BMA survey reveals concerns of 'second class' hospital doctors

Sep 23 2004

Three quarters of a key group of hospital doctors - most of whom qualified overseas - do not believe their skills and hard work are adequately recognised, the BMA reveals today (Friday, 24 September).

The NHS employs 12,500 doctors in the staff and associate specialist (SAS) grades. They cannot use the title 'consultant' and their jobs are not accredited for training. More than half of the 2,596 SAS doctors who responded to a UK-wide BMA survey gained their medical degree overseas - most often in India - and many took up SAS posts because their specialist qualifications are not recognised in the UK, preventing them from becoming consultants.

Less than a third (31%) of respondents would recommend a career as an SAS doctor to a medical student. Reasons given include lack of recognition, lack of career progression, low pay, high workload, and poor working conditions. The terms 'dumping ground', 'dead end', and 'second class' are used by respondents.

Mr Mohib Khan, chairman of the BMA's Staff and Associate Specialist Committee, said: "This is a group of doctors whose potential value has not been fully recognised, and whose expertise often goes to waste. If patients are to benefit from their skills, we need to see major change - better career progression, better recognition, and fairer remuneration. Full-time SAS doctors work an average of 73 hours a week for the NHS, but they aren't always getting the recognition they deserve."

When SAS doctors reach the top of their salary scale, their pay only goes up if they successfully apply for discretionary points. Unlike consultants, there is no obligation for hospitals to award any of their SAS doctors discretionary points. A quarter of the SAS doctors who had applied in the last five years had been unsuccessful - usually without being told why. Several respondents felt they had been victims of discrimination, and one had been told, "the trust does not give points to staff grades."

Half of respondents regard the work-related stress they experience as excessive. Contributory factors include lack of respect and recognition, long hours, bullying, and inadequate support and resources.