workforce marketplace, you are in the right place at www.locupedia.com.
Confirm before you rely on it
This guide is general information, not legal, licensing, tax, immigration or insurance advice. Rules differ by jurisdiction and profession, and they change. Confirm registration requirements with the relevant Canadian regulator or US state board, and confirm liability coverage with your protection provider or insurer, before accepting any assignment.