Most of us were told that moving from specialty doctor to specialist is about putting in the years, building a solid appraisal portfolio and waiting for someone to notice. But what if the work that proves you’re ready is already happening, and it’s invisible to your trust? What if the “business need” you’re asked to prove has existed for years, in the autonomous work you’re doing now? And what if a system that relies on that work without recognising it isn’t just slow, but exploitative?

Recorded during SAS Week, this conversation is with Dr Shashi Madhapura, SAS Development Programme lead and Associate Dean for SAS in the North West, and one of the country’s best-known advocates for SAS doctors. He goes further than the usual career-progression talk. Shashi moved to Manchester in 1998 with ten years of intensive care experience behind him. He quit a London post when he was refused even the chance to apply for regrading. He later helped 11 of Stockport’s 45 staff grade doctors become associate specialists in two years.

We cover:

• The hidden cost of autonomous practice. If a role needs no supervision, someone is saving money by not recognising it. Sashi and Simon name it plainly.
• Turning the business case around. Show trusts what you already deliver, the income it brings in and what it would cost to replace if you stopped.
• Why SAS doctors stay invisible. Anaesthetics regrades more readily than medicine, and the reason is visibility, not ability.
• True coding and scoping exercises. Could your GMC number show your activity on a national database? Getting coding fixed in Stockport took Sashi six and a half years.
• The job plan over the appraisal. Build a job plan around your trust’s and department’s objectives, keep a six-month activity diary, and walk into the meeting with a solution rather than a request.
• “Yad bhavam tad bhavati”: you become what you believe, and why Shashi says he’ll be an SAS doctor for life.

🎓 Want to put these strategies into practice? Book a workshop for yourself: https://doctorstraining.com/product-category/individual-booking/
🏥 Supporting SAS doctors in your organisation? Explore our workshops for teams: https://doctorstraining.com/our-workshops/
💡 More practical thinking for clinicians: https://doctorstraining.com/insights/insights/

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