It's a gate, not a bonus
Most locum assignments require board certification to credential at all. It does not generally command a premium in general practice categories — hospitalist medicine, emergency medicine, family medicine — because everyone in the pool has it. Losing certification, or letting it lapse, removes you from the pool entirely.
Treat it as maintenance of access, and budget accordingly: exam fees, MOC activities, and the CME hours each cycle demands.
Board certification is the baseline expectation for competitive locum compensation, and most facilities require it for privileging — a gate rather than a pay premium. The premium comes from subspecialty fellowship training in procedural areas (interventional cardiology, regional and cardiac anesthesia, surgical oncology, telestroke neurology) and from documented procedural volume. Source: LocumsOne, April 2026.
For cardiac anesthesiology specifically, most facilities require an ACGME-accredited Adult Cardiothoracic Anesthesiology fellowship plus Advanced PTEeXAM certification. Source: LocumsOne, April 2026.
Where the premium actually lives
- Subspecialty scarcity. Interventional cardiology, neonatology, pediatric subspecialties, and surgical subspecialties pay well above the base specialty because the credentialed pool is small.
- Scope you can cover alone. Certifications that let a facility close a coverage hole without a second physician are worth real money.
- Procedural privileges. Endoscopy, cath lab, and OB coverage change the rate more than the certificate itself.
- Geography. The same certification is worth substantially more in rural and critical access settings.
MOC, practically
Track your cycle in your own calendar, not the board's reminder emails. A lapse discovered during credentialing costs you the assignment, not just the fee. Agencies verify certification status at submission and again before start.
Time-limited vs lifetime certificates
Physicians holding older lifetime certificates are certified for credentialing purposes, but some facilities and payers now ask for participation in continuous certification anyway. Ask early if a specific facility requires it.
Sources
- LocumsOne, April 2026 — certification as a privileging gate, where subspecialty premiums sit, and cardiac anesthesiology fellowship and PTEeXAM requirements.