SAS doctors are about 20% of medical workforce and forms an integral part of NHS. Within the wider group of SAS doctors are a range of job titles and grades, derived from changing structures and contractual arrangements in recent years. The most common title is specialty doctor, a grade that is open to new appointees to which most new SAS doctors are appointed. They provide specialist clinical services, and at the time of first appointment normally have a minimum of four years’ full-time postgraduate training (or equivalent). Several national grades and titles are now closed (including associate specialist, staff grade, clinical medical officer, hospital practitioner and clinical assistant).

As part of the 2021 SAS contract reform, a new senior SAS grade has been opened called “specialist”. Previous senior SAS grade was associate specialist, which was closed in 2008, however there are still SAS doctors in this grade and other closed grades linked to old contracts. The new specialist grade is an autonomous grade and will provide career progression opportunities for highly skilled and experienced specialty doctors. The entry criteria for the specialist grade are minimum 12 years postgraduate experience, 6 years in the relevant specialty and meeting criteria for generic capabilities framework as derived by NHS Employers, BMA and Academy of Medical Royal Colleges.

SAS career provides an alternate and a viable career path to doctors in comparison to conventional training route leading to CCT. It provides geographical stability and flexibility at an earlier stage of career, along with opportunities to work in the individual’s area of interest. Most of the SAS doctors are keen to have a fulfilling career within the grade with opportunities to develop themselves in to senior and autonomous clinicians, along with pursuing interest in research, education, leadership, and management. SAS doctors with the appropriate accreditation are recognised as educators for trainees by GMC, Colleges, and Health Education England. There are many SAS doctors fulfilling various roles such as educational supervisors, tutors, and appraisers within the Trust. A small number of SAS doctors are keen to go down the route of CESR to get into the specialist register or go back in to training leading to CCT.

No matter whatever route they choose, SAS doctors are a respected and valued part of the NHS, they need support and opportunities to develop not only in clinical field but also in the extended roles as leaders and educators.