Ready to escape the demanding hours of your long-term physician position and instead gain work/life balance, while earning a good living? Want to travel near or far, while getting paid? Then, chances are, locum tenens can benefit you.
An important consideration is whether to take a domestic assignment or an international one. This doesn’t have to be an either/or proposition, as many physicians work both kinds during their career, points out Global Medical Staffing's Dena Sween, especially as they transition out of or back into the U.S.
Still, to help you get started on your first locum tenens assignment, we’ve broken down the pros and cons of both types.
Dr. Anu Taylor on assignment in the U.S. territory of Guam
Our international assignments deliver a memorable experience living like a local in another culture, while practicing first-world medicine in a safe environment, in locations such as Guam, Canada, the Caribbean, the U.K., China, or the “down under” countries of Australia and New Zealand. These positions usually involve set hours without on-call time, along with generous vacation time, allowing for extensive travel time while you are there. That’s one of the biggest reasons physicians choose international locums.
International assignments provide adventure and exposure to different health systems, which builds your CV and helps you to increase your skill level. Additionally, many physicians, like Dr. Sara Jalali, report that these assignments reinvigorate their passion for medicine, helping relieve burn out.
Another perk is that we’re placing in more areas of the world than ever before. “There are all of these fantastic options just starting to pop up, so basically what we tell people is to get on our list so that when that really cool new thing comes through, you hear about it first,” Sween says.
Challenges of international assignments can include collecting the necessary paperwork and the requirement to take on longer commitments, often one year. Although there are some three month assignments available in Guam and the Caribbean. Going to Guam and other U.S. territories requires that U.S. physicians possess a U.S. passport but no visa. Plus, as with all positions, it requires credentialing and privileging, often taking three months from the time you accept the assignment.
Paperwork for other international placements takes a little longer; the typical minimum assignment length is longer too. For instance, it usually takes three months to complete the medical registration and visa process for New Zealand, and requires a six-month minimum assignment. The paperwork for credentialing, privileging, licensing, and visa processes in Australia and Canada take six to eight months, and typically require longer assignments, usually one-year minimum.
“There’s going to be paperwork anywhere you go, domestic or international,” Sween points out. “They [the hospital administrators] need to know who’s coming in and working in their healthcare system. The fantastic thing is that we have an amazing team who walks you through all of that and holds your hand throughout the process.”
Another possible challenge of international locums might be an expectations mismatch. For instance, housing may be different from the typical U.S. set up.
“We look at what the local doctors live in, and that’s kind of the level we put doctors into,” Sween explains. “For example in New Zealand, you may not have air-conditioning; that’s standard in the area. Having that flexibility in your expectations and listening when our recruiters are setting those expectations is really important.”
She adds that part of the reason many physicians choose an international assignment is to live like a local. “It’s part of the adventure.”
Other possible challenges: Practicing medicine in another country might involve differences. Also, many people feel both excited and nervous about the assignment.
These are valid concerns, Sween points out, but it’s rare that a physician takes an international assignment and feels like it wasn’t worth their time or that their family didn’t bond because of it. The keys are to communicate your expectations with your recruiter, and then go with an open mind.
Dr. Anita Haugabrook takes a selfie with colleagues while on assignment in the U.S.
If you want less adventure or can’t leave the U.S. for several months, choose a domestic assignment instead of an international one, Sween says. Domestic assignments allow you to take on very short assignments. They provide more flexibility, more choice, and more options. You choose your pay, your schedule, and your working conditions.
“You can do weekend work. You can commit to five shifts a month,” Sween explains. “That’s the beauty of domestic work, the flexibility.”
Another benefit is that domestic assignments pay more than international assignments, and often more than a long-term position, especially for hard-to-fill shifts or specialties, like psychiatry.
Some physicians choose domestic assignments in order to spend time near their family/college kid, to tackle their travel bucket lists, or to use their skills to help a vulnerable population. Other motivations include spending more time with family, combating physician burn out, avoiding extensive admin and billing paperwork, and taking charge of their destiny.
Possible challenges can include the paperwork involved in getting licensing in other states, or for some positions, requirements can be very specific (i.e. certain certifications, experience, or training). However, don’t let those possible challenges hold you back. We have all kinds of assignments across specialties all over the U.S. and are committed to helping physicians find what they’re looking for.
