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SAS as viable careers

By Dr Helen Bonwick FRCP Associate specialist in palliative medicine at Marie Curie Hospice Liverpool and Liverpool Heart and Chest Hospital, and RCP SAS representative for Mersey region.

I was initially employed as a staff grade doctor in specialist palliative medicine working at Marie Curie Hospice in Liverpool in 1999. As a medical student, I wanted to work in palliative medicine, but it didn’t become a specialty until 1998. I had a circuitous route through medicine prior to that, and after I completed my medical rotation, I then worked in specialties that I thought would be helpful to my chosen career (haematology, oncology, psychiatry and medicine for the elderly).

Initially, my role was mainly service-related, and I was mentored by the two consultants in the hospice and encouraged to take more clinical responsibility, carrying out more education and clinically supervising trainees.

After my maternity leave in 2002, I was appointed to an associate specialist role, split between Marie Curie Hospice Liverpool and Liverpool Heart and Chest Hospital as the medical lead in the tertiary trust. I have been a responsible clinician in both clinical areas since then, working autonomously. Within the last year, I have taken on a further role in the tertiary trust as a medical examiner.

About 5 years into my associate specialist role, I became aware that although I was supported within my working environment, other SAS doctors in my region were not. I then began the process of trying to gain recognition for the invaluable clinical and non-clinical work that SAS doctors do within the NHS, and the palliative care specialty. In 2012, while I was making enquiries about how things could be improved, the Cheshire and Merseyside educational supervisors group agreed to take responsibility for the education and development of SAS doctors working in palliative medicine. As part of this process, an SAS development guide was initially written and has subsequently, with persistence, been adopted as good practice across the whole of the north-west region. It has now been endorsed by the Association of Palliative Medicine as the basis of development of SAS doctors across Great Britain.

I then decided to join the National Association of Palliative Medicine (APM) SAS Committee, so I could bring learning from across the country back to my region. I have since become co-chair of the committee and I am also a member of the APM Executive Board. My responsibility in these roles is to advocate on behalf of SAS doctors and ask difficult questions to other doctors. As part of trying to push the boundaries, I became an educational supervisor in 2014 and educationally supervise trainees from IMT to ST6.

I lead on all educational issues from undergraduate to postgraduate at the hospice. I also have an honorary contract with the University of Liverpool Medical School, where I deliver undergraduate and moderate master’s modules in palliative care. I deliver teaching locally, regionally and nationally to medical staff and allied health professionals, including non-medical prescribing courses, advance care planning and spiritual care courses I also facilitate advanced communication skills training regularly and I am part of the training team for the National Serious Illness Project.

Over the last 5 years I have also been an SAS tutor supporting palliative care doctors across the Cheshire and Merseyside region. Prior to this SAS doctors working in hospices were considered to be working outside the NHS and did not have tutor support.

Read more inspiring SAS doctor stories in the latest issue of Commentary, the membership magazine.