News

21/11/25

21 November 2025

Rapid response to BMJ investigation: Thousands of NHS doctors are trapped in insecure “gig economy” contracts

Hospital Corridor (1)

Today’s article shines a light on the reality faced by thousands of locally employed doctors (LEDs) in the NHS – many of whom are international medical graduates (IMGs) and from ethnic minority backgrounds – who are often trapped in insecure contracts, with limited access to training and career progression.

The RCP has issued clear educational and career support guidance for SAS doctors: once a doctor has been employed in the same specialty by the same trust for more than two years, they should be moved to a nationally negotiated SAS contract.

This is about much more than pay. It’s about access to training, supervision and a clear pathway for career development for all doctors. 

The RCP is proud to be the first medical royal college to endorse the #SASsix campaign, which calls for every early career SAS doctor to have an educational supervisor, equitable access to professional development and the opportunity to progress to specialist roles. Through our SAS leadership programme and regional representative network, we provide leadership training and mentoring, celebrate achievements and offer SAS doctors a collective voice to influence change. I am proud to say that SAS doctors are highly valued as RCP fellows and members.

The NHS cannot afford to leave any doctor behind. Ensuring fair working conditions, access to training opportunities, and career recognition for SAS doctors is essential for patient care, a sustainable medical workforce and the future of the health service. After all, there is no such thing as a non-training doctor.

Professor Mumtaz Patel

President, Royal College of Physicians