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Position statement on the Associate Specialist grade

21 February 2019

In April 2008 the ‘associate specialist’ (AS) grade was closed and succeeded by the new ‘specialty doctor’ grade. Over recent years there have been calls from the British Medical Association (BMA)1 and the Academy of Medical Royal Colleges (AoMRC)2 to reopen the AS grade.

The Royal College of Ophthalmologists (RCOphth) works directly with the Staff and Associate Specialist (SAS) Group to highlight the benefits and positive career opportunities for SAS doctors. It is important that the SAS career path is positively recognised as desirable and respected. The reopening of the associate specialist grade is a key element in promoting SAS career development and progression.

Dipen Boghani, Chair of the RCOphth SAS Group said ‘Reopening of the AS grade would be a significant step in recognising a SAS doctors’ knowledge, experience and contribution to patient care. A move to reopen the grade will continue to raise the profile of SAS doctors.’

The 2018 RCOphth survey of a nationwide sample of SAS doctors asked3How could SAS grades be promoted as a positive career choice? The resultant themes included:

  • Communicate more effectively the contribution SAS doctors make as part of the ophthalmic workforce
  • Improved career development and salary progression opportunities
  • A change in name/restoring the Associate Specialist role

The ophthalmic workforce is overwhelmed with a predicted 30-40% increase in demand over the next 20 years4. The 2018 RCOphth Workforce Census showed 85% of units reporting difficulties in recruiting SAS ophthalmologists, with hospital eye units requiring an additional 204 SAS ophthalmologists over the next two years5. As SAS doctors make up 23% of the ophthalmic workforce, they need to be encouraged and supported to continue this career pathway.

While recognising the negotiation of contracts does not fall under the RCOphth remit, we fully support our SAS doctors in advocating for the reopening of the associate specialist grade. It is encouraging to see the reopening of the AS grade is supported by the Royal College of Emergency Medicine6 and the Royal College of Anaesthetists7. The BMA and NHS Employers have also already made a wider commitment to support and develop the recognition of SAS doctors.

Through our Staff and Associate Specialist Group the RCOphth continues to be committed to supporting and encouraging SAS doctors in their day to day work and career aspirations. If you would like to find out more about our support for SAS doctors please visit our website or get in touch via


  1. Reopen associate specialist grade, doctors hear, British Medical Association, December 2018
  2. Reopening the Associate Specialist Grade, The Academy of Medical Royal Colleges, December 2018
  3. SAS Ophthalmologists – Supporting a key workforce, The Royal College of Ophthalmologists, August 2018
  4. The Way Forward Resources, The Royal College of Ophthalmologists, February 2017
  5. RCOphth Workforce Census 2018, The Royal College of Ophthalmologists, January 2019
  6. Position Statement – Associate Specialist Grade, The Royal College of Emergency Medicine, 20 September 2018
  7. Position statement in support of reopening the Associate Specialist grade, Royal College of Anaesthetists, November 2018