The medical field prides itself on equality and meritocracy, yet gradism persists – especially for SAS (specialist, associate specialist, and specialty) doctors.
To address this, several steps can be taken to improve the situation for SAS doctors and ensure they receive the respect and recognition they deserve.
1. Cultural change: There needs to be a cultural shift within the medical profession to recognise that professional titles do not necessarily determine the value a doctor brings to the table. Both consultants and SAS doctors have critical roles to play, and a more inclusive, team-based approach should be encouraged. Consultants should actively involve SAS doctors in decision-making processes, ensuring their voices are heard.
2. Career development opportunities: Healthcare organisations should provide equal opportunities for career progression to SAS doctors. This includes offering pathways to higher qualifications or consultant roles, as well as ensuring they have access to mentorship and leadership programmes. This would not only benefit SAS doctors but also the NHS by harnessing the full potential of its workforce.
3. Improving pay parity: SAS doctors often do the same job as consultants but with lower pay. Addressing pay disparities by ensuring SAS doctors are fairly compensated would be a critical step in improving their morale and sense of professional worth.
4. Policy changes: The BMA and other medical bodies should continue to push for policies that protect SAS doctors from gradism and offer them better support in terms of professional development, recognition, and mental health resources. NHS trusts should be encouraged to have clear anti-gradism policies and provide training to all staff to reduce unconscious bias against SAS doctors. Bullying and harassment should be addressed at a national level with protection for victims and those reporting it.
5. Empowerment through representation: Medical committees in colleges should have advisory groups where the SAS voice is heard, and have places reserved for SAS doctors on college councils. Local medical staff committees and negotiating committees must have SAS representation.
Valuing every doctor
Gradism is an insidious form of discrimination that undermines the contributions of SAS doctors. This bias not only affects their professional development and mental wellbeing but also the overall functioning of healthcare teams. Recognising the critical role SAS doctors play, providing them with the respect and opportunities they deserve, and ensuring they are treated equitably is not just a matter of fairness – it’s essential for the sustainability of the healthcare system.
It’s time for the medical community to confront gradism and work towards a more inclusive and equitable environment where every doctor, regardless of title, is valued for their expertise.
Amit Kochhar is a member of the BMA SAS doctors committee and an associate specialist in ENT