Oxford PGMDE
        The Department of Postgraduate Medical and Dental Education
          The Triangle, Roosevelt Drive, Headington, Oxford OX3 7XP

                   SAS DOCTORS AND DENTISTS


In 2008 the Department of Health (DH) made available to Deaneries resources to
support the further training and professional development of non-consultant career
grade doctors and dentists (mainly Staff Grades and Associate Specialists, generally
known as SAS Doctors and Dentists, or "SAS Grades" - SASGs). Doctors in this
group are those who “have completed the equivalent of at least four years of
postgraduate training and who are neither in a Deanery-approved training post nor
hold a consultant appointment”. New appointees to these grades are now known as
"Specialty Doctors".

The key recommendations of the guidance from NHS Employers are that:

      All specialty doctors should be employed in the spirit of the national contract.
      All specialty doctors should have appropriate clinical supervision.
      Specialty doctors should have access to a minimum of one programmed
       activity per week to support professional activity, for example, professional
       development, audit, teaching and research.
      Specialty doctors should have fair and reasonable access to study leave with
       appropriate funding according to the national contract.
      All employers should apply the minimum requirement of entry to the grade.
      Employers should use the professional development framework for specialty
      Employers should use the aid for employers when writing a person
       specification for a specialty doctor post.
      All specialty doctors should undergo an effective appraisal that:

          o   Ensures the specialty doctor is trained in being an appraisee
          o   Results in a personal development plan (PDP) with clear achievable
          o   Identifies the appropriate professional development and study leave to
              support the maintenance of and development of skills in a planned
              way, identified through the appraisal process
          o   Is supported by a portfolio of evidence.

      Experienced specialty doctors should be trained as appraisers.
      Employers should make time available in senior medical staff job plans
       (including senior specialty doctors) to ensure effective career discussions take
       place with specialty doctors.
      Employers should ensure specialty doctors are legitimate participants within
       their professional group within the employing organisation: supported in
       developing as managers, leaders, trainers and researchers.
      All specialty doctors should be seen as an integral part of the clinical team.
      All specialty doctors should be aware of support networks including the
       process for doctors who are underperforming.

In the pages which follow, where the term "SAS doctor" appears, it should be taken to
include both doctors and dentists, in the grades of Associate Specialists, Staff Grades,
and Specialty Doctors (under the new contract). In the Oxford Deanery, we have
elected to include those in the grades of Clinical Assistant and Hospital Practitioner,
and locums in SASG posts for a duration of over 3 months, among those eligible for
support. Trust Doctors, Clinical Fellows, and others in junior non-training posts are
not at this time included.

The NHS has not always recognised the need for ongoing education and training for
SAS doctors. It is important to recognise that an SAS doctor is often in the post
because their training is incomplete. Some SAS doctors aspire to further career
progression which will entail them gaining top-up training to an appropriate level.
Others wish to remain in the grade, but still require continuing professional
development and updating of their skills and knowledge base. This is especially
relevant with the imminent introduction of revalidation. Additionally, changes to
career pathways following the introduction of MMC are likely to result in greater
movement between training and SAS grades in the future.

SAS doctors are experienced and senior professionals in permanent posts working
within the NHS. They work across all specialties, both in clinical and non-clinical
areas. By tradition they have had a high level of service commitment, but training has
not usually been part of the SAS doctor's contract. All too often, continuing
professional development (CPD) and Continuing Medical Education (CME) for
SASGs has been ignored as well. The new and recurrent funding from the DH seeks
to redress this lack, and offer career and professional development support to this
important group who have been much neglected in the past.

This support might include arranging secondments to other units to learn new
techniques, advising on and supporting CME for SASGs, representing their views to
the Clinical Tutor/Director of Medical Education (DME) and other senior Trust
personnel, providing leadership and educational support relevant to their needs,
advising on further training, involvement in audit and research, and liaising with the
Royal Colleges. The funds can also be used to "top-up" the Trust study leave funding
to which all SAS doctors should be entitled (and which must be applied for and
utilised prior to any grant being made from the SAS Development Fund), to attend
courses and meetings.


