I was aware of staff, associate specialist and specialty doctor as a positive and viable career option from the start of my own career as I was lucky as a houseman to work with an inspirational SAS doctor.
After houseman year, I travelled to Australia and on returning did a number of standalone medical senior house officer jobs before finding myself at a crossroads where I needed to commit to a training post, but I was unsure if this was a path I wished to take.
I took up a locum maternity cover post in the ICU – where I still work – and realised I’d found my niche. I was fortunate to be offered a permanent staff grade post there.
I also did my membership exams at this time, but I did not want to leave my staff grade job as it allowed me to focus on the patient care aspects of my job.
I regraded to associate specialist in the window of opportunity with the 2008 SAS contract and – working with a fantastic team of consultants, nurses and allied health professionals – I have always felt supported to pursue my career on my own terms and at my own pace in this role.
I have been able to develop my own area of expertise within the ICU focusing on humanising ICU, long-stay patients, tracheostomies and complex ventilatory weans.
SAS on the frontline of COVID-19
We knew from reports from China and Italy that COVID-19 was going to have a major effect on the role of ICU. At that time it felt like we, along with the rest of secondary and primary care, were standing on the beach waiting on a tsunami wave to crash.
I was involved in the training efforts to upskill non-ICU staff in preparation for expanding ICU beds. Logistical issues around numbers of beds, number of available ventilators, amount of oxygen required and the staff needed to look after patients were immense, not to mention the infection control measures and PPE required to keep non-COVID and COVID patients apart.
During the first wave all the medical staff moved to a rota that was 12-hour shifts – three days on / three days off – to ensure an even spread of staff across the day and week. It was exhausting, especially as we were dealing with a novel virus, so we were constantly learning and adapting our treatments.
There was a huge concern among ICU staff at that time that we would end up nursing our colleagues and many doctors updated their wills. We also worried about keeping our own families safe, and again many of us developed decontamination routines before entering house or, in some cases, moving out of the family house to protect clinically vulnerable loved ones.
Those of us with school age children also had home schooling to deal with. But we got through it in no small part due to the camaraderie and teamwork, and with each surge we have learnt more about how to treat Covid, how to keep patients and staff safe while dealing with both COVID and non-COVID problems.
The longer the pandemic persists the more pressure the NHS is under as Covid has highlighted the underfunding and under-resourcing of staff and wards.
Staff morale is a huge worry currently as everyone is exhausted. Even during the quieter periods of COVID, ICU has maintained a high level of turnover as huge efforts went into getting as many urgent surgeries (cancer and otherwise) done.
A rewarding career
For me personally the most rewarding aspects of being a SAS doctor is the ability to concentrate on patient care, having a work life balance and having the freedom to develop personally and professionally at a pace that suits me.
SAS doctors were an integral part of the workforce during the covid response, whether that was on the front lines of emergency departments, respiratory, ICU or maintaining other services to free up their consultant and junior colleagues.
Similar to choosing a specialty, I would advise medical students and doctors in training to chat to SAS doctors about the positives and negatives of their chosen role. SAS offers a positive choice.
Leanne Davison is an associate specialist in critical care