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Non-Speciality Trainees

The Vascular Society would like to recognise the invaluable contribution that doctors working in SAS roles provide within the vascular multi-disciplinary team. SAS and LED doctors are a group of well experienced members of the medical team that contribute immensely to patient care in vascular surgery.

Surgery is a diverse field and there are 24 professional surgical specialty associations and expert groups that represent the interests and set standards for the various UK surgical specialties and patient groups. 

RCS England’s SAS Strategy 2023-2026 [hyperlink] commits to encouraging surgical specialty associations to review how they engage with specialty doctors and specialist grade doctors (SAS) doctors relevant to their surgical specialty.

Some professional surgical associations have already made strides in doing this; one example is the Vascular Society.

The Vascular Society has recognised the “invaluable contribution that doctors working in SAS roles provide within the vascular multi-disciplinary team.” This includes clinical fellows, associate colleagues (such as interventional radiologists, anaesthetists, care of the elderly physicians) and SAS colleagues who work as vascular surgeons.

The Vascular Society has said that in most vascular units the service would not be sustainable without the hard work and commitment of SAS doctors.,

The training, recognition and wellbeing of these groups of doctors is part of the remit of its Workforce and Education committees. 

The Vascular Society his keen to support Affilaite and Associate members, including Specilaity and Locally Employed Doctors in achieving their training and educational goals. We are engaging with all vascular SAS surgeons to support their individual career development. 

Specialty, Associate specialist and LED 

The importance of the training, recognition and well-being of SAS doctors working in vascular surgery is part of the remit of the Society’s Workforce and Education committees. Definitions of surgeons working in 'SAS' roles are as found below with relevant links:

Specialist doctor

Shall have full registration and a Licence to Practise with the General Medical Council (GMC); and

Shall have completed a minimum of 12 years’ medical work (either continuous period or in aggregate) since obtaining a primary medical qualification of which a minimum of six years should have been in a relevant specialty in the Specialty Doctor and/or closed SAS grades.

Equivalent years’ experience in a relevant specialty from other medical grades including from overseas will also be accepted.

Shall meet the criteria set out in the Specialist grade generic capabilities framework.

Specialty doctor

Shall have full registration and a Licence to Practise with the General Medical Council (GMC); and

Shall have completed at least four years’ full-time postgraduate training (or its equivalent gained on a part-time or flexible basis) at least two of which will be in a specialty training programme in a relevant specialty or as a fixed term specialty trainee in a relevant specialty; or

Shall have equivalent experience and competencies.

Employed on a nationally agreed SAS contract:

SAS Contract: 

SAS Charter :

Locally employed doctor (LED)

Also known as 'trust grades', and including other job titles such as clinical fellow.

Doctors who are employed directly by a Trust on individual contracts (rather than a nationally agreed one as per SAS).

Vascular Society SAS/CESR Council Representatives

Two SAS/locally employed doctors (LEDs) sit on the Vascular Society’s Elected Council “to ensure that the needs of this group are considered in Council decision making. The term of office for this position is three years with appointment by interview.

2023/4 representatives

  • Ibrahim Enemosah
Ibrahim Enemosah

“Within the last year, word of mouth has created an informal a kind of network effect. This has made more SAS doctors aware of the support provided by the Vascular Society – and my work easier.” 

Ibrahim is driven by helping others. Since joining the Elected Council of the Vascular Society in October 2021, he has worked hard to reach out to other SASvascular doctors, encouraging them to draw on the support available from the Society. 

It all started in August 2021, when Ibrahim spotted a national advert placed by the Vascular Society for Non Consultant grade/SAS representatives. Ibrahim applied, and soon after he was invited for an interview by a panel of five Society council committee members which  included representatives from the Rouleaux Cclub (vascular speciality trainees). He had to first give a five minute powerpoint presentation on ‘As the non-consultant grade representative how will you engage with doctors and surgeons who share a similar status’ before the interview began. Ibrahim was appointed to the new role, together with a colleague, Tatiana Martin. 

Ibrahim’s primary role is to help SAS and LE doctors (such as clinical fellows) in vascular surgery to access training and education to enable them to progress. Together with Tatiana, he has been working to identify SAS and LE doctors working in vascular surgery. By early 2022, they had identified 32 such doctors working in the UK. They continued with their mission to contact all vascular network leads to ensure that no one had been missed, and by 2023 had reached 70 doctors. 

Ibrahim and Tatiana are full members of the Vascular Society’s Elected Council and sit on the educational and workforce committees [not listed on website as council members; would be good to get this updated before publication]. They ensure that the voices of SAS and LE doctors in vascular surgery, including CESR applicants, are heard during Council discussions. They also identify mentors to support CESR applicants. “My role is to support them and help them get certification, so that they can become associate specialists/consultants themselves,” says Ibrahim. He believes that 80% of SAS and LE doctors working in vascular surgery would like to become vascular specialists, adding,: “ I believe everyone would benefit from the educational support.” 

