Specialty and associate specialist (SAS) doctors

SAS are a diverse group, they range from doctors having 4 years’ experience (trainee-like) to senior doctors practising independently (consultant-like). The SAS grade comprises specialist doctors, specialty doctors, associate specialists, staff grades, hospital practitioners, clinical assistants, senior clinical medical officers, clinical medical officers and long-term locally employed doctors.

All doctors appointed into new SAS posts are appointed as specialist doctors and specialty doctors. However, a number of doctors still remain on the terms and conditions for other grades that are now closed to new entrants.

• Specialty doctor (from 1 April 2008) – completed at least 4 years’ full-time postgraduate training (or its equivalent gained on a part-time or flexible basis) at least two of which will be in a specialty training programme in a relevant specialty, or as a fixed term specialty trainee in a relevant specialty, or equivalent experience and competencies.
• Specialist doctor (from 1 April 2021) – completed a minimum of 12 years’ medical work (either as a continuous period or in aggregate) since obtaining a primary medical qualification, of which a minimum of 6 years should have been in a relevant specialty, and meets the criteria set out in the generic capabilities framework for the specialist grade, which has been developed by AoMRC, BMA and NHS Employers.
• Associate specialist (closed in 2008) – completed a minimum of 10 years’ medical work since obtaining primary medical qualification, of which a minimum of 4 years should have been in a relevant specialty.

Recognition

The RCP recognises the vital role SAS doctors have in the delivery of NHS services. Our Safe medical staffing report states that Tier 3 clinicians have overall responsibility for the care of patients. They are currently consultants, or associate specialist or specialty doctors above threshold 2.

SAS and specialty doctor charter and SAS doctor development documents

We have worked alongside the Academy of Medical Royal Colleges – with NHS Health Education England, NHS Employers and the British Medical Association (BMA) – to produce:

• SAS and specialty doctor charter
• SAS development guide
• Maximising the Potential: essential measures to support SAS doctors.

The RCP has worked along with the other royal colleges and faculties at the AoMRC to support SAS doctors’ development and recognition. Read more about it.

Fellowship

SAS doctors can be fellows of the RCP. Fellowship of the Royal College of Physicians of London (FRCP) is an accolade held by some of the most exceptional and innovative physicians in the world. The criteria for fellowship is the same for all doctors irrespective of grade i.e. contribution to service, education, research.

Representation

The RCP has an SAS regional representative network which represents SAS doctors’ needs, views and interests to the RCP. The lead of the SAS regional representative network is also a member of the RCP Council, which develops policy in relation to professional and clinical matters.

The current RCP SAS lead is is Dr Jamie Read, who can be contacted at james.read@rcp.ac.uk.

Opportunities for SAS doctors at the RCP

• Acquire leadership skills: The RCP provides opportunities for SAS doctors to serve on committees and working parties. The RCP offers the MSc in Medical Leadership, a part-time programme delivered jointly along with Birkbeck, University of London.
• Develop educational roles: SAS doctors who are fellows and have the MRCP diploma can be examiners for the MRCP exam. The RCP promotes GMC guidance which states that recognised or approved trainers may be GPs, consultants or SAS doctors. SAS doctors who have experience of the physician associate (PA) role — a PA supervisor, significant involvement in a PA course, or significant ‘on the ground’ experience working with PAs can become an examiner for the national exam OSCE for Physician Associates. The RCP offers the MSc in Medical Education, a part-time programme delivered jointly along with University College London.

Support for SAS doctors at the RCP

• Prepare for revalidation: RCP SAS members receive access to the CPD diary, which allows for them to demonstrate supporting information necessary for revalidation. The RCP offers courses for SAS doctors on developing appraisal skills.
• Prepare for CESR: SAS doctors can use the ePortfolio developed by the JRCPTB to collect evidence of achieving competencies against the curricula. CESR applications are handled by the individual specialist advisory committees for each specialty under the auspices of the JRCPTB.
• SAS census: The RCP Medical Workforce Unit carries out surveys to understand the needs, views and experiences of SAS doctors. The survey results allow the RCP to influence the NHS bodies and the government so that SAS doctors receive the investment, support and recognition required for sustainability and to provide the best patient outcomes.
• Guidance for approving specialty doctor posts: The RCP recommends trusts appointing a specialty doctor obtain job description approval as a matter of good practice. The statements in RCP guidance for approving specialty doctor posts regarding secretarial/IT/office facilities, medical audit, CPD, revalidation and mentorship in specialty doctor posts are similar to the consultant post. The RCP advocates that specialty doctors employed above threshold 2 should have a minimum of two SPAs.