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There should be structured support and career guidance for new SAS doctors or those changing specialty and an expectation of support for professional exams. SAS doctors may benefit from explicit discussions around wellbeing. Some of these needs may be better addressed by having SAS doctors as appraisers, but this is likely to be insufficient in itself. Our research reveals the importance of enhancing the professional status and agency of SAS doctors. There should be structured support and career guidance for new SAS doctors or those chan