SAS doctors are senior clinicians who have completed medical training but have chosen a non-training career path, focusing on delivering high-quality, compassionate patient care. They play a vital role in providing continuity, leadership, and clinical excellence within our multidisciplinary teams.
Jon Van Niekerk, Group Clinical Director, said:
“This week, as we mark SAS Doctors Week, I want to take a moment to reflect on the incredible contribution that our Specialty and Associate Specialist (SAS) doctors make every single day across Cygnet services.
“SAS doctors are the backbone of our clinical services. They bring deep experience, continuity, and stability to our multidisciplinary teams. Their work ensures individuals in our care receive high-quality, compassionate, and consistent care, often acting as the crucial link between consultants, nurses, and allied health professionals.
“At Cygnet, we are proud of our SAS doctors’ commitment to excellence and their vital role in shaping the culture and standards of care across our hospitals and services. They are often leaders in clinical innovation, quality improvement, and mentorship, championing patient safety and wellbeing.
“SAS Doctors Week is not only a time to celebrate their achievements but also to reaffirm our commitment to supporting their professional development and career progression. We recognise the importance of investing in opportunities for training, leadership, and research, so that SAS doctors can continue to thrive and make an even greater impact in their roles.
“To all our SAS doctors, thank you. Your expertise, dedication, and compassion make an immeasurable difference to those in our care and colleagues alike. You are an essential part of the Cygnet family, and we are deeply grateful for all that you do.”
Across Cygnet services, SAS doctors bring unique perspectives and experience to their roles. Their insights into patient care, team collaboration and service improvement are instrumental in shaping the quality and consistency of care we provide.
We want to celebrate two of our outstanding SAS doctors – Dr Angela Misra, based at Cygnet Churchill, and Dr Toluwani Olafemi, based at Cygnet Bury Hudson – who share their journeys, inspirations, and reflections on what makes the SAS pathway such a fulfilling career choice.
From Inspiration to Impact: The Journey into Psychiatry
Dr Angela Misra trained in medicine at Imperial College London and her early career spanned acute medical, A&E and mental health services. Over time, Dr Misra recognised that the SAS career pathway aligned perfectly with her personal and professional values. “Being an SAS doctor has provided me with the flexibility to balance my family life whilst also building my clinical expertise, undertake leadership and Quality Improvement projects as well as having the freedom to professionally develop at my own pace.”
For Dr Toluwani Olafemi, the decision to pursue psychiatry was similarly rooted in a passion for meaningful patient care. “After completing my medical training, I realised that what I valued most was the clinical side of medicine, working directly with patients, families, and multidisciplinary teams to make meaningful differences in their lives, hence the choice to work in psychiatry.
“The SAS pathway offered me exactly that balance: the opportunity to develop as a senior clinician with autonomy, while maintaining continuity with my patients and teams. It also offers a training route gaining core competences.”
He continues: “Psychiatry has always appealed to me because it looks at the whole person, not just the illness. Mental health interventions can restore hope, relationships, and a sense of identity. I’ve found it incredibly fulfilling to help patients recover from crises and rebuild their lives. Mental health is an area where small changes can have profound impacts, and I wanted to be part of that transformation.”
Life as an SAS Doctor: Variety, Collaboration and Purpose
No two days are ever the same for an SAS doctor. Their work blends clinical decision-making, team leadership, mentoring and service development, with each day offering new challenges and opportunities to make a difference.
Dr Misra said: “A typical day at Cygnet Churchill is fast-paced, collaborative, and deeply purposeful. I have led the multidisciplinary team for a high-dependency rehabilitation service, overseeing assessments, risk management, and discharge planning for patients. Alongside direct patient care, I have chaired daily DRA meetings, ward rounds, and monthly restrictive-practice reviews.”
She adds: “As Cygnet Churchill’s Carers’ Lead, I led the hospital’s Triangle of Care re-accreditation process, integrating families more closely into recovery planning and providing them with peer-support groups.”
Education and mentorship are also key aspects of her work. “In particular I’ve really enjoyed being the supervisor for one of our senior nurses who has successfully completed her nurse prescribing course recently and also supporting the other resident doctors with their career development and MRCPsych preparation. I have also really enjoyed being involved in educational opportunities including Hospital Development Days for nursing staff and conducting peer group Portfolio Pathway learning sessions.”