Reach out to us today
If you’re interested in learning more about locum tenens, contact us. “Let us know what your expectations are, so we can find you a great fit,” Sween encourages. “And feel free to call us ahead of time, even years before you can go international. We can answer questions along the way, or place you in domestic assignments, or help you start planning in a certain direction to turn those dreams into reality.”
Ready to launch your own locum tenens adventure? Click the button below to browse our current opportunities or give us a call at 1.800.760.3174.
Locums for a Small World Blog
For as long as Dr. Eva McCullars can remember, she always wanted to be a physician, just like her mom. As a child, she helped her pediatrician mother with patients, answering the phone when her mom was out treating patients on house calls. Her father is also a physician, a surgeon, so Dr. McCullars says, “I was the only child, and I grew up in medicine, so I think it’s in my genes.”
When her family moved to the U.S. from Prague, Dr. McCullars pursued her medical degree, first considering pediatrics, but deciding against that particular specialty during residency. She found her calling in psychiatry after taking a psychiatry program and loving it.
“Even though you have the same diagnoses for different people, everyone’s different,” she explains. “Everybody’s their own person. I was always an artist growing up, and to me, psychiatry’s an art because you have to combine the people’s personalities and their histories with medication, if that’s appropriate, or with a type of therapy or other interventions. Not a single person is alike.”
While working in Yuma, Arizona, at a sub-acute hospital, she ran into physicians working locum tenens, which exposed her to the idea of trying locums at some point. She gave it serious consideration later when, while working at a permanent position at a big hospital, she became dissatisfied with the way things were being run.
“It was all about the bottom-line, and patients weren’t getting good care [because of it],” Dr. McCullars explains.
So she considered moving into private practice. At the same time, her family in Oregon needed help. “The two situations came together where I was starting to be dissatisfied with my permanent job and needing to respond to my family in crises,” she says. “I thought, I can go to Oregon and work. That’s how the process [to full-time locum tenens] started.”
After making the move, the big revelation for Dr. McCullars was discovering that locum tenens provides her with a better way to practice medicine than full-time permanent positions. She feels that with locums, she is better able to make a difference to patients, use her time effectively, and share her gifts.
Benefits of working locum tenens
Why does Dr. McCullars like working locum tenens? “I like the freedom,” Dr. McCullars explains. She says that with locum tenens, she gets to make a comfortable income while going to places she has always wanted to explore. “I wouldn’t go back to a full-time permanent position,” she adds.
Dr. McCullars points out some additional benefits of locum tenens. She says, you can:
- Set your own hours. For Dr. McCullars, this means working four 10-hour days a week and not having to be on call.
- Take off time between assignments. “I like being able to work for six months and then be off for four months,” she says, which allows her to take a month to go somewhere overseas.
- Spend time on patients, not politics. “There are a lot of pressures other than taking care of patients when in a permanent position. I love taking care of patients, and locum tenens allows me to do this without any of the other distractions,” Dr. McCullars explains.
- Avoid being tied down to one location/facility. “Let’s say I want to work in Canada,” says Dr. McCullars. “Just to be able to go to Canada if I want [is a big benefit of locums]. As is the ability to leave a political situation when it’s time to leave.”
- Avoid burnout. Working locum tenens allows physicians to set realistic work hours, not take work home, and to avoid much of the paperwork and politics that contribute to burnout, Dr. McCullers explains.
Dr. McCullars’ advice for physicians coming out residency
To younger doctors, she says, “It’s really hard to come out of training and make an instantaneous commitment to an area and to a facility. I think you should leave your options open…Definitely become a locums before you settle.”
READ MORE: 9 reasons to work locum tenens after residency
Dr. McCullars’ advice to other physicians
To all physicians considering locum tenens, she says, “You have nothing to be afraid of…you have lots of support along the way. The benefits: being on your own time, being able to work four days a week instead of five days a week, not doing weekends, not doing call, being able to finish an assignment and leave without worrying about the patients…That’s one of the problems of long-term jobs and private practice is you take it home with you…You don’t have to do that as a locum tenens.”
Ready to explore your own locum tenens adventure? Click the button below to browse our current openings or give us a call at 1.800.760.3174.
Dr. Anita Haugabrook (Doc Nita) first got into locum tenens during a transitional point in her career. She had just left a fulltime partner role in a physician group and wanted some time to consider options before signing a long-term contract. However, she soon fell in love with the locum tenens way of life and decided to make it permanent.
