A Doctor’s Pay in the UK

“Wealth consists not in having great possessions, but in having few wants.” -Epictetus

“How much will I get paid?” This is quite possibly the most frequently asked question by budding UK doctors, and plays a decisive role for many who want to move to the UK. Like the quote of the Greek stoic philosopher above, spending is as important as earning, ergo we will discuss both pay and expenditure of a doctor in the UK.

Nodal points of the Pay Scale

It is essential that you familiarize yourself with the different levels of doctors in the UK and what they are called. Even non-trainee doctors have a level depending on their responsibilities. The photo below shows different levels of doctors and also where you can start your first non-training job according to you background before GMC registration, so you can understand your salary after PLAB, MRCP/MRCS, etc.

Pay scale is determined on the basis of two things:

  1. Obviously, AT WHAT LEVEL (as pictured above) you are employed. Be 100% sure that you know this before you start your job.
  2. How many hours per week will you be working? Will your rota include working night duties (a.k.a on-calls) or is it a shift based duty? Or will it be basic hours only?

So, for basic hours only, there is a fixed basic pay depending on the level of the doctor:

Grade Stage Nodal Point Basic Pay (GBP per year before taxes)
Foundation Year 1 FY 1 1 26614
Foundation Year 2 FY 2 2 30805
Specialty Registrar (Core Training) CT 1 3 36461
CT 2
CT 3 4 46208
Specialty Registrar (StR) (Run-Through
Training) / Specialty Registrar (StR) (HigherTraining) / Specialist Registrar (SpR)
ST 1 3 36461
ST 2
ST 3 4 46208
ST 4
ST 5
ST 6
ST 7
ST 8

Banding of the pay

Banding is a variable supplement to reflect how many extra hours are being worked on average, the type of working pattern, the frequency of extra duty, and the antisocial nature of the working arrangements. If a doctor is working 40 hours a week on average, and the hours are always Monday to Friday, within 7am-7pm, NO BANDING applies. That means they will get paid only basic pay.

A summarized pay band chart can be seen here:

Band Definition Salary supplement
as a percentage of basic salary
Band 3 For those working more than 56 hours per week on average or not achieving the required rest 100%
Band 2A For those working between 48 and 56 hours per week on average,
most antisocially
Band 2B For those working between 48 and 56 hours per week on average,
least antisocially
Band 1A For those working between 40 and 48 hours per week on average,
most antisocially
Band 1B For those working between 40 and 48 hours per week on average,
moderately antisocially
Band 1C For those working between 40 and 48 hours per week on average,
least antisocially
No Band For those working no more than 40 hours per week on average,
between 7am and 7pm

But banding isn’t that straight forward under the new contract. You trust will make a rota for you which will include on-calls/shifts managed as per the number of doctors employed and from that they will calculate the amount of enhancement you will get.

The important thing is to making sure that you know your BASIC PAY and GROSS PAY AFTER ENHANCEMENTS before starting the job.

Income Taxes and other deductions

Generally if you are employed in a fixed term contract with an NHS trust, your income tax, National insurance and NHS Pension (If you don’t opt out it) will automatically be deducted from your pay and and you will be paid the rest. This is called PAYE (Pay as you earn). So, you don’t have to think about or remember to pay taxes. Other taxes and bills like council tax, utility bills can also have a direct debit system where they will timely take the bill from your bank account and again, you don’t have to remember to pay.

How much is the income tax?

An explanation with an example will probably make it easier to understand. If you are in a fixed term contract with a NHS trust, you tax code should be 1185L. Make sure you ask for a P46 form to fill before your payroll is setup, otherwise you will be taxed at a Basic Rate without any personal allowance. This is important to know because if you aren’t aware, you won’t be able to find out whether you are getting paid correctly or not. For example, let’s say your income in a year is £48641. Now let’s calculate your income tax.

