When I arrived in the UK in 2014, I didn't have a detailed roadmap for my career. Like many doctors, I thought I knew what the route ahead would look like. Life, however, has a habit of presenting alternative paths, and I've learnt that some of the most rewarding opportunities come from being willing to adapt.
Medicine has always been part of my life. Both my parents are doctors and my grandfather was a medic, so I grew up seeing medicine not simply as a profession but as a commitment to serving others. What I never imagined was that my career would eventually bring me to Wales, into the SAS grade, and ultimately to a specialist post in frailty medicine.
One of my early placements was at the Royal Gwent Hospital. Although I worked in other parts of the UK afterwards, I found myself repeatedly drawn back to Wales. There was a sense of belonging here. The people were welcoming, the opportunities were plentiful, and I was fortunate to meet mentors who believed in me, supported my development and encouraged me to keep moving forward.
Looking back, I realise how much of my journey has been shaped not by having a perfect plan, but by being willing to embrace opportunities as they arose.
Finding the right path
Like many trainees, I initially thought I would pursue cardiology. I enjoyed the subject and the science behind it, but over time I realised that what I valued most was not focusing on a single organ system. What interested me was understanding the whole patient, supporting them through complex challenges and following their journey over time.
That was what drew me towards geriatrics and frailty medicine.
I enjoy the variety, the complexity and the clinical detective work that comes with caring for older people living with frailty. No two patients are the same, and the specialty allows me to work across multiple disciplines while keeping the individual's goals and quality of life at the centre of every decision. As my mum likes to say, it's about being a ‘jack of all trades, and a master of one.’
The SAS route ultimately became the right fit for me. At a point where I could have viewed a change in direction as a setback, I chose to see it as an opportunity instead.
What attracted me to the SAS pathway was the ability to continue progressing while developing at my own pace. It gave me the flexibility to build clinical expertise, pursue educational interests, develop leadership skills and create a career that reflected my strengths. Six years after becoming a specialty doctor, I achieved a specialist post in January 2026.
For me, that progression is proof that a fulfilling and successful medical career does not have to follow a traditional training pathway.
Lessons I've learnt
One lesson stands out above all others: opportunities rarely arrive when everything feels comfortable.
Throughout my career, I have been offered roles and responsibilities that initially felt slightly beyond my comfort zone. Whether it was taking on educational responsibilities, presenting at national and international conferences, speaking at medical grand rounds, or exploring new leadership opportunities, there was always a moment of hesitation. But I've learnt that growth often sits on the other side of that discomfort.
My instinct has generally been simple: if an opportunity presents itself, take it with both hands.
The second lesson is that careers are rarely linear.
Medicine often creates the impression that there is one ideal route and one correct timeline. In reality, everyone's journey is different. The SAS pathway demonstrates that progression is not defined by following a prescribed sequence of steps. It is defined by continuous development, building experience, demonstrating capability and creating opportunities for yourself and others.
Some of the most satisfied and accomplished clinicians I know have taken routes that look very different from what they originally planned.
What I'd like people to understand about SAS doctor
SAS doctors make an enormous contribution to the NHS, although that contribution is not always fully recognised.
Within my own health board, experienced SAS doctors provide continuity, stability and expertise across multiple services. They are often the clinicians who know how departments function, who support colleagues, who mentor resident doctors and who help maintain high-quality patient care every day.
If SAS doctors disappeared tomorrow, services would quickly realise how much they contribute.
One of the great strengths of the SAS grade is its flexibility. It allows doctors to shape careers around their interests while continuing to provide high-quality clinical care. Many SAS doctors are involved in leadership, education, quality improvement, research and service development alongside their clinical roles.
My own experience reflects this. Alongside clinical practice, I completed postgraduate diplomas in medical education, care of the elderly and preventative cardiovascular medicine, presented my work at national and international conferences, delivered teaching and developed interests that have broadened my professional life beyond direct patient care.
One area I've found particularly rewarding has been my involvement with the BMA and local negotiating committees. It has allowed me to contribute beyond my clinical role, working to improve opportunities, representation and recognition for SAS doctors locally. Supporting colleagues and helping shape positive change for the SAS workforce has been one of the most meaningful parts of my professional development.
The SAS pathway gave me the space and freedom to do those things.
Advice to other SAS doctors
If you're wondering whether you're ready for the next step, my advice is simple: find a mentor.
Speak to someone who has already travelled the path you're aiming for. Whether that is a SAS tutor, SAS advocate, specialist colleague or someone within your own department, having access to guidance and honest advice can make a huge difference.
I would also encourage people not to be afraid of careers that evolve differently from what they originally imagined.
Sometimes a door closes. Sometimes things don't work out exactly as planned. That doesn't mean the journey has failed. Often it simply means another opportunity is waiting.
Many of the most rewarding experiences in my career have come from opportunities I wasn't originally looking for.
Looking ahead
Achieving a specialist post has been a significant milestone, but I don't see it as the destination.
What continues to motivate me is the opportunity to keep learning, keep developing and keep contributing. Medicine is constantly evolving, and there are always new ways to improve patient care, support colleagues and develop services.
The SAS pathway has taught me that career satisfaction is not about following a predetermined route. It comes from finding work that is meaningful, continuing to grow professionally and having the confidence to take opportunities when they arise.
I certainly didn't end up exactly where I expected when I arrived in the UK in 2014. Looking back, I'm very glad that I kept an open mind.
Because sometimes the route you never planned turns out to be exactly the one you were meant to take.
Bio: Kavan Arora is a specialist doctor in the Gwent Frailty Unit, Newport Intermediate Care Service.