The NHS publishes pay scales. What it doesn't publish is what you actually take home after pension contributions, tax, NI, and the student loan — or what the total package looks like when you add on-call supplements, additional duty hours, and weekend premiums to the basic salary.
Here's the real picture at each grade.
Foundation doctors (FY1 & FY2)
FY1 basic salary: approximately £32,400 (2024/25 scale, pending any 2025/26 uplift). This is the starting salary for a newly qualified doctor.
FY2 basic salary: approximately £37,300.
With enhancements: Foundation doctors working the standard rota (including nights, weekends, and on-call shifts) typically earn 30–50% above basic through the 2016 contract's pay enhancements. A typical FY1 total pay is £40,000–£48,000. FY2: £45,000–£55,000. The range depends on your rota intensity — more antisocial hours means more money.
Actual take-home (FY1, ~£44,000 total): After 9.8% pension contribution, income tax, NI, and Plan 2 student loan repayment: roughly £2,400–£2,600/month. This is the number that matters for budgeting, and it's the number nobody tells you at medical school.
Core/specialty training (CT1-2 / ST1-2)
Basic salary: approximately £43,900–£46,000 depending on nodal point.
With enhancements: Total pay typically £50,000–£65,000 depending on specialty and rota. Surgical training with heavy on-call commitments pushes toward the higher end. GP registrars working a less intensive rota sit lower.
Higher specialty training (ST3-8)
Basic salary: approximately £52,500–£65,000 rising through nodal points with each year of training.
With enhancements: Total pay typically £60,000–£85,000. Senior registrars (ST6-8) in acute specialties with heavy on-call can exceed £80,000. GP registrars in ST3 typically earn around £60,000–£65,000 total.
Consultant
Basic salary: £93,666–£126,281 (2024/25 scale). You start at the bottom and progress through annual increments. The top of the scale is reached after approximately 19 years as a consultant.
With enhancements: On-call availability supplements (1–8% of basic depending on rota frequency), additional programmed activities (PAs), and clinical excellence awards (competitive, worth £3,000–£75,000+ per year). A consultant on a 12 PA contract with on-call supplements typically earns £100,000–£140,000 from NHS work alone.
Private practice: Varies enormously. Surgical and procedural specialties with private demand (orthopaedics, ophthalmology, plastics, cardiology) can double or triple NHS income. Medical specialties with limited private demand (geriatrics, acute medicine) have minimal private earnings.
The deductions nobody discusses
At every grade, the gap between gross and net is larger than new doctors expect:
NHS Pension: 9.8% (for earnings up to ~£26,800), rising to 12.5%+ for higher earners. This is valuable (employer contribution is ~20.6%), but it's invisible money — you never see it.
Income tax: 20% basic rate, 40% above £50,270, effectively 60% between £100,000–£125,140 (personal allowance taper). Consultants and senior registrars feel this acutely.
National Insurance: 8% on earnings between £12,570–£50,270, 2% above.
Student loan: Plan 2: 9% on earnings above £27,295. Plan 5: 9% above £25,000. This is a significant deduction that persists for decades.
A consultant earning £120,000 gross takes home approximately £72,000–£78,000 after all deductions — 60–65% of headline pay. Understanding this gap early prevents lifestyle inflation based on gross figures.
The less-than-full-time calculation
LTFT (less than full time) training and posts are pro-rated. An 80% LTFT registrar earning £60,000 FTE receives £48,000. But the tax calculation is on the reduced amount, meaning LTFT doctors pay proportionally less tax — the marginal rate on the last pound earned is lower. For some trainees, 80% LTFT provides 85%+ of full-time take-home pay due to the progressive tax structure.
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