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Consultants, SAS and Locally Employed Doctors


As a Consultant, Specialty, Associate Specialist, Specialist (SAS) or Locally Employed (LE) Doctor returning to work, you may experience different stressors to doctors in training due to seniority and the level of expectation from you on immediate return.

This may include supervision of juniors during potentially complex procedures, which you yourself may not have performed for the entire period of your absence.

As with doctors in training, any absence of more than three months can lead to a significant decline in skills and knowledge and any period of more than 2 years is likely to require some form of formal re-training3.

It is therefore important that your learning needs and concerns are addressed. Integration back into work should also include a phased return to work which allows you to focus on rebuilding confidence, clinical and non-clinical skills to your previous level as quickly as possible.

The principles for all doctors returning to work should follow the same principles for doctors in training returning to work.

In addition to this, either a formal or informal ‘buddy’ system should be in place. The buddy system would involve you being paired with a peer who might be a similar level or more experienced than you with whom you can meet for on-going support after the phased return to work period has ended. SAS doctors should connect with their local SAS tutor and/or SAS advocate if available.

Pre-absence planning

  • Review your employer’s absence/leave policy.
  • Notify your employer of your absence as soon as possible. Inform Head of Department/line manager of intention to take absence from work.
  • Arrange Occupational Health appointment for Workplace Risk assessment as needed.
  • Organise appraisal meeting to discuss how to maintain CPD, knowledge and skills whilst away.

Complete forms required by your employer as appropriate. You can also access a sample Absence from Work form.

During leave

  • Maintain contact with your line manager during your period of absence and update on any change in circumstances.
  • Once return to work date is confirmed, contact your department beforehand to meet with your line manager in advance (6 to 8 weeks before return date is recommended).
  • If returning from sickness, your line manager should refer you to occupational health to discuss your fitness to return to practice, a period of phased return, workplace adjustments, etc.
  • Discuss your needs on return with your line manager, focusing on ways to rebuild skills and knowledge in most efficient way, e.g. flexible working, workplace adjustments, organising theatre lists with uncomplicated cases with appropriate access to supervision or buddy operating for complex cases.
  • Agree on period of phased return to work and method of feedback/assessment.
  • Agree on timeline for review of progress and assessment of readiness.
  • Complete first part of the Return to Work form.
  • Arrange KIT days with department – can be used for regaining passwords, IT training.
  • Arrange refresher courses e.g. Human Factors, PROMPT/local skills and drills training.
  • You can keep track on the ePortfolio. The RCOG has different ePortfolios to choose from. For more information ePortfolios for SAS and LE Doctors please see here.

On return to work

  • Once an agreed period of phased return is completed, meet with your Line Manager to review progress.
  • If it is decided that extra training or supervision is needed before full responsibilities can be resumed, it is important to agree during the return to work interview how and when progress will be measured and formally assessed (42).
  • Individually tailored return to work should include:
    • The anticipated duration of the programme
    • The level of supervision required (direct or indirect)
    • An agreed format for assessment and feedback on progress
    • Any targeted training areas
    • The timing of progress reviews and agreed ‘milestones’
    • The date when independent practice would formally recommence in the event of a successful return to the workplace
  • Successfully participating in a return to work programme, backed by your employer, is an important item of supporting information for your appraisal and revalidation portfolio
  • You may decide to extend the period of phased return or mutually agree on your readiness to return to usual clinical duties.
  • Complete second part of the Return to Work form.
  • Agree ongoing support with informal/formal ‘buddy’ system.
  • If you have an Educational Supervisor (ES), arrange to meet and discuss your support needs (ES Toolkit).
  • If you are a consultant, a senior SAS or LE doctor who does not have an ES, you could consider asking for a mentor/buddy to provide additional support.

You may find additional useful information in Resources.