SAS doctors: how to get your autonomous work recognised If you are already working at a senior level, the next step is making sure your trust can see it, and value it. In the most recent podcast episode of Why Medics Matter, I talk to Dr Shashi Madhapura, Associate Dean for SAS doctors and SAS Development Programme Lead in the North West. Shashi shares practical steps to make your work visible, build a business case for regrading, and find the people who will open doors for you. He speaks from experience. Shashi arrived in the UK with ten years of intensive care experience. As a staff grade, he was covering for consultants. When he asked for the chance to apply for an associate specialist post, he was turned down. He went on to help eleven staff grades in Stockport become associate specialists in two years. Three things you’ll learn in this episode: Make your work visible In large specialties, activity is often coded under a consultant, so your work may never show up in the data. Shashi’s test: if someone searched national records by your GMC number, could they find what you have done? Ask your department for “true coding” of SAS activity, and for a local scoping exercise of what SAS doctors actually deliver. Shashi persisted for six and a half years to get this done in Stockport. Build a business case, not just a request Years of service alone rarely persuade. Instead, keep a diary for six months. Record the work you do, the income it generates, and what would happen if you stopped. Talk to your business manager, or build a quality improvement project around a service development. Then go in with a solution: this is what I deliver, and this is what more I could do. As I said in our conversation, autonomous work that isn’t recognised would otherwise need supervision, and that is a hidden cost. Find the people who will give you a chance When his work wasn’t valued, Shashi made the difficult decision to move trusts. In Stockport, his mentor Dr Colin Watson told him: “I will give you a chance to apply. I will do everything I can do, but I can’t guarantee it will happen.” That opportunity to progress changed his career. If you supervise SAS colleagues, you can be that person for someone else. There’s much more in our full conversation, including Shashi’s journey from a small town in Southern India to Manchester, and the Sanskrit phrase that has guided his career: “you become what you believe.” Whether you are an SAS doctor, or you work alongside, supervise or manage SAS colleagues, I’d love you to listen. Watch on YouTube or listen on Spotify or Apple Podcasts (linked in the comments)

Ready to become a supervisor, but can’t get a place on the training you need towards sign-off? Local courses fill up fast. Dates clash with your rota. Waiting for the next session can stall your progress for months. Our Educational and Clinical Supervisors Core Programme workshop is now open for individual booking, so you can book directly without waiting for your trust to run a session. In one virtual day, an experienced supervisor and education leader will take you through what the AoME and GMC standards mean in practice. The day is built around real case studies, with practical strategies you can use straight away. You’ll leave able to: ✓ Understand your role and responsibilities under current standards ✓ Build inductions that give new doctors real clarity from day one ✓ Give constructive feedback and spot performance issues before they escalate ✓ Support trainees with concerns through a fair, documented action plan ✓ Write Portfolio, ARCP and workplace assessment reports with confidence For consultants, GPs, and SAS doctors. 96% of our delegates rate our workshops and facilitators as excellent or very good. 📅 Friday 13 November 2026, 9:20am to 3:30pm 💻 Virtual 💷 £275 The link to book is in the comments.

What a superb day in Oxford with SAS Leads and Advocates at the MedEd Leaders SAS Leads Annual Conference. My session was on building the business case. The idea at the centre of it was simple. Clinicians already use SBAR for every handover. We just need to use it on a post instead of a patient. In this version, each letter stands for something slightly different: S - Situation and Strategic Fit. What is happening now, and how does fixing it serve what the organisation has already said it cares about? B - Benefits and Risks. What improves, by how much and for whom? What is the risk of doing nothing? A - Ask and Alternatives. Make one clear ask, and show the alternatives you considered and why they don't work. The alternatives are what make an ask look reasoned rather than opportunistic. R - Resources and Route to Delivery. Who does it, how it is governed, and how you will know it worked. If a case fills all four boxes, it is hard to refuse without giving a reason. Two tests I'd add. If you can't say the ask in one or two sentences, you don't have a case yet. You have a feeling. And count how often the benefit lands on the doctor and how often it lands on the organisation. If it's all doctor, rewrite it. The tables then built real cases using SBAR and pitched them to a Dragons' Den panel in ninety seconds. You soon find out whether your case holds up. A good business case is not a request for money. It is an answer to somebody else's problem. Thank you to everyone who came ready to connect, challenge and collaborate.

Great piece from our own Dr Claire Ashley on why doctors are so good at giving self-care advice and so bad at taking it. We've all done it. Told a patient about sleep hygiene and stress management, then gone home after a twelve-hour shift, eaten whatever was quickest, scrolled until late, and done it all again the next day. Claire takes James Clear's Atomic Habits and applies it properly to medical life: 💡 Identity first: "I am someone who moves every day" beats "I want to exercise more". Willpower runs out fast on a busy rota, identity doesn't. 💡 Design your environment: a gym kit in the car or decent snacks on hand removes the need for willpower at the exact moment you have none left. 💡 Habit stacking: use the margins you already have. The commute, the coffee before a shift, the drive home. 💡 The two-minute rule: start embarrassingly small. Three slow breaths, not a twenty-minute meditation you'll keep postponing. None of this fixes a broken system. But it might help build a working life that's a bit more sustainable than the one you've got right now. Well worth a read, especially if you're brilliant at giving this advice to others and rubbish at taking it yourself. Read it here: doctorstraining.com/insights…

