Specialist, associate specialist and specialty (SAS) doctors from across the UK came together last week to discuss career development, leadership, autonomy and progression at an RCP SAS forum, held as part of SAS Week 2026.
Chaired by Dr Sumanta Kumar Saha, SAS representative for the Wessex region, the virtual event brought together SAS doctors and senior leaders to explore the many different routes through a SAS career and challenge perceptions about what career progression can look like.
Opening the event, Sumanta highlighted the importance of creating spaces where SAS doctors can learn from one another, share experiences and support career development.
Celebrating diverse and successful SAS careers
The first talk was delivered by Professor Jamie Read, dean of Lincoln Medical School and a specialist in geriatric medicine, who reflected on his own career journey and the changing position of SAS doctors across the NHS.
Jamie spoke about the importance of challenging outdated assumptions about SAS careers and argued that SAS doctors should be recognised as senior clinicians whose contributions extend far beyond direct patient care. ‘There are almost no roles that a consultant can do that a SAS doctor can't do,’ he said. ‘We're talking about a group of highly experienced clinicians who have chosen a different career pathway. Difference should be celebrated.’
Drawing on his own experience of leaving a traditional training pathway to pursue a career that combined clinical practice, education and leadership, Jamie described becoming a SAS doctor as ‘the destination, not a stepping stone’. He acknowledged that misconceptions and structural barriers remain, including assumptions that SAS roles represent a second-choice career path, but said progress was being made.
‘The glass ceiling is cracking,’ he said. ‘It isn't completely broken yet, but things are changing.’
Jamie also highlighted the importance of role models, professional identity and representation in leadership positions, arguing that medical schools and NHS organisations have an important role in helping future doctors understand the breadth of career options available.
Practical guidance on the portfolio pathway
The forum then turned to one of the most frequently discussed areas of career progression for SAS doctors: the portfolio pathway. Dr Liz Estabrook, clinical lead and training programme director for general internal medicine, shared her experience of obtaining specialist registration through the portfolio pathway after returning to the UK following a decade of clinical practice in the United States.
She outlined the process of demonstrating equivalence to UK training programmes through a detailed evidence portfolio and encouraged colleagues considering the route to engage early with specialty-specific guidance, seek advice from others who have completed the process and organise evidence systematically.
‘The evidence requirement is rigorous, but it is manageable if approached methodically,’ she said. ‘The key is understanding what the curriculum requires and mapping your experience against it.’
Dr Ben Chadwick, RCP deputy registrar and an experienced portfolio pathway assessor, followed with practical advice from the assessor's perspective. He encouraged aspiring applicants to start collecting evidence early, make use of electronic portfolios where possible and ensure evidence is clearly mapped against curriculum capabilities.
‘Think about what evidence you need, identify gaps and fill those gaps over time,’ he said. ‘The clearer you make the evidence, the easier it is for assessors to understand the case you're presenting.’
The discussion included questions from attendees about evidence requirements, structured judgement reports, specialty-specific experience and practical approaches to preparing an application.
Exploring autonomy and self-advocacy
Following a comfort break, delegates took part in an interactive session led by Graham Stow, senior educationalist at the RCP. The session explored professional autonomy, self-advocacy and the factors that help SAS doctors develop confidence, influence and recognition in the workplace.
Using live polling and discussion, participants reflected on how autonomy is experienced across different aspects of their work, including clinical practice, teaching, leadership, quality improvement and supervision. Graham argued that autonomy is not simply about working independently but about having the confidence, support and organisational trust needed to use professional expertise effectively. Participants discussed barriers that can limit opportunities, including lack of recognition, assumptions about SAS roles and limited access to leadership opportunities.
The session encouraged attendees to think about practical steps they could take to increase their influence and visibility, such as building evidence of leadership activity, seeking formal recognition for roles already being undertaken and raising career ambitions through job planning and appraisal discussions.
Peer discussion highlights continuing challenges
The final discussion session focused on what autonomy and recognition mean in practice for SAS doctors. Attendees shared experiences of leading multidisciplinary teams, contributing to education and quality improvement activities, and navigating career progression pathways that can differ significantly between organisations.
Several delegates reflected on the need for greater awareness of SAS careers among medical students, resident doctors and senior NHS leaders, while others highlighted the importance of ensuring SAS doctors can access the same opportunities for leadership, development and recognition as other senior clinicians. Questions also focused on pathways into specialist roles, job planning, organisational support and how doctors can demonstrate readiness to take on greater responsibility.
Jamie urged doctors to challenge barriers and hold employers to their commitments on inclusion and fairness. ‘If you're being asked to work at a level that you're not being recognised for, organisations need to live by the values they say they hold,’ he said.
Looking ahead
Closing the event, Sumanta encouraged delegates to identify one action they could take over the coming month, whether starting to collect evidence for a portfolio pathway application, pursuing a new development opportunity or having a conversation about job planning and career progression.
This online RCP forum on developing SAS careers was part of a wider programme of SAS Week activities designed to celebrate the contribution of SAS doctors and support their development across clinical practice, education, leadership and service improvement.
Reflecting on the day, Sumanta explained:
‘As our discussions demonstrate, there is no single SAS career pathway. Instead, career development can take many forms, shaped by individual interests, strengths and ambitions. The shared message from this RCP forum was that SAS doctors should be recognised not for what they are not, but for the expertise, leadership and value they already bring to patients, services and the wider NHS.’
