SAS: an alternate career pathway

Katie Shellis, SAS doctor and SAS advocate, Shrewsbury and Telford Hospital NHS Trust (SaTH)

As a medical student, when asked what specialty I wanted to do, my answer would always be deliberately vague. I never really found my groove. I liked all the specialties I rotated through, but, loved none. After graduating in 2009, I spent my first years as a foundation trainee in Mid Staffordshire, desperately trying to find my place.

I decided to apply to general practice (GP), it seemed a logical choice for someone who liked a bit of everything. My first two GP placements were both within hospital specialties, and I had my first child when I was at the end of ST1.

I quickly found out that having a baby and being a working parent is incredibly tough. My partner worked away a lot and I struggled to find childcare that could support the hours that we needed. I sought support from the deanery, which was very helpful, as was my educational supervisor. I just could not see a way to make it work, I was an exhausted first-time mum. I remember telling a senior colleague of my plan to resign from training and being informed that a move like that could end my career.

I brushed myself off and set about looking for my next role, I did contemplate leaving medicine altogether. However, a local job in a hospice presented itself, the hours worked perfectly for us as a family.

I loved palliative medicine, finally I had found my place! I spent many hours contemplating my next move, but I decided at this point in our lives, formal training was not for me.

I was so happy with the introduction of the specialist role, finally I had somewhere to progress to that would enable me to work as an autonomous practitioner.

After four years (and with two children under the age of three) it was time to move. This was a difficult choice but with thoughts of progression and possibly applying for a Certificate of Eligibility for Specialist Registration (CESR) in the future, it felt like the right thing to do. I had gained a couple of post graduate courses and qualifications by this stage.

I spent time in various SAS roles from 2017 and moved to the new specialty doctor contract in 2021. I was so happy with the introduction of the specialist role, finally I had somewhere to progress to that would enable me to work as an autonomous practitioner. This became my goal. I set about organising my portfolio and pursued roles, that previously I would not have been confident to go for.

I strive to break down some of the barriers we face and to challenge the culture.

Life as a SAS doctor has not always been easy. The downsides are often that you must direct your own learning and development. Another problem which is not often talked about is ‘grade-ism’ we really do need to challenge this narrative. The derogatory ’middle- grade and non-consultant grade’ should be terms of the past, they only serve to limit those that may otherwise fly.

There is a need for a culture change and the grade absolutely needs parity of esteem. We are absolutely the backbone of the NHS.

For me, the positives by far outweigh the negatives. I thrive on stability, both geographically and within my team. I like being closer to home and knowing that I can plan my life outside of work. It has worked well for my family, ultimately, you have to do what works for you and yours.

In terms of development, I am now employed as the SAS advocate at the Shrewsbury and Telford Hospital NHS Trust. I strive to break down some of the barriers we face and to challenge the culture. I am co-chair of the national SAS advocate group where we work collaboratively to really try and represent and advocate for SAS doctors. I love working with this group of like-minded individuals who are all so passionate about improving things for SAS doctors and dentists.

I am delighted to have been appointed as a specialist doctor in palliative medicine, this needs to become the norm for more specialty doctors. We need to recognise seniority where it exists and value these SAS doctors who meet the criteria.

Nobody told me as trainee that there was a route outside of formal training, had I have known sooner, I may have saved myself a lot of anguish. It has not always been an easy road to walk but the destination is perfect for me. I would strongly encourage anyone to consider the ‘alternative pathway’.