“Transitioning to the world of locums was a leap of faith. Thanks to Global Medical Staffing and my consultant, Sydnee Shelton, for making my dreams a reality!” Doc Nita says.
What Doc Nita loves is the way locum tenens allows her to passionately practice medicine, regain work/life balance, and travel to new places.
“I choose my shifts and locations, which provides me autonomy and allows me to spend more time with my family. Now, I’m back in control of my life and my destiny,” she says.
Flexibility and work/life balance
Doc Nita loves the flexibility of locum tenens and her ability to set her own schedule. “I only accept the times and places I want to work,” she says. “I literally work when I want to and don’t work when I don’t want to.”
For her, that means no nights or weekends.
With the ability to be in charge of your own schedule comes true work/life balance. That, in turn, means Doc Nita has fallen back in love with medicine after feeling burned out for years.
With locum tenens, instead of spending so much time handling staffing crisis and admin tasks, she can spend much of her working time doing what she loves: helping patients.
“I get to practice medicine,” she says with a smile. “When I was burned out, I wasn’t able to see the joy in my work anymore, and I went into medicine to make a difference, to get people well, and to see the joy in people when they’re feeling better. I feel like I’m helping people again.”
She loves practicing in different healthcare settings — and she loves that she can choose not to go back to a certain hospital or healthcare facility if she didn’t like the way it was managed.
Also, she says that now instead of bearing the brunt of the problems, she’s on the receiving end of gratitude.
“Almost every time I leave a shift someone tells me ‘thank you’ because they were going to be overworked without me there. I really feel the appreciation as a locum tenens physician filling in their gaps.”
One of my favorite things about locums (travel medicine) is meeting and working with new people all the time! Meet my APC team at UVMC and a couple of photobombers.
The flexibility of locum tenens has made it easier for Doc Nita to do medical mission work. So far, since she started locum tenens in August 2017, she has helped out in Panama and Costa Rica.
“The missions were eye opening and rewarding,” she shares. “I don’t complain anymore about anything in my life because of it. The people we helped would walk six miles each way to see us. They would leave the day before just so they could see us!”
Sydnee, Doc Nita’s recruiter at GMS, shares in on the joy of witnessing someone so willingly helping others.
“Doc Nita’s passion to help those who otherwise wouldn’t receive medical assistance is unparalleled,” says Sydnee. “When she shares the stories of her time abroad, she oozes with love and passion for the people she served. She speaks of how much these beautiful people have changed her view on life.”
Doc Nita adds, “I look forward to my next mission!”
Living somewhere else like a local
So far, Doc Nita has taken travel assignments in St. Louis, Missouri, and Northern California.
The way locums works is that Global Medical Staffing arranges the travel to the location. The contract also includes medical malpractice insurance and usually housing and transportation as well, with GMS taking care of the logistics, including helping with credentialing, licensing, and privileging before the assignment starts.
When on assignment, Doc Nita makes sure to take time from work to take in the local sights.
“Missouri was a good experience,” she recalls. “I worked with a physician group that was in between management teams, and it was really neat to come to help a solid group of people who had been there for a while but also were in flux. It was a well-run group. And St. Louis was a pretty neat town. It was nice visiting there and learning more about it, seeing the Arches, going to Sweetie Pie’s Restaurant for soul food, and checking out other local places.”
Doc Nita’s next traveling assignment was in Ukiah, California. “The drive to work every day is amazing because it is so beautiful!” she says. “The local culture and tribal people are amazing. The transplants are too — it’s kind of a little melting pot. I tried some local food and wine and then went to the farmers market with all of its local teas. My goal every time I go somewhere is to absorb some of the culture.”
The City of Ten Thousand Buddhas — the largest Buddhist monastery in western society. Travel opportunities are of a hallmark of locum tenens. Where would you like to visit on your next assignment? Let GMS help you get there!
Choose your assignments
Finding the right assignments involves teamwork. As Sydnee puts it, “I partner with Dr. Haugabrook rather than ‘work’ with her. She has made me an equal and has so much trust in me. Her trust in me is at times intimidating and humbling! She has said to me on more than one occasion regarding her transition from her permanent job to locums, ‘Syd, you are a Godsend!’ However, I feel it is the other way around!”
