SAS – the alternative career pathway

Most trainees embarking on a training programme will progress through the “standard” training pathway; however others may opt to take up a SAS grade post, either in the short-term or as a long-term career option. This could be to support work-life balance; for caring or childcare commitments; to enable a portfolio type medical career or to combine with non-medical interests; or for health, exam or personal reasons.  

In considering a move away from the “standard” training pathway it is important to explore the many positive career options which are available, including LTFT working and SAS grades, and decide which is the right path for each person’s own needs and career goals - both in the short and long term.  

Some taking up a SAS post may have already completed several years of training and will use these skills in their new role; others may be less experienced and will continue to develop their skills while in post; other SAS may aim to pass exams or to gain further experience in a specialty before applying for a training number.  

To be eligible for a Specialty Doctor post, individuals require:  

• a minimum experience of 4 years’ full-time postgraduate training (or equivalent if working less than full time) of which at least 2 years have been in a Specialty Training programme or LAT post or equivalent, if from non-UK. 

The introduction of the Specialist grade provides potential opportunities for experienced Specialty Doctors and others to progress to a more senior SAS role in Scotland. Health Boards and departments may identify the need to establish a new Specialist post; these clinicians will work with a degree of autonomy providing expertise in their specific area of practice and competence. 

To be eligible for a Specialist post, individuals require:  

• a minimum of 10 years medical work since obtaining a primary medical qualification, of which a minimum of 6 years should have been in the relevant speciality in the Specialty doctor or closed SAS grades, or equivalent years’ experience in a relevant specialty from other medical grades including from overseas, and
• to meet the criteria in Generic capabilities framework. 

Taking up a SAS role can be a very positive career choice, offering a very rewarding and flexible career, developing specialist areas of interest, practicing autonomously, and taking on leadership, education, and other roles. SAS make a valuable contribution to the medical workforce in NHS Scotland; NES and the SAS Development Programme offer SAS grade doctors and dentists working in Scotland access to ongoing training opportunities and support. There is funding available from the SAS Development Programme which enables Specialty Doctors/ Specialist grades to develop skills and knowledge relevant to their clinical roles or to develop in extended roles such as in Medical Education. 

In Scotland, the SAS training needs survey 2021 indicated that around 12% of SAS are already on the Specialist register; a similar proportion indicated their intention to apply for Certificate of Eligibility for Specialist Registration (CESR). From 30 November 2023, the GMC is to be renaming the CESR pathway the “Portfolio pathway”. Guidance from the GMC is available on  Changes to how doctors demonstrate the standard required for specialist and GP registration – GMC (gmc-uk.org). SAS with clearly identified gaps in their portfolio of evidence may apply to the SAS Development Programme for funding to support top-up training towards specified gaps in their competencies.  

If you are considering entering the SAS grade, you may wish to speak to your clinical team to explore any potential local opportunities, as well as discussing with NES Careers team and your own health board’s local SAS Education Adviser, as listed at Specialty, Specialist and Associate Specialist Doctors and Dentists  

Dr. Lynne Meekison