In the Oxford Deanery, an Associate Postgraduate Dean, Mr. John Lourie
(john.lourie@oxforddeanery.nhs.uk, or his successor after 1st. March 2012), has
overall responsibility for the delivery of career and professional support for the nearly
500 SASGs working in the 11 Trusts within the Deanery. The actual provision of this
support, together with funding on a basis proportional to the number of SAS doctors
in each Trust, has been devolved to seven SAS Tutors, who work in the major Trusts
in the Deanery (see below).
Three of the Tutors are consultants and four are Associate Specialists, and all have
complete autonomy in delivering educational and professional support in whatever
way is locally considered most appropriate. Within each Trust, the Tutor has formed
a small sub-committee to assist with day-to-day decision-making, and dealing with
applications for funding from SAS doctors. For administrative purposes the smaller
Trusts in the Deanery (mainly PCTs) are amalgamated with the larger nearby Trusts,
who receive a proportional per capita increase in funding allocation (including a
nominal amount for administrative support).

A database of all SAS doctors in the Deanery is maintained and regularly updated by
the SAS Project Officer, Linda Day, who is based in Milton Keynes. The target grades
included in the listing of "SAS doctors" are Associate Specialists, Staff Grades,
Clinical Assistants, Hospital Practitioners and Specialty Doctors (under the new


John Lourie, Associate Postgraduate Dean for SAS Doctors (who is also responsible
for International Medical Graduates) can be contacted at
john.lourie@oxforddeanery.nhs.uk (or his successor after 1st. March 2012)

Linda Day, Project Officer, can be contacted on sas.doctors@hotmail.co.uk

The Trust SAS Tutors are:

Berkshire Healthcare NHS Trust (East and West):- Dr. Alison Stewart

Buckinghamshire Healthcare NHS Trust (including Stoke Mandeville and Wycombe
General Hospitals):- Mr. Govindan Thirumamanivannan

Heatherwood and Wexham Park Hospitals NHS Trust (including Berkshire
Healthcare NHS Trust (East)):- Miss Pampa Sarkar (pampa.sarkar@hwph-tr.nhs.uk)

Milton Keynes General Hospital NHS Trust (including Milton Keynes PCT):- Mr.
Shafiul Chowdhury (shafiul.chowdhury@mkhospital.nhs.uk)

Oxford Health NHS Foundation (formerly Oxfordshire and Buckinghamshire Mental
Health) Trust (including Ridgeway Partnership and Oxfordshire PCT):- Dr. Hugh
Series (hugh.series@xfordhealth.nhs.uk)

Oxford University (formerly Radcliffe) Hospitals NHS Trust (including the John
Radcliffe Hospital, Horton Hospital (Banbury), Churchill Hospital, and the Nuffield
Orthopaedic Centre):- Dr. Denise Tritton (denise.tritton@ouh.nhs.uk)

Royal Berkshire Hospital NHS Trust, Reading (including Berkshire Healthcare NHS
Trust (West) and West Berkshire PCT):- Dr. Peter Tun

The goal of the Oxford Deanery SAS Doctors' Support Project is to facilitate the
continuing medical education and professional development of these doctors in the
ways most appropriate to their individual needs and aspirations. This will always
include support to ensure SAS doctors get regular annual appraisals, which to date is
by no means universal practice. Some senior SASGs will themselves develop the
skills to become appraisers (as a number already have) and so contribute significantly
to the educational process. We also wish to offer strong encouragement to SAS
doctors to become involved at an appropriate level with management issues, and to
gain the appropriate training and skills for this by attending courses, some of which
are offered within the Deanery.

SAS doctors should be encouraged to participate in decision-making processes in their
department, specialty group and employing organisation. They should look to
develop leadership and management skills to enable them to contribute in this way at
the most appropriate level.