This type of mutually respectful and heartfelt relationship is common between our GMS recruiters and physicians. We want to find you the right assignment that works out for your goals, needs, aspirations, and wanderlust.
Still unsure? Give it a try, says Doc Nita. “You can always try it and then go back to full time if you want. For me, I love locums and am not going back.”
Doc Nita recently took over our Instagram to share her locum tenens adventure in Ukiah, California. Head over to our page to check out her photos right here.
Want to start your own locum tenens adventure? Click the button below to browse our current opportunities. Or just pick up the phone and give us a call.
You've thought before about an international assignment, but how do you know if the timing is right? Take our fun, short, eight-question quiz to find out whether you’re ready to head off on your own international locum tenens assignment.
Ever consider doing a short work stint on the other side of the world to immerse yourself in another culture, explore the tropics, and travel throughout Asia? When Dr. Kevin Arnold approached retirement from fulltime urgent care, he and his wife, Linda, wanted to explore new places, so they researched options and talked to Global Medical Staffing. In the end, they picked Guam for its nearly limitless potential for travel.
“It’s America’s other tropical paradise,” Dr. Arnold says. “At 10 p.m., it’s still 80 degrees. It was a delight to experience weather like that.”
Almost like a vacation rather than work
In the mornings before Dr. Arnold’s shift started at noon, he and Linda had plenty of time to explore and relax. They went hiking in the jungle, saw tourist sights like the local World War II museums, and spent time poolside.
The couple also checked out Guam’s massive amusement and water park, along with exploring all kinds of natural pools out in the jungle.
“You go in and hop into tiny lagoons among the rocks,” Dr. Arnold explains, “which is a lot of fun since it’s always hot and sunny.”
True to its reputation, Guam provided the Arnolds with numerous travel opportunities. For instance, they took a three-day weekend to visit Tokyo, and after the assignment, they flew to Manila, and during a month-long adventure, also checked out Singapore, Vietnam, China, South Korea, and Japan.
“Guam is like the ‘Chicago of Asia,’” explains Dr. Arnold. “You can easily go anywhere on that side of the world.”
And about the current tensions between the U.S. and North Korea — Dr. Arnold says that the U.S. military, which maintains a strong presence in Guam, showed no signs of concern, nor did the local people, so the Arnolds didn’t worry.
Medicine in Guam
Practicing medicine in Guam felt refreshingly different to Dr. Arnold from his 35 years of urgent care experience in Wisconsin, something that included many colds and sinus infections. “I treated almost no sinus infections in Guam, a real treat for me,” he says with a grin.
Territorial authorities own the hospital where Dr. Arnold worked, so like any public hospital, it operates on a tight budget. That said, the technology was all up-to-date, Dr. Arnold adds.
He treated many abscesses along with sprains and strains in the local population. “I had a little bit of a learning curve with the Chamorro culture, in that they do everything as a family, including coming into the clinic together and all staying in the exam room during procedures.” But he adjusted quickly, he says. “The Chamorro people are friendly and gracious.”
He also saw a mix of tourists, most of whom didn’t speak English, so he made good use of the Google translator app. Through this, and some of the nurses, the patients and Dr. Arnold communicated back and forth without problems.
A welcoming people
The people are friendly and inviting, Dr. Arnold emphasizes. While there, the Arnolds went to a couple of local festivals, including one that celebrated the Chamorro indigenous culture. Residents invited them to try the local food dishes. “I asked if I could buy our meals, and they said please join us, for free. They’re very inclusive,” Dr. Arnold explains.
While there, the Arnolds both easily made friends — Dr. Arnold mostly through work and Linda through social groups, like a book club. Now, they keep in touch with their new friends in Guam.
Step outside your comfort zone
If you’ve ever considered traveling and practicing medicine in another part of the world, all while earning a typical U.S. physician salary, consider Guam. Physicians can take short three-month assignments like Dr. Arnold did, and licensing and privileging prove no harder than anywhere else in the United States, he adds.
“It’s a step outside your comfort zone, but the experience is rich and fulfilling,” Dr. Arnold says. “You’re taking care of a population that really needs doctors. I would definitely urge you to try it.”
Take your spouse and family along, he adds. “Linda really enjoyed it, and the physician who replaced me signed up for two years and even brought his kids,” Dr. Arnold says. “All and all, our experience there ended too soon.”
