It was at the Peninsula Medical School (University of Plymouth) that Dr Jamie Read’s journey into medical education first began. “I was only the fourth cohort [of medical students] to go through the school. Things were developing very rapidly and the school was really good at involving students in designing and updating the curriculum.” In his final year, Jamie applied for an academic foundation programme in medical education, which led to a year in Plymouth and another in South Devon. This offered some protected time to engage in education research and teaching; it also provided a taster for a potential career in education.
Following a few years in core training as a physician, Jamie applied for an NIHR Academic Clinical Fellowship – a clinical specialty training post in medicine that incorporates academic training. During the three-year fellowship, he completed a Masters in Medical Education and put together a proposal for a PhD. This was a key transition point, as Jamie stepped out of training for three years to focus on his PhD. He says: “It was a really amazing time, not just because of the PhD, but actually being off the medical rota and realising what it was like not to have to work nights; the fact that I had my weekends back was really rather pleasant. Also, I had protected space to think.”
Six months before he was due to resume training, Jamie questioned whether this was what he really wanted. He spoke to his training programme director about relinquishing his training number and explored what kind of role there might be for him at the hospital. He also weighed up his options with consultant colleagues as, up until that point, his identity was couched in terms of training tobecome a consultant. Jamie described these conversations as “very helpful in terms of recognising the additional flexibility [becoming an SAS] would provide, but also realistic in terms of acknowledging that we have some way to go in terms of parity of esteem.”
In 2018, Jamie became an SAS doctor as a Trust Associate Specialist. He says: “I suppose I was in the right place at the right time, as there was a role at the university for a lead for clinical skills, looking at curriculum and assessment development. There was also the opportunity to step into an associate specialist role at Derriford Hospital (Plymouth’s large teaching hospital).”
“I’ve never looked back really because for the last five years I have been very much involved in both providing senior medical cover as an associate specialist but also increasing my experience in medical education”. Jamie became the deputy head of school in Plymouth, before becoming dean of Medical Education at Cardiff medical school in September 2022. “For me, the associate specialist route provided the flexibility and ability to keep my education work going that I think would have been much more difficult, if not impossible, through a training post.”
Jamie is mindful that he has had opportunities that might not be as accessible to other SAS doctors. “We know that international medical graduates and colleagues from overseas are a very significant part of the SAS workforce and clearly hugely valued colleagues. But so much of working within the NHS is understanding the system…understanding how elements like primary and secondary care interact and links with social care. Having trained in that system and knowing how it works is a huge benefit and particularly around some of the medico-legal aspects.”
“I’m delighted to be where I am. Would an international medical graduate or someone from an ethnic minority who had the same skills have been able to get the same position as an associate specialist? I don’t know, but it’s the kind of question that keeps me up at night. It’s also why I’m so keen to work with the royal colleges to try and make sure that it would be exactly the same.”
Jamie’s career journey
Advice for SAS doctors on pursuing leadership roles
Don’t put limits on yourself – “I think it’s about demonstrating what you can do, rather than worrying about what you can’t,” says Jamie.
Champion diversity of experience – whether your experience comes from training internationally, through protected characteristics or because you went to a different school. Jamie says, “When you look at SAS doctors, in general we are much more representative of the wider medical workforce and, indeed, representative of the patients that we serve. Championing that can be a really good way of getting into leadership roles.”
Support each other to grab opportunities – people interested in leadership roles need to be given leadership opportunities. Jamie says, “We know that SAS doctors are still underrepresented at senior leadership roles, but those who get there have a real responsibility to make sure they are putting the ladder down behind them to bring people up… For example, it’s making sure that job descriptions include SAS doctors and that we actively seek out colleagues who are interested from an SAS background.”
Leverage the size of the SAS workforce – the GMC’s workforce report 2022 shows that if trends continue, by 2030, SAS and locally employed doctors in secondary care will form the largest group in the medical workforce. Offering SAS doctors leadership roles will have to become part of listening to and engaging with this workforce.
Increasing awareness of SAS roles amongst medical students
‘I think we, as colleges, as doctors, as groups, have not been particularly good at explaining what SAS roles are to our medical colleagues, and we’ve been particularly poor at explaining them to patients’
SAS doctors are still often described in terms of what they are not (e.g. ‘non-training grades’), which, says Jamie, can lead to a lack of opportunity. He also considers the SAS label to be problematic: “If we focus on this very heterogeneous group and deliver the same thing for everyone, we might not deliver the right thing for anyone”.
As dean of medical education at Cardiff University School of Medicine, Jamie is mindful that undergraduate medical education tends to focus on the expectation that doctors will train to become GPs or consultants. As SAS lead for the Royal College of Physicians, he is also keen to raise the profile of SAS roles. “I feel very conscious that what I don’t want to do is put people off becoming GPs and consultants because they are brilliant jobs, and the health service is under so much pressure that we need consultants and GPs more than we’ve ever done before.” However, he wants to present medical students with all the options. “It’s about retaining workforce and it’s about encouraging those who might otherwise have experienced burnout, to pursue really interesting careers in medicine.”
SAS careers may offer an option for doctors who are unhappy or dissatisfied with specialty training, particularly where the doctor wants more flexibility, for example, to pursue another interest, due to commitments as a carer or simply wants more of a work-life balance.
For anyone considering a career as an SAS doctor, Jamie advises: “Ask yourself the question, what is it that I want to change? What is it about an SAS role that attracts me and do the two things actually marry up? I would certainly not jump into it. I think take wise counsel, and particularly if you’re in training, sometimes just having a bit of a break can be the most useful thing to help you make up your mind.”