To all the doctors who wince at the word resilience: Burnout has very little to do with how resilient you are, and everything to do with how long you've been under pressure without the right support. In this episode of Why Medics Matter, Dr Simon Frazer sits down with Dr Claire Ashley, GP, Chief Growth Officer at Doctors Training and author of The Burnout Doctor, to unpick that assumption properly. Claire burned out as a newly qualified GP, despite ten years of training and a degree in neuroscience, had no education on what burnout actually was and no idea she was heading towards it, until the day she had her first ever panic attack. Burnout is the normal physiological endpoint of stress that hasn't been managed. A little stress sharpens performance, but sustained high cortisol and adrenaline change your brain and body in ways a weekend off can't fix. Burnout carries a genuine 1 to 3 year recovery period, an average of three and a half months off work sick, and measurable increases in heart attack risk, type 2 diabetes and all cause mortality under the age of 45. Understanding this took a huge weight of self-blame off Claire's shoulders, and it can do the same for you. Lack of insight is one of the clearest features of burnout. Claire and Simon walk through the five recognised stages, from honeymoon phase through to habitual burnout, and at every stage the person going through it struggles to see it in themselves. Claire describes ticking almost every box of full-blown burnout and still turning up to work, still believing she was coping. Colleagues and loved ones usually see it long before the person does. The reason this matters so much is that burnout is preventable if it's recognised early, in yourself or in someone you work alongside. Recognising your own early warning signs and building real support are things every doctor can learn, even if nobody ever taught you how. For Claire, the signs are disturbed sleep, nightmares and snapping at her family. What helps once you notice them: real boundaries around work spilling into personal time, protecting space for activities that get you into flow state, and a network of people who will listen without judgement and without it getting back to a manager. Claire also talks openly about her experience with Practitioner Health, the confidential service that gave her a GP and a therapist outside her own workplace, and the shame that nearly stopped her asking for help at all. Listen to this episode if you've ever wondered whether what you're feeling at work is "just stress," or perhaps if you manage a team and want to know what to actually look out for, Maybe you've been through burnout yourself and want to understand why. You'll come away with a clearer picture of your own early warning signs and where to go if you need support. Watch the full conversation on YouTube or listen on Spotify or Apple Podcasts. eu1.hubs.ly/H0x3spW0

When did you last walk out of a difficult conversation at work feeling like you actually got what you needed? For most doctors, the honest answer is rarely- or never. Not because the ask was unreasonable, but because nobody ever taught us how to make it land. Imagine being able to successfully influence at work, and walk away from difficult conversations feeling valued, heard and confident.  After listening to this podcast, you will have the tools to do exactly that. In this episode of Why Medics Matter, Dr Amie Burbridge and Dr Simon Frazer cut straight to the skill medicine forgot to teach us: how to negotiate, how to make your case land, and how to get what you need without burning the relationships that matter. Watch on YouTube eu1.hubs.ly/H0wLQb50  Listen on Spotify and iTunes

Nobody teaches doctors how to negotiate, and it shows. The job plan that never gets fixed. The rota request that keeps getting dismissed. The meeting where you knew what you needed but could not find the words to make it land. Now, imagine walking out of that conversation having got exactly what you needed, feeling valued, respected and genuinely heard.  We are trained to clinical excellence. We learn how to communicate with patients. But when it comes to negotiating a job plan, advocating for a change in the rota, or simply asking for what we need from a manager, most of us are left to figure it out alone. The result? Years of unrecognised effort. Burnout that builds quietly. Conversations we dread having and outcomes that leave us frustrated and undervalued. But- you can learn the skills to influence and negotiate successfully and with ease.  In the latest episode of Why Medics Matter, Dr Amie Burbridge and Dr Simon Frazer have an honest, practical conversation about the professional skill medicine forgot to teach us: influence and negotiation. Doctors who learn these skills walk away from difficult conversations having actually got what they needed, with relationships intact and their confidence growing. You can too.  Here are the three things that will change how you approach every difficult workplace conversation. 1. Move from positions to shared interests Stop thinking about what you want versus what they will allow. Ask instead what the service needs, and what everyone in the room needs to make that happen. Dr Simon shares the story of a colleague who reframed her entire job plan negotiation around service requirements rather than personal demands. She left with two new colleagues in her team and a workload that was finally sustainable. 2. Preparation changes everything How much preparation do you do before a negotiation compared to a job interview? Understanding the other person's interests, managing your emotional state, and choosing the right moment are not soft skills. They are what determine the outcome. Go in prepared and you will go in confident. 3. Protect the relationship Hard positional bargaining might feel like winning in the moment, but principled negotiation gets you better outcomes and keeps the relationships you depend on intact. You can be assertive, achieve what you need, and still be someone people want to work with. When you know how to negotiate well, you stop dreading those conversations and start owning them. You get what you need. You feel listened to, seen and valued.  This means that when the hardest parts of the job press in on you (as they always do) you carry yourself differently knowing that you can advocate for yourself successfully.  Watch the full episode on YouTube or listen on Spotify or iTunes. Search Why Medics Matter. eu1.hubs.ly/H0wLNL30