Emergency Medicine in the UK -
Working as an SAS
OTHER
MEDICAL CAREERS IN EMERGENCY MEDICINE - THE
SAS DOCTORS
The Staff and Associate Specialist Doctors’ group represents
a considerable proportion of the senior doctors working in Emergency Medicine
in the UK. Exact figures are hard to collect, but in 2005 it was thought that there were
over 800 doctors in these posts.
In 2002, the BMA established SASC, the Staff and Associate Specialists Committee,
to represent the needs of this group of doctors.
The main members:
- The Staff Grade was introduced in 1988. At the time of its introduction,
the intention was that Staff Grades would be doctors who helped meet service
requirements whilst bridging the gap between Consultant level staff and
Junior Doctors in training. The posts were intended to provide a secure,
well-remunerated and well-supported option for those medical staff wishing,
for a variety of reasons to continue to work in hospitals whilst choosing
not to pursue completion of full higher specialist training.
- The Associate Specialist grade (initially entitled Medical Assistant grade)
was introduced in 1964 and re-named in 1981. These doctors are senior clinicians,
responsible to named consultants, although they frequently work at the
same level as their consultants, as do a number of Staff Grade doctors.
In
the 1990s, a national ceiling limiting the number of Staff Grade posts
was removed and there was a rapid increase in the number of Staff Grade
posts in many specialities, especially the acute specialities such as Emergency
Medicine.
Other
members of this group:
- Clinical
Assistants (part-time medical officers) are doctors working on a sessional
basis. National terms and conditions of service are not clearly defined
and it is recommended that such posts should be converted to Staff Grade
posts.
- Non-Standard
Grades:
In
recent years, many trusts have faced restrictions on the allowed
proportion of Staff and Associate Specialist doctors at the same time as
needing more medical staff. One way around this has been to introduce new
grades of doctor, e.g. a Trust Grade doctor. These positions have non-standard
terms and conditions of service and are looked on with disfavour by the
BMA
WHAT
ARE THESE JOBS LIKE?
This
is a very difficult question to answer. From some members of the group,
one hears stories of job satisfaction, whether working full or part-time,
being made to feel a valued member of the team, opportunities to pursue
special interests, a share of management responsibilities and adequate
educational opportunities. At the other end of the scale, there are stories
of lack of appreciation from senior colleagues, solely shop-floor working,
especially anti-social hours, and no educational or training opportunities.
Over
the years, other groups of colleagues have had new contracts and new pay
deals, while this group has not. This has led to situations where a senior
SAS doctor may be supervising a junior doctor who is earning more than
they are.
Negotiations
for a new contract have been going on for several years – at the time of
writing, in January 2008, this process is still going on and the proposed
new contract is about to be circulated to all SAS doctors who will
then have the opportunity to vote for or against it. Details of the new
contract, including step by step comparisons between it and the existing
contract, are available on the BMA website.
CAN
I MOVE ONWARDS AND UPWARDS FROM ONE OF THESE POSTS?
It
is possible to apply through PMETB to have one’s qualifications, training
and experience recognised so that one can apply for consultant posts. This
is a lengthy process, but several of our Associate Specialist doctors have
stayed the course and have now been appointed to consultant posts. For
those with less experience, who would like to move from a SAS post into
the new speciality training system, it is too early to say exactly what
degree of difficulty would be encountered.
SHOULD
YOU CONSIDER ONE OF THESE JOBS?
It
is not all doom and gloom. Some of us are very happy with our jobs (although,
like anybody else, we wouldn’t say ‘No’ if someone offered us a pay rise)
or feel that we are able to negotiate changes and improvements for ourselves.
The new contract certainly offers some improvements, but not all the improvements
many had hoped for, and requires careful study.
Perhaps
the best advice one can offer to someone considering a career as a SAS
doctor is to make sure they find out as much as they can about the department
they would be working in, ideally from someone already in the job. One
also needs to remember that to a certain extent, a job is what you make
of it.
FASSGEM
- About FASSGEM
Acknowledgements:
Information
obtained from BMA website documents about SAS doctors, plus articles by
Dr Andrew Newton, first chairman of FASSGEM
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