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