Intended for healthcare professionals


Five ways to support SAS doctors

BMJ 2017; 356 doi: (Published 28 February 2017) Cite this as: BMJ 2017;356:j1032
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}


The BMA, Health Education England, the Academy of Medical Royal Colleges, and NHS Employers have produced guidance on the career development of specialty and associate specialist (SAS) doctors in England.1 Here is some of the advice in the guidance

1. Consult

Hospital boards should regularly consult SAS doctors to understand the work these doctors do and to consider any support they may need. Boards can ensure that they are making the most of SAS doctors’ abilities by finding out the proportion of SAS doctors with a mutually agreed job plan or who use their agreed study leave.

2. Encourage

SAS doctors should be actively encouraged to apply for management roles and appropriate consultant posts, the guidance says. Boards should ensure that negative terms such as “middle grade” are not used. SAS doctors who are appointed to management and consultant posts should be appropriately supported.

3. Appraise

The guidance says that medical directors must ensure that SAS doctors undergo appraisals each year. Appraisal can help provide evidence of SAS doctors’ current level of practice. Medical directors should also recognise that, where appropriate, SAS doctors can work autonomously.

4. Develop

SAS doctors should be supported by their medical director to apply for a certificate of eligibility for specialist registration where there is a service need that can be met only through increasing the consultant workforce. Medical directors could consider how SAS doctors could fulfil roles such as educational supervisor and appraiser.

5. Empower

SAS doctors should themselves be assertive in taking advantage of opportunities available to them and challenge colleagues when opportunities are not open to them. They should take personal responsibility to take the initiative.


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