Working in NHS Fife, I’ve had the pleasure of collaborating with many SAS doctors across various departments. While there are currently no SAS colleagues within radiology in our trust, I regularly work alongside SAS doctors in other specialties. They are among the most valued and skilled members of our clinical teams.
SAS doctors are often the unsung backbone of the NHS. Many have extensive experience, postgraduate qualifications, and a deep commitment to patient care. They provide continuity, stability, and clinical excellence in a system that increasingly relies on their expertise. Their roles span acute care, outpatient services, teaching, and leadership – yet their contributions are frequently overlooked in discussions about workforce planning and career development.
During my time working in general medicine, I seriously considered the SAS pathway. It offered things that traditional training routes often lack: autonomy, flexibility, and a sense of control over one’s professional life.
For many resident doctors, training can feel like a relentless cycle of service provision, with learning squeezed into personal time. The SAS route, by contrast, allows clinicians to focus on their strengths, develop their careers on their own terms, and maintain a healthier work-life balance.
This pathway is also a vital entry point for international medical graduates. It enables highly qualified doctors from around the world to contribute meaningfully to the NHS, often bringing unique perspectives and skills that enhance patient care. These colleagues are not ‘junior’ in any sense – they are senior clinicians who often take on roles in governance, education, and service development.
The recent introduction of the specialist grade is a welcome evolution. It provides a clearer structure for career progression and formal recognition of the expertise SAS doctors bring to the NHS. This change is long overdue and reflects a growing understanding of the importance of retaining and supporting experienced clinicians outside of traditional training pathways.
In my experience, SAS doctors are often the glue that holds services together. Their presence brings consistency to teams facing high turnover or staffing pressures. They are trusted, respected, and relied upon – not just for their clinical acumen, but for their mentorship, leadership, and dedication to patient-centred care.
As we look to the future of the NHS, it’s essential that we continue to support and celebrate the SAS workforce. Their value is not in filling gaps, but in shaping the very fabric of our healthcare system. They deserve recognition, investment, and a voice in shaping the services they help sustain.
Kate Thomas is a consultant radiologist working in Fife