Ibrahim emphasises the value of drawing doctors into collegiate structures, in terms of combating loneliness and dissatisfaction due to a lack of support – and the knock-on benefits of happier doctors for service delivery. The support available includes providing access to courses and conferences, withand educational content tailored to the needs of SAS and LE doctors in vascular surgery. Without support, doctors who are ndo not hold a ot on the national training programme number (NTN) are more likely to leave the specialty. 

Ibrahim is all too aware of the challenges SAS and LE doctors can face in accessing training and educational opportunities. “I experienced difficulty accessing training in the UK because the competition is so fierce. I applied for a training number three times but was unsuccessful as the wealth of my surgical experience counted against me. Colleagues, and the centre where I work, are now supporting me on the CESR route,” says Ibrahim. He has worked as a clinical fellow in the NHS for four and a half years; he completed a two-year fellowship in Plymouth, before moving to Southampton for two and a half years as a Senior Vascular clinical fellow. He had seven year’s general surgical residency training in Nigeria under his belt, before coming to the UK to pursue his interest in vascular surgery. His long-term plan is to return to Nigeria and deploy his specialism to the benefit of developing communities. He says, “To complete my mission, I have to give back, which means providing vascular care to those who cannot afford or access it. That’s my end goal.” 

“What SAS doctors need is support, to unleash their full potential. If they do not receive this support, they receive criticism, feel unhappy and move on. Not many SAS doctors have a lot of experience in leadership roles, so they need support to thrive.”

Ibrahim is optimistic about the future for this workforce. He says, “The SAS role is more in focus now. As I am an insider, I can see there are a lot of things happening.” He observes that RCS has recognised the need for change and raised awareness of the potential, and capabilities, of SAS doctors. Healthcare organisations and networks also play a crucial role, he says, in demonstrating the benefits of employing SAS doctors. “It is important for everyone involved to work together and make a concerted effort to break down the historical barriers that have limited the employment opportunities for SAS doctors,” he says. 

Ibrahim’s advice for SAS and LE doctors wanting to get involved with one of the many specialty associations or RCS England (or other college)

  • Engage with your specialty representative - drop them a mail highlighting your interests and enquire how you can get involved.
  • Ears to the ground - Avail yourself of networking opportunities at RCS, SAS, Specialty and CESR conferences. 
  • Start Locally - Being a Chief resident and supporting junior doctors in my Ttrust enhanced my skill set for my national role. 
  • Andrew Irwin

Ibrahim and Andrew can be contacted at

ASPIRE Digital

ASPIRE Digital is open to all Society members and SAS surgeons have been accommodated onto ASPIRE courses.

SAS/LED/CESR Educational day

The Society hosted the inaugural online ASPIRE Digital SAS/LED Education day scheduled on 27 June 2023.

The focus of the educational day was clinical updates with case based discussions (CBDs) covering abdominal aortic aneurysms, peripheral arterial disease and carotid disease. The day also included sessions on equality diversity and inclusion, CESR (Certificate for Eligibility for Specialist Registration) and an update on the FRCS Vascular exam.

The training day covered important areas of every vascular surgeon's practice, where we currently are with CESR and how to assemble a high quality CESR portfolio. There was time allocated for questions at the end of each session answered by the panel of experts.l


Prof Sadasivam Selvakumar, Keith Jones, Patrick Coughlin, Ansy Egun, Kamran Khan, Sophie Renton, Jon Ghosh, Kaji Sritharan and Prof Arun Pherwani. 


We are pleased to announce that we have plans to commence ASPIRE 7 for eligible SAS surgeons.

Date of course to be confirmed. 

Intercollegiate SAS committee (ISECSN) and IMG specific guidance

The newly formed Intercollegiate Surgical Education Committee for SAS, LED, and Non-Consultant Hospital Doctors (ISECSN) is composed of representatives from across the Royal Surgical Colleges, Surgical Speciality Associations and existing Intercollegiate Committees, aims to bring together experience, assess needs, and support the development of educational provision specifically required for this group.

The ISECSN has launched a website to support the educational development of SAS Grades and those in related grades. The website provides key information, resources, and various access to support, helping those in SAS grade posts to enhance their skills and progress in their career.

Intercollegiate SAS/LED Education Website

Improved communication and relationships between the new committee and the Joint Committee on Surgical Training (JCST) will provide a broader less piecemeal approach. All Colleges and Specialty Surgical Associations (SSAs) will provide input, and there should be ongoing discussions as relationships build up.

Many of the SSAs already provide significant support with the CESR process, and by sharing their ideas and experience, SSAs can develop further in this area. Mentorship training can be provided for SAS at a College level, and more specific mentorship within specialties or for CESR application is available from some SSAs, possibly more in future.

Although issues such as funding for education and training, recognition and employment terms and conditions are outside the responsibility of Colleges, the Colleges can have influence in these areas.

The ISECSN aims to provide a unified voice for SAS and related grades and advocate for support and progress in these important areas.


Intercollegiate Surgical Curriculum Program (ISCP) 


Intercollegiate MRCS Exam

Vascular Surgery Curriculum 2021


JCST CESR guidance for applicants

JCIE Website