All SAS doctors should develop a personal portfolio containing information on their
activity and experience. The preparation of a portfolio and its use at the appraisal will
help support the requirement of the Personal Development Plan for the next period, an
important outcome of the appraisal process. This will also form an essential
component of the revalidation process. Specific contents will differ with specialty.
Clinics attended, procedures completed (solo and working with a consultant), teaching
experience, study leave, courses and meetings attended, certificates and audits are
valuable information to keep. Most Colleges will have specialty specific logbooks that
could be used for part of this purpose.

We also wish to provide support to those doctors wishing to obtain the Certificate of
Equivalence of Specialist Registration (CESR) or Certificate of Equivalence of
General Practice Registration (CEGPR) via the Article 14 (8) or Article 11 routes

Of course, careers don't always proceed smoothly, or according to plan, and a wide
range of personal and professional factors can adversely affect anyone's progress.
These can include periods of mental or physical ill-health, workplace problems such
as bullying or intimidation, or simply uncertainty about career progression or choice
of specialty. In the Oxford Deanery we have a strong tradition of providing practical
pastoral care and support through a variety of mentoring schemes, as well as career
guidance and help for "doctors in difficulty" - of whatever nature. These can be
accessed by SAS doctors through the Career Development Unit
(CDU)(http://www.oxforddeanerycdu.org.uk), based at the Triangle, Roosevelt
Drive, Headington, Oxford, via email to cdu@oxforddeanery.nhs.uk. Further
information is also available from the Director of the CDU, Dr. John Derry


The British Medical Association (BMA) Staff and Associate Specialists Committee
can be contacted on info.sasc@bma.org.uk. They have produced a ‘Statement of
Principles and Priorities for the Allocation of the Additional Funding for the Training
and Professional Development of SAS Doctors’ (www.bma.org.uk) where further
information is available. The Association also undertook a survey of SAS doctors’
training and professional development needs in England through their Staff and
Associate Specialists Committee and a report was published in September 2008,
which identified the five “most wanted” training opportunities identified by SAS

1.   Top up training (for CESR/Article 14)
2.   Training secondments
3.   Management training
4.   Specialist clinic or theatre placements
5.   Postgraduate qualifications.

A questionnaire survey undertaken in the Oxford Deanery a few months after this
BMA survey produced broadly similar results.



We have 7 SAS Tutors in place, and your first contact if you are an SAS doctor
seeking professional or career support or advice should be with your SAS Tutor.
Quarterly meetings of the SAS Tutors and SAS Trust representatives are held in
Oxford, chaired by the Associate Dean, at which plans are discussed to utilise the
funding to help the professional development of SAS doctors and dentists in the

A significant number of SAS doctors around the Deanery receive funding every year
for various educational projects including courses and further training. Remember -
the funding is there - come and get it!

Courses and Meetings

Educational courses are regularly organised by individual Trusts, and more are
planned, both at a Deanery level, and locally. In the latter case doctors from other
Trusts will usually be very welcome to attend where space is available.

The first Oxford Deanery SAS Doctors' Development Day was held in September
2009 at Milton Hill Conference Centre, near Abingdon. The themes of the meeting
were Appraisals, Portfolios and Revalidation. The meeting was very well attended
and attracted many positive comments. Since then, equally successful Development
Days have been held in February and October 2010, and May and October 2011. The
themes covered have included: gaining the CESR via Article 14, and credentialing for
SAS doctors, Leadership, Management and Team-working for SAS Doctors,
Mentoring and Pastoral Care, and Educational Supervision.

