Authors' reply

We thank the authors for their valuable contribution to this ongoing discussion surrounding performance anxiety, which we acknowledge is not limited to trainees.We agree that SAS doctors are vital to the NHS and that they must be celebrated and supported to fulfil their potential.We agree that the underutilisation of SAS doctors with extensive experience and expertise to provide service provision of more junior roles would promote undesirable performance anxiety.This lack of professional identity may negatively impact performance anxiety and therefore, potentially patient care.Similarly, amongst trainees in O&G, while lack of resilience and burnout are key contributors to the 30% attrition rate in our speciality, recent findings suggest lack of professional identity is a major factor amongst senior trainees, in a similar fashion to SAS doctors. 1 As Mr Rafi acknowledges, the GMC Barometer Survey 2022 highlighted some of the specific challenges and sentiments of SAS doctors working in O&G in the United Kingdom.Interestingly, the survey actually demonstrated that SAS doctors have the highest perceived levels of satisfaction (59%) when compared to trainees, specialists and GPs.Moreover, whilst this level was lower than in previous years, the level fell most steeply amongst trainees to 50%, from 83% in 2021. 2 This higher level of satisfaction amongst SAS doctors may be related to the various initiatives in place celebrating and recognising their role within the workforce, such as national SAS week, which is endorsed by the Royal College of Obstetricians and Gynaecologists, the SAS charter, which helps support career development, as well as protected pay for out of hours locum work.Hopefully, such initiatives can help facilitate the culture shift needed to empower SAS doctors to feel more valued, and help instigate further organisational change to make the most of their extensive experience and expertise, and promote career progression.We are pleased that our article 3 has prompted further discussion on this important topic, which covers the full spectrum of our workforce and hope that future work is directed towards retaining all doctors within the speciality, as we highlight areas for improvement to do so.