'I don't belong anywhere': Identity and professional development in SAS doctors

Area of Science:

• Medical Education
• Professional Development
• Sociology of Professions

Background:

• Specialist, Associate Specialist, and Specialty (SAS) doctors are a distinct professional group within healthcare.
• This group often experiences marginalization and faces barriers to desired professional development.
• Understanding their professional identity is crucial for addressing these challenges.

Purpose of the Study:

• To explore the influence of SAS doctors' professional identity on their professional development opportunities.
• To investigate how appraisal processes address or fail to address the development needs of SAS doctors.
• To provide a theoretically informed perspective on the lived experiences of SAS doctors.

Main Methods:

• Qualitative study employing in-depth, narrative interviews with ten UK-based SAS doctors.
• Participants represented diverse medical specialities and experience levels.
• Critical discourse analysis using Figured Worlds theory was applied to interview transcripts.

Main Results:

• SAS doctors' professional identity contributed to an unstable and ambiguous position within the healthcare system.
• They were frequently perceived as outsiders, facing mistrust from colleagues.
• Development needs of SAS doctors were often subordinated to those of consultants and trainees, with appraisal systems inadequately addressing these issues.

Conclusions:

• The lived experiences of SAS doctors often diverge from formal policy regarding their roles and development.
• There is a significant need to enhance the professional status and development opportunities for SAS doctors.
• Improvements in appraisal processes are essential for better supporting SAS doctors' career progression.