Click the button below to browse our current opportunities. Or just pick up the phone and give us a call at 1.800.760.3174.
You've gotten the itch to place your feet on new land, you know that much. But where to go? Take our fun, short, seven-question quiz to find out where you should head off to on your next international locum tenens assignment.
What inspires you most in this life? Ask that question to any number of people across many professions and you’ll probably get a different answer each time. Pose that same inquiry to a room full of doctors and we imagine that some aspect of their answers will include the words “helping others.”
Go ahead. Take a minute to answer that question for yourself. In fact, to go about it a slightly different way: what inspired you to become a doctor? Don’t limit it to just one reason, either. To gain medical knowledge and a comprehensive, problem-solving skillset all in an effort to heal others and be of service to society is a noble – albeit arduous – pursuit. But that’s only one component of your answer, right?
We know your desires go deeper because all of our reasons for choosing our unique career paths in life go deeper. Perhaps for you it is the altruism, or your insatiable interest in science and medicine, or that it’s a well-respected field, or you come from a family of doctors, or that it’s a stable career path with great earning potential. Heck, it could very well be all of the above or an entirely different answer altogether.
But at the end of a demanding day in an industry where burnout rates are on the rise and patient care never stops sometimes you have to remind yourself of your reasons in order to stay afloat. Other days you need a little more motivation outside of mentally cataloguing why you started in the first place.
A change in scenery is just what, well, you ordered. And we mean that as conceptual as possible. Something as seemingly small as going for a daily walk or something much bigger like taking that huge vacation you’ve been wanting to for years. Or something even more crucial like changing career paths, finally trying out locum tenens for want of the perks you’re afforded. All three of those “changes in scenery” can be accomplished all at once. In other words you could go for a daily walk in an idyllic island country by taking an international locum tenens assignment.
In an effort to see whether or not you’re at a point in your life where taking a medical job overseas makes sense we’ve come up with these three foolproof questions that will help clear your mind. They’re not scientific by any means; they’re simply honest questions that we’ve compiled from all our years of sending doctors abroad.
First and foremost, do you feel burnt out? (Y/N)
We suspect that you’ve heard at least some form of burnout talk – whether colloquially or as a real condition at some point in you’re medical career. Maybe you’ve already experienced some symptoms yourself. Keep in mind that it’s not a phenomenon that solely affects the medical field, either. Many professionals have been impacted by burnout.
Christina Maslach, a Stanford social psychologist, developed a cohesive assessment tool many years ago concerning professional burnout. It’s called Maslach Burnout Inventory and it addresses three general scales:
- Emotional exhaustion: Measures feelings of being emotionally overextended and exhausted by one’s work;
- Depersonalization: Measures an unfeeling and impersonal response toward recipients of one’s service, care treatment, or instruction;
- Personal accomplishment: Measures feelings of competence and successful achievement in one’s work.
If you feel emotionally overextended, dispassionate about your work, or have a low sense of personal accomplishment then you may be feeling symptoms of burnout. These are real issues that should be taken seriously. And there are solutions out there outside of an international locum tenens assignment: take time to seek out professional help (yes even doctors need someone to talk to), get restful sleep, exercise frequently, etc. (You can find out more about solutions here.) If you’ve tried everything you can think of then maybe a change of scenery is what you need next.
Have you recently gained more free time in your personal life? (Y/N)
There’s no doubt about it; the road to becoming a physician is physically, emotionally and financially demanding to say the least. And that’s not counting the balancing act you have to perform with your personal life along the way.
But let’s say life is slowing down a bit. Maybe you’re still living the bachelor life right out of residency and you want to experience an adventure in New Zealand before you take on a full-time pursuit in the States. Or maybe you’re nearing retirement and considering a sabbatical of sorts in Australia. Or maybe, just maybe, you’re mid-career and your kids want a new experience, too. (The public school systems down under are top-notch and they do accept foreign students often.)
Do you want more freedom in your schedule and control over your work life? (Y/N)
Who is really going to say no to that? Locum tenens gives physicians of all specialties the ability to go where they're needed. And there are a lot of needs around the world. There are limitations at times (e.g., if a position closes or if a need doesn't currently exist in a specific location) but for the most part you get control over where you want to practice and when. On top of that you get more freedom to treat patients. That means you spend less time handling paperwork and processes typically associated with a non-locum-tenens pursuit.
