The SAS Doctor: Past, Present and Future

1. The SAS Doctor: Past, Present and Future Dr Chris Clark SAS Education Lead ELHT

2. East Lancashire Hospitals Trust

3. Medicine

4. We were watching

5. News

6. Music

7. 1993

8. History 1981 • Title of associate specialist introduced • Originally personal appointments 1988 • Staff grade position introduced to meet service requirements • Commitments solely to service requirements 1991 • Associate specialist ceases to be a personal appointment

9. Non Consultant Career Grade

10. Rights vsResponsibilities

11. Access to • Training? • Teaching? • Career progression?

12. CESR • Certificate of eligibility for specialist registration • 2005 PMETB gained full statutory powers- article 14 • 2010 GMC-CESR

13. 2008- The New Contract • Specialty Doctor Grade introduced • Replaced Staff Grade, Hospital Practitioner, Senior Clinical Medical Officer and Clinical Assistant • These grades closed to new entrants • Associate Specialist Grade, eligible doctors given 1 year to apply to regrade

14. £12 million of recurrent funding made available by the DOH to support the development of SAS grade doctors and dentists in England

15. This is separate and in addition to any existing study leave funding and contract implementation funding

16. In the North West Deanery we have 1098 SAS doctors (We think)

17. In the last year the total allocation was £823K

18. How has this been used? • £650K allocated to trusts based on numbers of SAS doctors • Central initiatives • In 2011, 29 applications for deanery bursaries, 17 awarded

19. The SAS Trust Leads Network • First meeting 2008 • Currently 24 Trust Leads • Are involved in their own trusts’ allocation of the monies • Trust bursaries • Organise in house courses/initiatives • Act as a link • Support SAS within trust • Problems the same in every trust

20. Management

21. Leadership

22. Self Belief

23. Resilience

24. Deanery • CESR Champions • Workshops • Mentorship training • Medical ethics and law • Communication skills • And many more

25. How do others see us?

26. Survey of FY doctors • Grade FY1/FY2 • Have you heard the following terms? If yes please provide a brief description of what you understand by the terms. • SAS Doctor • Associate specialist • Specialty Doctor • Staff Grade Doctor • Have you ever considered any of the above grades as a valid career choice? Y/N • If no is there anything that might change your mind • If yes what has attracted you?

27. Responses • Total responses 23 • 8 FY1 • 15 FY2

28. Have you heard the terms;

29. SAS Doctor • Unsure • ? A&E – sounds like army doctor? On-call specialty doctor • No idea what it stands for • Technically a non-training post, however achievements can be transferred onto a training post • SAS??? • A non training post but the experience can be used when applying for a training post • You are in the SAS? (The one with the guns)

30. Associate Specialist • Consultant equivalent of the non training post route • A non training post consultant /SPR level • Similar level to consultant but didn’t want responsibility of consultant. Different training than UK • ?consultant level but no exams • Doctor trained in a speciality not trained in UK • Same as staff grade? • Unsure • Cannot progress to consultant level

31. Specialty Doctor • Doctor registered to a particular specialty (as viewable on GMC website) • Similar to associate specialist and staff grade • Can be SHO or SpR level, works in one specialty • ? Registrar • Dr with specialty training but not in training post • Unsure • A doctor trained in a certain field • On training curriculum , registrar following which can progress to consultant

32. Staff Grade Doctor • Middle grade doctor not in a training post • Senior doctor having completed specialty training but not in permanent consultant position • A non training post, generally SpR level • Didn’t want responsibility of cons. Paid less therefore. Stepped out of training program • Senior doctor, above registrar; without the tension/responsibility of consultant grade, flexible working hours

33. Doctor w/o CCT • Someone who is highly qualified but not going for a consultant post • A doctor trained overseas and did not participate in the foundation/ official program • Doctor just below consultant level but above registrar • Unsure • Out of training • Senior doctor in particular specialty but not in training- no progression in career

34. Valid career option

35. If no is there anything that might change your mind? • If unable to get training post • Nothing would attract me • Stable job in one location without the headache of running a service or having to sit continuous exams. More flexible job plan • A proper understanding of what they do • If I had a guaranteed job long term • Knowing something about them. Know they are above SHO and below consultant but that is about it • More information of their job description and how to apply

36. If yes what has attracted you? • Staff grade-senior, well trained w/o as much paperwork • Less pressure of responsibility • I haven’t looked at it in detail but I feel it would provide a better work life balance than a consultant job • Whilst I’m not sure completely what this means I understand that it can have less responsibility than a consultant • Can concentrate on patient care, less focus on other activities

37. In summary • “Staff grade” most understood • Confusion between the terms “specialty doctor” and “specialty registrar” • Lots of negative connotations • Use of outdated terminology e.g. SHO • Surprising (to me) number of FY’s interested in the grade (but note the confusion in terms )

38. Rights vsResponsibilities

39. Responsibilities • Raise our profile • Take advantage of what's on offer • Get involved on every level • Put ourselves “out there” • Use our new skills and get noticed as the valuable members of staff that we are • Remember no one is going to do it for you

40. The Future?

41. Who dares wins ANY QUESTIONS?