For many years, doctors in the staff grades, clinical assistants and associate specialists have made a substantial contribution to the care of psychiatric patients in the NHS but their position within the NHS and the College has been largely unrecognised. This article will describe recent attempts to remedy this situation. Numerically they comprise an important group of doctors (Table 1) and have always been more important in psychiatry than in other specialities, particularly in non-teaching districts where there are fewer consultants and junior doctors.