Associate specialist
In the United Kingdom, an associate specialist doctor is one who is appointed to a permanent position in the 'middle ranks'. The rank is the highest that a doctor not seeking to be made a consultant may achieve, and is usually conferred upon staff grade doctors after several years' experience (although it is possible to go from specialist registrar to associate specialist if one chooses at that stage to leave the consultant career path).
This grade was closed to new entrants from 1 April 2008 after contract negotiations between the BMA and NHS Employers.
Rank and speciality
An associate specialist ranks below a consultant and is always nominally accountable to one, but as associate specialists do not count as junior doctors they are able to have their own clinic lists and see patients independently. Associate specialists are often (but not always) on the specialist register of whichever field of medicine in which they practice, and can be specialists in any field. Promotion from staff grade or specialty doctor was normally on experience rather than qualification, although an associate specialist is free to sit any required exams and apply for a consultant post (often without having to have been a specialist registrar first) if they wish. An associate specialist can sit for an exam at any time.
Difference from consultants
An associate specialist is normally reached by doctors taking what is known as the non-consultant career path which involved becoming (after being a Foundation Doctor) a staff grade and then reaching this rank with seniority. It was however possible for anyone not yet a consultant to leave the consultant career path and take up either this rank or staff grade depending on experience.
An associate specialist is a hospital doctor and is generally treated as a senior doctor. Pay is usually lower than that of a consultant (though as associate specialists sometimes have fewer duties they may be also be paid less overall).
The main difference between an associate specialist and a consultant is that an associate specialist is more of a for-hire role, generally called in to look at specific patients, or treat a list of patients with one common specific ailment. Associate specialists can be part-time or work across many hospitals far more easily than consultants can, and are often not responsible for the teaching and supervision of medical students and junior doctors. They will generally perform less management duties and spend more time on patient care.
The associate specialist grade is no longer open to new entrants since the 2008 Specialty Doctor contract was introduced. However there remain some 6,000 associate specialists in England alone.
General practitioners
General practitioners are not associate specialists. Due to similar training and pay, their autonomy in practice, and level of responsibility, they are often more comparable to consultants. Consultants and GPs both gain a CCT, a certificate of completion of training, after undergoing a recognised specialty training programme.
Further information - https://web.archive.org/web/20120212131902/http://www.bma.org.uk:80/employmentandcontracts/employmentcontracts/staff/backgroundinfo.jsp