Every article about moving to Canada as a doctor quotes the gross billing figures. CAD $369,000 average for family physicians (CIHI 2023/24 data). Sounds spectacular compared to a UK GP's £100,000. But the comparison is misleading because the two numbers measure fundamentally different things.
Here's what Canadian GPs actually take home.
Gross vs net: why it matters
UK GP salary = what you receive after the practice has paid all overhead. Your £100,000 salaried income is net of premises, staff, equipment, and running costs. The practice absorbed those expenses.
Canadian GP gross billings = what the provincial ministry pays you before any expenses. You then pay your own clinic rent, staff, equipment, supplies, licensing, insurance (CMPA), IT, and everything else. The overhead is yours.
Typical Canadian GP overhead: 25–40% of gross billings. CIHI and provincial medical associations have documented this range. The variation depends on: whether you own or rent your clinic space, how many staff you employ, urban vs rural location, and your billing model.
The real numbers, by province
Alberta: Highest average gross billings for family physicians in Canada — approximately CAD $380,000–$420,000. Alberta has no provincial sales tax and among the lowest income tax rates. After 30% overhead (~CAD $120,000) and personal tax, a typical Alberta GP takes home approximately CAD $180,000–$220,000 net.
British Columbia: Average gross billings ~CAD $340,000–$380,000. BC's new Longitudinal Family Physician (LFP) model is shifting some GPs from pure FFS to blended payment — early adopters report comparable income with more predictable cash flow. After overhead and tax, net take-home is approximately CAD $160,000–$200,000.
Ontario: Average gross billings ~CAD $360,000–$400,000 (varies significantly by payment model — FHO capitation physicians often bill less per encounter but have lower overhead and more predictable income). After overhead and Ontario's higher tax rates, net take-home is approximately CAD $160,000–$195,000.
Saskatchewan / Manitoba: Average gross billings ~CAD $350,000–$380,000. Rural practice often commands higher billings due to procedural income (ER shifts, obstetrics). Lower cost of living means net income goes further. After overhead and tax, net take-home is approximately CAD $170,000–$210,000.
Atlantic provinces (Nova Scotia, New Brunswick, Newfoundland, PEI): Average gross billings ~CAD $320,000–$360,000. Lower billings but also lower cost of living and lower overhead (cheaper clinic space). Net take-home approximately CAD $150,000–$185,000.
The UK comparison (properly adjusted)
A UK GP partner earning £150,000 gross (before tax) with practice overhead already covered, after tax, pension contribution, and NI, takes home approximately £88,000–£95,000 (roughly CAD $155,000–$170,000 at current exchange rates).
A Canadian GP in Alberta netting CAD $200,000 takes home more — but has no employer pension contribution (the Canadian pension equivalent, CPP/QPP, is minimal compared to the NHS pension), must fund their own retirement savings, and pays for their own indemnity (CMPA: CAD $3,000–$5,000/year, partially rebated by some provinces).
When you adjust for: pension value (the NHS pension is worth roughly £30,000–£50,000/year in employer contributions alone), indemnity, and purchasing power parity — the real income difference between a well-earning UK GP and a Canadian GP is 20–40% in favour of Canada. Meaningful, but not the 3× headline that the gross numbers suggest.
What costs more in Canada
Housing in Vancouver and Toronto rivals or exceeds London. Calgary, Edmonton, and Ottawa are more affordable. Prairie cities and Atlantic Canada are genuinely cheap by UK standards.
Childcare is expensive nationwide (CAD $10,000–$20,000/year per child, depending on province — though federal subsidies are reducing this).
Professional costs are higher: CMPA fees, provincial licensing fees, College of Physicians membership, and the cost of maintaining your practice (if FFS).
Healthcare for things not covered by provincial plans — dental, vision, physiotherapy, prescriptions (no universal pharmacare yet in most provinces). You'll want private supplementary insurance.
What costs less
Income tax is lower in Alberta, Saskatchewan, and BC than UK rates for equivalent earnings. Cost of living outside the big three cities (Toronto, Vancouver, Montreal) is lower than most of southern England. Petrol, food, and consumer goods are generally cheaper (though this varies).
The bottom line
Canadian GPs earn more than UK GPs in absolute terms, even after adjusting for overhead and tax. The real advantage is approximately 20–40% higher net income, plus a lower cost of living outside major cities. The disadvantage is the absence of the NHS pension (which is the single largest hidden benefit of UK practice) and the higher professional overhead costs. For doctors in their 30s–40s with decades of earning ahead, the Canadian income premium is substantial. For doctors approaching retirement who've built significant NHS pension entitlements, the calculus is more complex.
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