Taxable Income Tax Rate (Band) Rate Calculation Tax paid
up to £11850 Personal Allowance 0% 11850 times 0% 0
£11,851 to £46,350 Basic Rate 20% 46350-11851=34499 times 20% 6899.8
£46,351 to £150,000 Higher Rate 40% 48641-46351=2290 times 40% 918
Over £150,000 Additional Rate 45% You’re not getting paid this high 0
Income Tax/year For taxable £48641 per year 7817.8
Income Tax/month For taxable £4053.41 per month 651.48

National Insurance

The national insurance is contributed from both the employers and the employees. Employees- your contribution will be deducted from your pay by the employer. Again, let’s say your gross pay is £48641. (Income tax is on your taxable pay, but NI is always on your gross pay).

To avoid the headache of calculating, you can use online calculators.

The most commonly used one is The Salary Calculator

Take-home pay

You can see in the following picture a nice breakdown of your income tax, NI, and NHS Pension contribution. Keep in mind that the NHS pension is tax exempted, and that your taxable pay is calculated deducting from your gross pay, just like your personal allowance is free from income tax. (The calculation below is made taking into 9.3% NHS pension into account.)

How much a doctor actually gets paid in the UK?

As mentioned earlier, you have to know how much you will get paid after enhancements to have a general quote. I am putting a general quote from the trust where I work.

Nodal Point Working hours Gross pay after enhancements Take-home pay (9.3% NHS pension)
FY1 46 hours / week (less antisocial hours) £34174 £2043.79
40 hours / week (more night hours) £32673 £1968.04
FY2 46 hours / week (less antisocial hours) £39555 £2315.35
40 hours / week (more night hours) £37818 £2227.69
CT1/2, ST1/2, SpR1/2 46 hours / week (less antisocial hours) £46818 £2688.69
40 hours / week (more night hours) £44761 £2578.08
CT3, ST3/8, SpR3/8 46 hours / week (less antisocial hours) £59333 £3348.27
40 hours / week (more night hours) £56727 £3222.32

At this point again, I want you to look the photo at the top of this post again, where I mentioned which level you can start depending on your previous qualification, and check the general pay. This is for my trust only. Your gross pay may change depending on your contract and hours and that’s why it is VERY important to know this information when you agree to take a job. By using online calculators, you can easily find out what your take home pay will be.

So, a fresh graduate junior doctor who completed internship and obtained GMC registration via PLAB, can potentially earn between £2200-£2700 (FY2-CT1) per month.

What about the cost of living?

Epictetus’ words come forth here again. Even if you earn £2500 a month it may not be enough if you spend twice that on average. Where could the money be spent?

  • Food
  • Housing
  • Clothes
  • Transportation
  • Personal Care
  • Entertainment

It is vital you know how to budget to your allowance. There’s no need to scrimp an save, but you should be practical about the amount of money being deposited and the amount being spent. That being said, some things cannot be helped depending on location. For instance, a studio flat in London can cost you £800-£1000/month or even more, whereas in Liverpool or Hull, it might be £500-£700/month or less. Also look into hospital provided accommodations if offered, they tend to be considerably cheaper, less of a hassle, and are close to your hospital.

There are many cost of living comparison sites on the internet, so with a little digging, you can have a general idea regarding the cost of living.

For a quick snapshot- the cost of living in London is 55% more expensive than in Manchester, 64% more than Liverpool, 167% more than in Dhaka, 210% more than Delhi, and 251% more than Islamabad. [Source: expatistan.com]

So think about location before you take a job if your concerned about saving. Learn more about the hospital and surroundings and cost of living situation. If you don’t live in a big city, your expenditure per month for two people should not exceed £1000.

What about extra-hours or overtime?

Yes, in addition to your fixed job hours, you can work extra hours and shifts, these are mostly locum shifts/duties. The hourly rate is definitely higher than your main job and as it highly varies from trust to trust and place to place, it’s beyond general discussion. You will definitely get to know about this, when you start working in the UK. But, yes, a considerable amount can be earned doing locum shifts/duties along with your day-to-day job, if you are up to it.

To summarize

There is more to life than money and to think that in a country like the UK, doctors don’t make a liveable wage, would be a mistake. Yes, there are definitely other countries where doctors are paid more, but often the cost of living, working hours, and standard of life are not taken into account.

“Money is numbers and numbers never end. If it takes money to be happy, your search for happiness will never end.” – Bob Marley

Good luck!


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