SAS Career Development 

Did you know that in 2023 SAS doctors made up 20% of the NHS workforce? Who are SAS doctors? (

The GMC predicts that by 2030, SAS and Locally Employed doctors on the GMC register in secondary care will form the largest group in the medical workforce. Workforce report 2022 - GMC (

The approach of following a formal, linear trainee route to CCT doesn’t suit everyone. It is positive to take time to look at all the alternative ways to create a career that fits with you and your needs.

Specialist, Associate Specialist and Specialty (SAS) are a group of experienced doctors who form a significant proportion of the medical workforce. Whether you are exploring this career option as a trainee or currently a SAS doctor then this information is for you. It has been created to enable you to access resources, knowledge, and insight to understand more about the career and learning opportunities available to you and how to develop key areas of interest. Appreciating the benefits and challenges that you may encounter and how to approach these productively will help you to cultivate your career as a SAS clinician.

SAS Doctors CLINICAL Conversations 


How do I become a SAS doctor?

SAS posts are accessible to you throughout your clinical career. If you opt to depart from your training route to move into a SAS post, do consider the stage of training you are at beforehand. For specialty posts you need a full General Medical Council registration and a minimum of four years’ postgraduate training (two years of which must be in the relevant specialty).

One of the distinctions to reflect on is how your role will differ if you stay on the pathway to CCT as opposed to pursuing a specialty doctor career route. As you are no longer in a training role you may find that your focus is on meeting NHS service requirements, compared to your consultant colleagues. To learn more about the similarities and differences in specialty, specialist and consultant roles, the BMA have produced a comparison table  bma-specialty-doctor-specialist-and-consultant-roles-and-responsibilities-comparison-table-jul-2021.pdf (if this pdf can’t be linked then this takes you to the web page) ​​The 2021 specialist grade explained (

Is SAS the career route for me?

If you are at the concept stage and starting to gather insight and understanding about the SAS career route, then it is useful here to think of the 3 D’s to your decision making

  1. Data – What do you know about the opportunities that are available in the location and specialty that you would like to work in?
  2. Discussions – Map out anyclinicians you know who are working as SAS doctors. Can you arrange a time to have a career conversation with them about the positives and drawbacks that they have experienced?
  3. Drivers – It is a useful exercise to consider what is driving you to this career route.  For some clinicians it is connected to flexibility and work patterns, for others it is clinical independence and the ability to avoid other managerial tasks that they are not interested in.

There are two activities that can help:

  • Access the Careers Unit, Career Planning Module and focus on the self-awareness module so that you have a clarity of purpose.
  • Undertake a Cost / Benefit analysis including the emotional, physical, and financial cost of doing this route and then the benefits so that you can compare the options.
















Within the 2021 specialist grade there is a list of generic capabilities that have been created. This is useful as you can see the skills and experience that you need to help you to make this transition. These 5 areas below are the competencies and skills needed.

  1. Professional values and behaviours, skills, and knowledge
  2. Leadership and teamworking
  3. Patient safety and quality improvement
  4. Education and training
  5. Research and scholarship

An activity to do next would be the 7 Things where you can highlight examples from your work and life. From this you will have areas of strength as well as a clear focus of where your gaps are.

Read more about Dr Janine Griffiths transition from trainee to Specialty Doctor and her advice on the benefits of making this career choice for her.

CASE STUDY: SAS Psychiatrist

Dr Janine Griffiths is a Specialty Doctor in Perinatal Mental Health for Mersey Care NHS Trust. Dr Griffiths qualified in 1997 and started her training in Psychiatry and combined this with family life. Dr Griffiths had a period of ill health and reduced to LTFT. She continued to progress through her placements, on calls and passing the required exams but a turning point came after her third child was born. After much deliberation, Dr Griffiths realised that having an active part and being present in their lives meant that she needed to think differently about her clinical career and carved out a career route for herself that enabled her to fit in her love of clinical practice with raising a family. Dr Griffiths spoke with supervisors, management and other doctors and realised there was the option of becoming an SAS doctor, applied for a job in the Early Intervention team in a part-time capacity and this was the best career decision she has ever made. Dr Griffiths now has 4 children, loves her job and gets personal satisfaction from her work and parent life.  

