Specialty, associate specialist, specialist and locally employed doctors survey 2026

Foreword

Doctors in specialty, associate specialist and specialist (SAS) roles, together with locally employed (LE) doctors, now account for nearly a fifth of the UK medical workforce. Their contribution to patient care and the development of other doctors is substantial.

More than 10,500 doctors responded to this survey, our first dedicated survey of SAS and LE doctors since 2019. The findings reveal a gap between the contribution expected of these doctors and the support and opportunities available to them.

Across both groups, doctors value the stability and flexibility these roles can offer. For some, particularly LE doctors, they also provide a route into UK practice or a career when formal training or permanent employment is not available or does not fit their circumstances. Yet doctors want greater opportunities to learn, progress and make full use of their experience.

Workplace culture remains a significant concern. Almost one in four LE doctors and nearly one in three SAS doctors reported experiencing or witnessing bullying or harassment. Internationally qualified doctors were also more likely to report discrimination and unequal access to opportunities, highlighting the need for more inclusive and supportive working environments.

Career progression is another key issue. Forty-two per cent of specialty doctors reported being eligible for a specialist contract but unable to secure one. More needs to be done to ensure career structures provide meaningful progression for experienced doctors.

The findings will inform our wider work on medical education, training and career development, including further analysis of differences in doctors’ experiences. Together, these insights can help shape more flexible and inclusive career pathways that recognise doctors’ skills, support their development and strengthen patient care.

Locally employed doctors key findings 

The 2026 survey highlights the large and increasingly important contribution of LE doctors to NHS services, education and patient care. Their experiences and career pathways vary considerably, with many doctors viewing LE roles as one stage within a broader career journey rather than an end point in themselves.

However, many LE doctors continue to face challenges such as employment insecurity, limited opportunities to develop, discrimination, burnout and uncertainty about their future. Providing greater support, recognition and flexible training pathways can help these doctors develop and progress in their careers.

SAS doctors key findings 

The 2026 survey highlights the extensive contribution of experienced and committed SAS doctors to clinical services, education, training and leadership across the NHS. Many value the stability and work-life balance that SAS careers can provide.

However, career progression remains uneven, with barriers including unequal access to learning and development, difficulties progressing to specialist contracts, and limited opportunities for advancement. SAS doctors also reported concerns about discrimination, burnout, bullying and a lack of recognition for the work they do. Greater support, inclusive working environments and fair opportunities to progress are needed to help SAS doctors develop and sustain their vital contribution to patient care.