Authors:

• Dr Thomas James, Specialist, Bradford Teaching Hospitals NHS Foundation Trust
• Dr Ashwini Keshkamat, RCoA SAS Member of Council, Dartford and Gravesham NHS Trust

SAS doctors play a pivotal role within the anaesthetic workforce, and their professional development must be nurtured. 

In this article, the authors share their experiences of becoming SAS doctors – both tell stories of patience and perseverance, which ultimately led them to professional fulfilment.

Becoming a specialist

Dr Thomas James, Specialist, Bradford Teaching Hospitals NHS Foundation Trust

While I obviously welcomed the opening of the new Specialist grade in 2021, I had my misgivings around what would happen to us existing specialty doctors (SDs), especially as the guidance at the time was suggesting that these had to be new posts, requiring SDs to either move trusts or potentially even resign to create a post.

At this stage I had only just moved to a new hospital, and another move wasn’t an option. Equally though, it was something I was very keen to work towards, and I felt that my job plan, and some of the additional roles I was performing were more in line with the new Specialist grade. I was working autonomously within my scope of practice and had additional roles such as being an appraiser, organising governance meetings, and involvement in teaching.

Fortunately for me, I had a supportive department who were keen to help, an engaged LNC and a medical director who was receptive to the idea and understood why it was so important to SAS doctors. At the same time, guidance from NHS Employers and the BMA was clarified, suggesting that while competitive appointment was essential, these posts could be open to internal applicants, and there were ways to appoint without increasing head-count of staff.

A local policy was developed, with the principle that departments should make the case for the need for a specialist and then identify if there were suitable internal candidates. At the same time, I spoke extensively to our clinical lead and director and our business manager about the role. Crucial to this were the BMA/NHS Employers’ documents highlighting differences between an SD, a specialist and a consultant, and the RCoA specifications. This enabled us to work together to justify creating a role. Following much work, a business case was approved, a job description drawn up, and a post advertised – which I was delighted to be appointed to.

So, what would be my tips to others hoping to get such a post? Firstly, read all the guidance around the grade and its role. Next, speak to all the stakeholders, clinical leads, business managers, and senior staff. Make it clearly understood what this role is, why it’s so important to SAS, and what it can offer to a department and hospital. And finally, make sure that your portfolio and practice demonstrate the qualities required by the grade,and evidence of independent working, additional roles, and leadership. A mentor or colleague who was been through this journey can be invaluable for help and support through the inevitable bumps. And be patient! There were many points where I felt downhearted that this would never happen, but we got there in the end.

Is it an uphill journey?

Dr Ashwini Keshkamat, RCoA SAS Member of Council, Dartford and Gravesham NHS Trust

SAS career journeys always remind me of the poem ‘The road not taken’ by Robert Frost. If I look back on my own career journey, it has had its own peaks and troughs but it was all worth it.

Being recognised and feeling valued at the workplace for the non-clinical roles is something that most SAS doctors have struggled through for decades, and some all through their careers. We know that there is a lot of untapped potential in this cohort of the workforce, and that they can be educators and leaders given the opportunity and time in their job plans, to do so.

The introduction of the Specialist contract in 2021 was a step to ensure career progression and recognise the skills and experience. As a specialty doctor with more than two decades of clinical experience, and having done a spectrum of roles in the non-clinical areas both locally and nationally as an RCoA Council member, it was the next obvious step forward in my career journey. It did take a while for all stakeholders to create this post but having a very supportive directorate and College tutor helped the process. The post was advertised nationally, and after a competitive interview process, I take pride in saying that I am now the first specialist in our directorate.

For those aspiring to be on this path, please read the recently published RCoA guidance Autonomy for SAS and guidance on progression. This was developed by the College’s SAS committee with support from the ETE board. The generic person specification for the specialist post has been updated, with the addition of the evidence column giving the specialty doctors some tools to demonstrate their progression towards becoming specialists.

I hope these tools will help, not only SAS colleagues but also clinical leaders and stakeholders, to build more awareness when lobbying for, or creating the specialist posts.

As with any pathway, there are hurdles, but, in Swami Vivekananda’s words, ‘with patience and perseverance, success is bound to come’. I believe it’s important for all my SAS colleagues to tap into all the resources from the College to help build and transform their journey into fulfilling careers.