Conversations with SAS doctors, employers, regulators, and medical leaders have led us to identify six key areas where the potential of SAS doctors is yet to be unlocked:
- Rewarding SAS careers can improve the quality of care
- The SAS workforce can improve access to patient care
- SAS doctors can support medical education and training
- SAS careers offer opportunities to retain doctors who might otherwise leave the profession
- SAS doctors can enrich medical leadership positions
- SAS doctors can enhance professional and workforce development
There is still some way to go in terms of providing SAS doctors with opportunities to develop their skills and experience outside of their clinical roles. The GMC has found that the majority of SAS and locally employed (LE) doctors were involved in additional activities outside service provision, particularly teaching, audit and clinical governance (GMC, 2020). However, involvement was low in some areas where SAS surgeons could make important contributions.
Resources
Academy of Medical Royal Colleges
Resources on independent practice, private practice, acting up and locum working:
BMA
SAS appraisal and revalidation
All licensed doctors must meet the GMC’s requirements for revalidation and should have annual appraisals to support this process. The SAS Charters for all four countries state that SAS doctors and their employers must engage in processes for appraisals, revalidation and continuing professional development (CPD). A GMC survey found that only 63% of SAS doctors reported having a named person to support them with revalidation and appraisal (GMC, 2020).
Professional development
All SAS doctors and most locally employed (LE) doctors reported, when surveyed by the GMC, that they participated in some form of CPD, mainly via internal and external training events (GMC, 2020). Almost half of LE doctors said they had a named person to support them with CPD, compared to just under a third of SAS doctors.
SAS surgeons are expected to build a portfolio of clinical work and professional development activities, such as:
- formal teaching
- clinical and educational supervision
- continuing professional development
- appraisal
- research
- audit
- management (e.g., local management groups within trusts and health boards)
- work with a professional body (such as a royal college or the British Medical Association)
Attending relevant courses will also benefit your portfolio; the RCS runs a variety of courses for all specialties.
You will have achieved a high level of expertise and specialist knowledge by the time you reach the top of the specialty doctor grade. What’s the difference between a specialty doctor and a specialist grade doctor? You will also have both the ability and opportunity to work independently as agreed with your employer. The College SAS forum has drafted guidance to support SAS surgeons in the job planning process.
Portfolio evidence
Your portfolio is an invaluable record of your clinical and professional experience, training, and achievements. It will be useful for appraisals, revalidation, and job applications and should include the following:
- Up-to-date CV
- Up-to-date job plan
- Appraisal records
- Logbook
- Annual ISCP summary
- Certificates from courses and meetings attended
- Audit and research activities
- Thank you letters and complaints