Dr Misra’s days are a balance of clinical care, leadership and innovation. “No two days are the same, and that’s exactly why I love it.”
At Cygnet Bury Hudson, Dr Olafemi describes a similarly varied and rewarding daily routine. “Each day is varied, which keeps the role interesting. My mornings usually start with a multidisciplinary team meeting where we do daily risk assessments on our patients or ward rounds, reviewing patient progress and updating care plans. I carry out assessments, review medications, and work closely with nurses, psychologists, occupational therapists, and social workers to ensure a holistic approach to care.”
He adds: “The SAS role in psychiatry also involves a lot of collaborative work, liaising with community mental health teams, crisis services, and primary care colleagues to provide continuity for patients across different settings.”
Rewarding Work
For both doctors, the most rewarding part of being an SAS doctor is witnessing recovery, seeing patients rebuild their confidence, purpose, and independence.
“For me, the greatest reward is seeing recovery unfold, when someone moves from crisis to confidence, and you know the system, family and patient have worked together to make that possible,” says Dr Misra.
She has also found deep satisfaction in leading change and improving outcomes through quality improvement initiatives. “Implementing trauma-informed care on my ward led to a 23% reduction in restrictive interventions, and our co-produced care plan model reduced serious incidents by 27% over 12 months. Knowing that these changes improve real lives makes the work deeply meaningful.”
Dr Misra also appreciates the diversity and autonomy the SAS role offers. “Being an SAS doctor also offers incredible variety and autonomy, from presenting at international conferences to mentoring junior doctors, every day brings a new opportunity to make a difference.”
Dr Olafemi shares that sentiment, describing the perfect balance between independence and teamwork.
“For me, it’s the combination of clinical independence and teamwork. I have the flexibility to focus on patient care while still being involved in teaching, leadership, and service innovation. The gratitude and trust that patients show, especially during recovery, is incredibly motivating. Another rewarding aspect is the sense of stability SAS doctors bring to a service, being a consistent presence for both patients and the team.”
The Backbone of Mental Health Services
Dr Misra explains: “SAS doctors are often the anchor of clinical teams. We bring stability, long-term service knowledge, and leadership that bridges the gap between trainees and consultants. Because we stay embedded within services, we understand their rhythms and can drive sustainable quality improvement. We are able to champion the development of psychologically safe environments, ensuring that teams feel supported to learn and grow. In that sense, SAS doctors are both the backbone and the innovators of modern mental healthcare.”
Dr Olafemi agrees: “SAS doctors form the backbone of many mental health services. We bring a wealth of clinical experience, often across different specialties and settings, which helps in managing complex cases and mentoring less experienced colleagues.
“We provide consistency in care and help maintain high standards across services. In many ways, we bridge the gap between trainees and consultants, offering practical insights, supporting training, and ensuring that services run smoothly and safely.”
A Versatile and Empowering Career Path
Both doctors are passionate advocates for the SAS career pathway, emphasising its flexibility, professional autonomy and opportunities for leadership and development.
Dr Misra encourages others to embrace the full breadth of what the role can offer: “See it as a leadership pathway in its own right. The SAS role is incredibly versatile, you can lead quality-improvement, publish research, teach, mentor and shape national strategy, all while remaining close to patient care. My advice would be to embrace opportunities beyond your job description: present your work, apply for fellowships, and contribute to professional networks.
“The SAS route offers both flexibility and depth, it rewards curiosity, initiative and commitment. I’ve found it to be a fulfilling and empowering career choice, and I would encourage any doctor drawn to clinical excellence and innovation to explore it fully.”
Dr Olafemi offers similar advice: “The SAS route is a fantastic option for those who enjoy clinical work and want to shape their own career. It offers flexibility, professional development, and increasing opportunities for leadership and recognition. If you’re considering this pathway, make the most of your SAS Tutor and the opportunities available through the Trust and the Royal College of Psychiatrists. Get involved in teaching, quality improvement, and even research if you can. Above all, don’t see SAS as a ‘step down’ from training , it’s a respected, fulfilling, and evolving career that allows you to make a real impact on patients and services.
“Lastly and very importantly it also gives you a lot of family time which is paramount.”