If you answered yes to any of these questions then a medical adventure overseas may be just the journey for you. But if you're still feeling indecisive then we’d like to throw these last two queries your way:
Do you want to see how doctors in different countries deliver care, in other words, would you like to diversify your medical knowledge? (Y/N)
Do you enjoy travel and experiencing other cultures? (Y/N)
It’s possible that all of this has left you with even more ambivalence. Never fear. Our physician placement specialists are here to help. Pick up the phone and give us a call. Or if you're ready to start looking now then click the orange button below to see what opportunities are available.
It’s an almost impossible task to respectfully describe the United States’ four regions in their entirety. They’re all so bountiful and beautiful. They’re all so chock-full of diversity. We don’t want to accidentally favor one over the other (we'll leave that to you), or even fail in naming off every great thing about them. What’s important to remember though is that each region has its own unique flair and verve. They all have extraordinarily diverse cultures, dialects and landscapes that make up their life-blood. Even the weather packs a different punch everywhere you go.
Below we explore the Northeast with its nation-birthing prowess and world-famous cities, then the South with its home-style cooking and historic music scene. We dive into the Midwest, too—America’s Heartland. It’s full of Great Lakes, Great Plains and great people. Last but not least we find ourselves in the West. Don’t worry it’s still wild (just not the exact kind of wild you would've encountered in Billy the Kid’s days). Today, its wild is wonderfully preserved in massive canyons and red deserts, and in crashing waves and tall trees.
Now, bear in mind, in what follows we'll very likely leave something iconic out (not on purpose, of course) but that only lends to the fact that these regions are too grandiose to fit on one page. So when you're on your next locum tenens assignment in any one of these regions, it's up to you to explore as much city and country as you can.
The U.S. has managed to pack about 60 million people into this one corner of the country. That means you get all kinds of variety from culture to cuisine and it’s all at your beck and call. You can drive state to state in the blink of an eye and while you’re driving you’ll find some of the most amazing landscapes in the country—especially during leaf-peeping time and cherry-blossom time.
Seriously, an itinerary in the Northeast reads more like a fantasy or action-adventure novel. It’s a place where you’ll find fiddleheads, oyster sloops, and whoopee pies next to Tiffany’s, old money, and Wall Street. It’s a place where leather jackets and skinny jeans meet belt buckles and cowboy boots. It’s a place where Michelin Star Chefs reign supreme yet fluffernutters are frequently touted as the greatest sandwich of all time...read more.
Learn to love the drawl, y’all, because while each U.S. region has a unique identity and personality the South offers a world of differences—and one of the most recognizable is their vocal inflection. No matter where you go in the South, everything is served up with gracious hospitality and sweet tea. Even the weather is hospitable.
Beaches run for hundreds of miles down the Atlantic coast and sailboats bob on the water from Galveston Bay in Texas to the Golden Isles of Georgia. Cities vary from genteel (think Savannah) to slick (think Raleigh), yet nothing is as fulfilling as taking a journey into the heart of the deep South to see its historically rich, culturally scenic splendors...read more.
Ah, the Midwest. We find it at the intersection of those two disparate but quintessentially American Coasts: east and west. The divide between the two began in 1849, when hundreds of thousands of forty-niners, migrated to California and—legend has it—they were carrying lattes and surfboards. You could say they left their Burberry scarves for North Face gear; the Great White Way for Hollywood. Early settlers of the frontier didn’t fly at the time, but some of the states here have been erroneously dubbed “fly-over” states. Yes, erroneous because we think America’s Heartland is full of great destinations. Gold Rushers who never made it past the Midwest—seems they found their own field of dreams right here—will tell you it’s true...read more.
In the Great American West everything somehow seems grander and larger than life. Long before the first cowboy rode onto the silver screen, the world's love affair with the American Frontier burned bright.
Come here to witness the spectacle that is the Grand Canyon; admire the giant saguaros (pronounced "sah-wah-ro”) that dot the Sonoran Desert; or stand at the celebrated Four Corners—the only point in the U.S. where the boundaries of four states touch (though if you read the news, the surveyors apparently missed the real mark by 2.5 miles). Hike the hoodoos of Utah’s Bryce Canyon National Park or tread lightly at Acoma Pueblo in New Mexico, America's oldest settlement...read more.