How Much Do Doctors Really Earn?

A doctor’s annual pay can range from around £28,000 for doctors that are just starting their training, to more than £100,000 for experienced consultants. There is no such thing as “one size fits all” when it comes to doctors’ salary. The salary depends on many factors, including level of training, years of experience, specialty, region where work is carried out, hours working full-time and any additional work or additional responsibilities.

The factors determining doctors’ salaries, and any bonus payments may be slightly different between England, Scotland, Wales, and Northern Ireland. This article will focus on data available for the English NHS.

Generally, the basic annual salary scales for doctors according to the stages of training (described by NHS England) are as follows:

• Foundation year doctors earn between £28,243-£32,691 

• Doctors in the early years of their specialty training earn £38,694-£49,036 

• Specialty doctors/registrars earn £41,158-£76,751 

• Consultants earn between £82,096-£110,683 depending on the length of their service

• Basic salary of General Practitioners (GPs) depends on whether they are so-called ‘independent contractors’, meaning they manage their own practice as a business, alone or in partnerships, or whether they are salaried GPs and are employed by independent contractors or larger primary care organisations. Independent contractors are in charge of their own finances but also have more responsibilities, such as paying the practice staff, paying rent/mortgage for the practice and buying equipment. Fully trained salaried GPs earn a basic salary between £60,455-£91,228. GP trainees earn an average annual salary of £49,000 for the duration of the 3-year programme.

• Trainee medical academics will earn between £29,243-£32,691 in foundation years, and between £49,036-£52,036 in later specialist training. Trained medical academics below consultancy level (e.g., senior lecturers) earn a basic salary of £54,309-£76,824 depending on the region they work in/NHS trust they work under. Consultants in medical academics earn between £82,096-£110,683, increasing with more experience.

• Finally, for doctors training less than full time the pay is calculated pro-rata based on their pre-agreed working hours. Any pay enhancements will also be calculated pro-rata depending on how much time the trainee dedicates to extra work.

These values are basic salary, meaning before tax is deducted and before any pay enhancements are applied, meaning the take home pay may be very different. 

Pay enhancements may be given for a variety of reasons. Working night shifts, weekends, and holidays, locum work (covering any gaps in rotas), and working any additional hours above the 40-hour working week will usually grant a pay enhancement. Doctors will also get an “on-call allowance”: an increase in their usual hourly salary during the hours they are available on-call.

For example, a surgeon’s basic salary is similar to any other specialty but since surgery often requires more on-call availability and working at night, on weekends and on holidays, a surgeon may get paid more once on-call allowance, bonus for working in unsocial hours (9pm-7am), and out-of-hours and locum work bonus is added. Additionally, working in London qualifies a doctor to receive the London Allowance - approximately £2,000-£3,000 annually on top of their usual salary.

Lastly, flexible pay premia are awarded to trainees in hard-to-fill specialties, including general practice, psychiatry, histopathology, oral and maxillofacial surgery, and emergency medicine, and doctors returning from a successful period of clinical training will likely also receive flexible pay premia. This means that for example a psychiatry trainee’s “take home” pay will be a larger sum than the basic salary standards for junior doctors, as psychiatry is a hard-to-fill specialty and trainees are eligible for flexible pay premia.

The pay increases (according to NHS England) for on-call availability are 8% of basic salary regardless of the frequency of on-call availability, working night shifts/unsocial hours grants ~37% added to the basic salary, and junior doctors working locum shifts will usually get paid between £30-£50 additional per hour (increases slightly with more training and expertise).

Nurses and non-medical staff

The pay for non-medical staff is divided into NHS pay bands. These pay bands cover all staff except doctors, dentists, and very senior managers. Each band has several pay points through which the staff can advance, previously referred to as spine points but now defined by years of experience. On top of the basic pay for the staff in their specific bands, staff living in high-cost regions such as London will receive allowance, and any additional pay premia is added on top of the salary, unless otherwise listed in the band description.

The NHS pay bands use the Knowledge and Skills Framework to ensure better links between salary, experience and career progression and equalise terms and conditions such as sick pay and pay for working during unsocial hours (9pm-7am). The 12 bands, examples of roles that belong to these pay bands, and the salary ranges for each band are summarised in a table below. Band 1 has been closed to new entrants since December 2018, and all roles included in this band are included in Band 2 instead.

All medical and non-medical staff can use the NHS pay calculators to determine how their basic salary will change as they progress in their career. The NHS pay calculators also allow the staff to add any additional earnings and pay premium to determine their true salary rather than basic salary. For this, the staff will need to know what spine point they belong to according to the old classification of the NHS pay bands. 

There are different pay calculators available online for England, Scotland, Wales, and Northern Ireland, as the basic salaries and some additional payments or bonuses may differ in different regions.