Career opportunities  

  1. SAS rep on the LNC. The BMA provided training and this was a role that Dr Griffiths was involved in for over 10 years. 
  2. An Appraiser, the Trust was encouraging and supportive and training was provided the biggest challenge was managing time as many appraisals fall at the same time. 
  3. In 2019, Dr Griffiths became the SAS Lead which coincided with Covid. The role altered significantly from education and career development to wellbeing and creating a supportive online SAS community.  
  4. Perinatal SAS rep for the Royal College of Psychiatrists, this takes a management role, and this experience is thoroughly enjoyable as she has two branches of knowledge the perinatal and the SAS experience to share.  
  5. SAS Advocate - this is the next area of interest for Dr Griffiths. These are still very new roles and what is interesting about this opportunity is that it combines wellbeing and leadership together which is a natural for her skills, interest, and experience. 


  1. It is vital to find your SAS Peer Group in your Trust. From a career development perspective, you learn about the ever-changing career opportunities open to you and you have an opportunity to share best practice with each other. 
  2. It is so important to work in an area that brings you joy so do take time to think about this in your career decision making.
  3. Make sure you use your SAS study leave and develop your non-clinical skills whether that be leadership, education, or service improvement.  
  4. The SAS Charter has created management roles and it is important to think through your job plan and be clear with your supervisor how much time is needed within your job plan.  
  5. There are Trust meetings that you can attend. Remember that you are invited to these and do make time to go. Often it is where you hear about other career opportunities that you otherwise wouldn't do. 
I am in my first 5 years as a SAS doctor – What career options may I consider?

At this stage in your career, you are at a developmental stage where you have started to establish yourself in your role.

  1. You’ll need to prepare for revalidation, if this is new to you learn more here
  2. You may be thinking about becoming a consultant via the CESR, CEGPR route. This is a significant undertaking and the GMC has excellent guidance on the planning and process ahead.
  3.  If you decide that you want to work towards a specialist role then you’ll need a minimum of 12 years medical work, with at least six of these working as a specialty doctor.
  4. As you develop your clinical and non-clinical interests as a SAS doctor, you’ll have had an opportunity to meet regularly with your seniors to discuss your job plan, attended appraisal meetings and undertaken professional development reviews.
  5. Credentialing - The GMC are introducing a process to formally recognise a doctor’s expertise in a specific area of practice known as a GMC Credential. There are some branches of practice to have gone through this and if you are interested in learning more the link to the GMC’s
  6. If you are in your early years as a SAS clinician the Startwell and Staywell programme initiated by the Royal College of Psychiatrists has resources and information that is relevant for many specialities. Startwell and Staywell | Royal College of Psychiatrists (
CASE STUDY: Specialty Registrar Orthopaedics

Dr. Kshitij Srivastave started his career in India and became a consultant in 2015. From a career enhancement perspective Kshitij wanted to gain further sub-specialty experience in the UK and applied for the Master of Surgery (MCh). This  is an International Training Fellowship Scheme designed to offer an opportunity for international clinicians, who have already achieved higher postgraduate qualifications to come to the UK and study for the Master whilst working in a NHS Trust. After completing the programme and working as a Specialty Registrar in Bolton NHS Foundation Trust he applied for a post in Orthopaedics in London and successfully secured this position.

Benefits and Challenges 

From a career perspective, Kshitij highlighted areas to think about and consider. Think about the role you are in as often within your job plan the focus will be on service provision and as such you need to be flexible and responsive to the needs of the team and department. Kshitij is working towards his CESR and this takes time, not only to achieve the number of procedures needed but as a non-trainee you have to be very proactive to secure the clinical and non-clinical requirements.  

Cultivating my career as a SAS doctor

There are a number of extended roles that you can become involved in these are not exhaustive but could include; education, leadership, research, and service improvement

I am interested in...





General resources for SAS clinicians

Career Insights and labour market knowledge

Workforce report 2022 - GMC (

SAS doctors | Health Careers

Staff, associate specialist and specialty (SAS) doctors | RCP London

SAS_Report_Web.pdf (


Susie Edwards [NHSE London KSS Careers Consultant]