Some of the other courses already held or to be held shortly include:

        Mentoring Skills Workshops at Wycombe General Hospital
        SAS Doctors Convention at Milton Keynes Hospital
       Career Progression Workshop at Wexham Park Hospital
       3-day Leadership Course in Milton Keynes
       Blended Learning Leadership Course at the John Radcliffe Hospital, Oxford
       Mentoring Course, John Radcliffe Hospital
       Educational Supervisors' Courses, and Team-Building Away-Days, at both
               Milton Keynes and Wycombe General Hospitals
       Effective Appraisal Workshop at Wycombe General Hospital
       Communication Workshop at Wycombe General Hospital
       Human Factors Awareness Training Courses in all Trusts
       Appraisal, Job Planning and Personal Development Plans at Milton Keynes
       Appraisal for Revalidation for SAS doctors at Royal Berkshire Hospital
       Doctors as Leaders; Organisational Leadership, and The Individual as Leader
               at Royal Berkshire Hospital
       and others………

A pilot Coaching Project for SAS Doctors is also in preparation and will run during
2012, in collaboration between the Oxford and Wessex Deaneries. For further details
please contact Dr. Suri Dhanoa (suir.dhanoa@virgin.net).

"What's On" and the OXSAS Newsletter

All the above meetings and courses are detailed in the "What's On" information sheet
which is sent out regularly to all SAS Doctors on the database. Our other means of
communication is the OXSAS Newsletter. Six issues of this newsletter have come
out so far; if you aren't receiving this, or "What's On", it means we haven't got a
functioning current email address for you, so please contact Linda Day
(sas.doctors@hotmail.co.uk) about this today, and tell your friends.

Other Courses and Meetings

The Oxford Deanery SAS Development Project has also contributed to several
national meetings, including three meetings of the National Association of Clinical
Tutors, the Inaugural Joint Royal Colleges SAS Conference, and meetings at the
London and Wessex Deaneries. The Associate Dean attends the meetings of
COPSAS, the grouping of Associate Deans and SAS Leads responsible for SAS
Doctors' CME/CPD support around the UK (see below).


In 2009 the Oxford Deanery initiated an electronic Directory of Providers of Courses
relevant to SAS doctors and dentists. This resource has now been taken on by the
BMA’s SAS Committee, and will be updated every three months. It can be accessed
by members via the BMA website. For more information, contact Naa Addo, the
BMA’s SAS Committee Executive Officer (NAddo@bma.org.uk).

Another recent resource provided by the BMA is the on-line SAS e-handbook
"Strength to Strength", which "showcases the support provided by the Association to
SAS members, offering advice on making the best of their contracts, and covering
areas ranging from job planning and leave arrangements to career development,
mentoring and appraisal." BMA members can access this via the BMA website.

A useful source of links to other courses, meetings, and various resources relevant to
the needs of SAS doctors can be accessed via Frontier, the London Deanery's SAS
doctors website: www.frontier.londondeanery.ac.uk.


Three national meetings have now been held of “COPSAS”, a group including
Associate Deans and SAS Educational Leads from around the country who have
responsibility for delivering the SAS doctors' professional career support funded by
the Department of Health. The group meets twice a year, and reports to COPMeD
(the Conference of Postgraduate Medical Deans). The Chair is Dr. Hilary Cooling,
Associate Specialist in Sexual and. Reproductive Health at the Bristol Sexual Health
Centre, in the Severn Deanery (hilary.cooling@southwest.nhs.uk).

BMA SAS Committee

The BMA has a committee specifically for SAS doctors, details of which can be
found on www.bma.org.uk. Additionally, the link contains relevant information and
links on employing and supporting Specialty Doctors.

BMA seminars for SAS grade doctors

The BMA Staff and Associate Specialists Committee has organised a series of
seminars designed to offer SAS doctors practical guidance when applying to join the
specialist register under Article 14. This access to the specialist register enables these
doctors to be considered for substantive consultant posts in the NHS.

CESR applications through Article 14/CEGPR applications through Article 11

Until 1 April 2010 applications for specialist or GP registration by those who have not
completed a specified training programme were dealt with by The Postgraduate
Medical Education and Training Board. This has now merged with the GMC, who
should be approached by those wishing to proceed down this route to specialist or GP


A number of Royal Colleges have their own SAS doctors committees, and some run
specific meetings and courses tailored to the needs of this group. You are advised to
consult your own College's website for further information.

Mr. John Lourie BM PhD FRCS
Associate Postgraduate Dean for IMGs and SAS Doctors
(updated January 2012)

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