Employing specialty doctors

Specialty doctor is the umbrella term for a non-consultant career-grade doctor. These doctors were previously known as staff grade doctors and the title was incorporated into the new specialty doctor grade in 2009. Specialty doctors are often grouped under the term SAS doctors, which refers to specialty doctors, associate specialists, staff grades and a number of other clinical career grades.

Specialty Doctors should have full registration with the General Medical Council. UK trained doctors should have completed at least four years’ full-time postgraduate training (or its equivalent gained on a part-time or flexible basis), at least two of which will be in a specialty training programme in a relevant specialty or as a fixed-term specialty trainee in a relevant specialty. Non-UK trained doctors should have equivalent experience and competencies.

Many specialty doctors already work as autonomous practitioners. There are a number of benefits to encouraging and enabling autonomous practice, where appropriate, and these include:

  •  recognition of the high level of clinical skills and professionalism 
  •  provision of personal and professional development opportunities 
  •  the opportunity to have greater medical engagement 
  •  support for the recruitment, retention and motivation of highly skilled clinicians
  •  improved governance and accountability.

Guidance is available to help clarify arrangements for employers. The guidance is also helpful for SAS doctors seeking to demonstrate an increasing ability to make decisions and carry responsibility without direct supervision, or those defending current working arrangements when an employer is seeking to make a unilateral change.


Employers should ensure all SAS doctors have an annual appraisal that is supported by a portfolio of evidence (patient and colleague feedback) and has clear achievable objectives and a personal development plan.


Employers should provide support and guidance for SAS doctors to work to their full potential and to develop. They must also support doctors to acquire a Certificate of Eligibility for Specialist Registration (CESR) should they wish to gain entry to the specialist register.

Revalidation, appraisal and job planning

SAS doctors should participate and engage with the revalidation, appraisal and job planning processes. Employers must provide time and support for these doctors, so they are prepared for revalidation, able to become appraisers and effectively map out their job plans.


Every SAS doctor should feel supported in their place of work. Effective support mechanisms are essential for SAS doctors. They often experience more bullying and harassment than other branches of practice and it is important that they are free to raise any concerns and challenge all inappropriate behaviour without fear of any consequences.

Involvement in management structures

SAS doctors who wish to be involved in the management of their directorate should be encouraged to do so. SAS doctors who meet the person specification requirements for management and education or academic positions within their hospitals should be considered eligible. SAS doctors must be invited to attend directorate meetings, so their voice is included in the operation of hospitals.

Guidance and resources on SAS contract 2021 (England)

The New Specialist grade