- 27 May 2021
- 15 min read
How Much Junior Doctors Are Paid [Real Figures]Subscribe To Advice
Orthopaedic Surgeon, Dr Jude, Outlines the Junior Doctor role and salary, explains salary deductions and why he thinks the term ‘Junior Doctor’ is misleading.
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Hey, guys. My name is Dr. Jude.
I'm an Orthopaedic Surgeon here in London.
I graduated up in the north of England, but did all of my postgraduate training in London.
We have a short stint in the US and also spent some time in Canada.
I made this video before, but YouTube took it down for some music copyright infringement, but that's cool.
It was really popular.
So we're going to do a more updated version of it.
If there's anything I leave out, be sure to put it in the comments.
Doctors Are Not As Well-Paid As People Think
Doctors are not as well-paid as people think, but equally we're not poor.
That is because the NHS is founded on socialist values, which means every Doctor for the same grade will get paid the same amount of money for a fair day's work.
Most, or if not all, Doctors now will be on what you will probably have heard called the new Junior Doctor contract.
Jeremy Hunt in 2016, who was then health minister, who frankly was very unpopular amongst Junior Doctors, forcefully imposed a new contract upon Doctors, which changed the way we were paid.
It meant the amount of money that we were paid for unsociable hours was significantly reduced, which means you could work more weekends and nights and your salary wouldn't change that much.
The reason is he was trying to bring in what is now known as a seven-day NHS.
I was just thrilled to have a paycheck.
What Do You Think?
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The Term Junior Doctor Is Quite Misleading
I think the term Junior Doctor is quite misleading, and a lot of people don't fully understand what that means.
Essentially, that means any Doctor in the UK who is not a Consultant.
We in the UK spent a long time as a Junior Doctor, so it is misleading.
People often think it's Doctors in their 20, but actually we have Junior Doctors in their 30s and even 40s and even 50s.
So many of us have children, elderly parents that we care for, want to buy a home, get married, live in a nice neighbourhood, that kind of thing.
Actually that can be quite challenging on a Doctor salary if you haven't planned ahead.
If you're coming to work in the UK, you'll see that there are two broad types of Junior Doctors, and those are trainees and non-trainees.
All that means is you have Doctors who are in training, they're on a program and they're moving forward to achieve certain competencies so that they can one day become a Consultant.
Understanding The Different Grades Of Doctors
You also need to understand the different grades of Doctors.
When you graduate, you will complete a two-year foundation program, and that starts at FY1, which is like an internship year.
You then receive a pay jump, which is then when you become an FY2.
Following this, you will complete a core training program, which is two years, and you become a CT1, CT2, and you'll have an additional pay jump at that stage.
When you complete that, you will then become what's called a registrar or a specialty trainee, and you'll be an ST3 and above.
Again at that stage, your pay then goes up again.
When I was training previously, we used to receive an incremental pay rise for each additional year of service.
Your pay, essentially, goes up with each grade of Doctor.
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The Different Pay Grades For Doctors
Anyway, let's get into the numbers.
I'll leave a link in the description.
Anybody can find it, and Google it.
Let's go and have a look.
Okay, so this is the NHS Pay Circular for 2020.
It has all Junior Doctors pay on it.
It's there for anybody to view, and it's the same for all Doctors across the country.
If you head over to Page 5, you'll see this table called Doctors in Training Basic Pay.
If you look at the top of the table, you'll see Foundation Doctor, Year 1.
So that's, like I said, it's like an internship year almost.
So your first pay, which is Nodal point 1 straight out of medical school is £28,243.
Now Foundation Year 2, your pay goes up by £4,000 and becomes £32,691.
As a core trainee, your pay then goes up to Nodal point 3, at which point you are paid £38,694.
Bearing in mind, this is your basic pay.
We'll talk a little bit in a minute about how this is supplemented.
When you become a specialty registrar, or ST3 and above, your pay goes up again quite significantly by £10,000 so £49,036.
This is your basic pay, remember? Okay.
So I briefly mentioned that our pay comes from two main sources.
One is your basic pay, and that is the salary that you are given, irrespective of which specialty or hospital you work at.
That is the basic pay, and those are the numbers that we just looked at.
But you'll also receive what's called your Banding.
Your banding is an additional bump in your salary, which is dependent on how many unsociable hours you were doing.
Unsociable hours are nights and weekends.
So, for example, if you do an acute specialty such as surgery or accident and emergency, where a lot of the work is out of hours, and you're doing lots of on-calls, then you will be paid perhaps an additional 20% or 30% of your basic pay on top.
On-Call Availability Allowance
If we head back to this document and look on Page 6, you'll see here, it says, "On-call availability allowance."
So if you're doing on-calls, you'll be paid an additional, for example, if you're Nodal point 4, so you're at a registrar level ST3 and above, you will receive an additional £3,923.
For example, let's say you're doing one in five weekends, perhaps split between nights and days, you'll receive an additional 6% of your salary.
If you're working at Nodal point 4, the registrar level, then you'll be paid an additional £2,943.
What will happen is the HR department that gives you your contract will tell you, based on how many on-calls and out-of-hours you were doing, how much your banding is on top of your basic pay.
But I think if you're working at the registrar level earning £49,000, you can expect perhaps to earn upwards of about £60,000.
You see the ST3 to ST8 are paid exactly the same.
When this was introduced, this was quite contentious because, well, an STA who is nearing the end of training is often a very skilled Doctor, who's able to work independently and take on a lot more clinical responsibility.
When I was training, the STAs were paid a lot more for that.
However, that's all changed.
It doesn't matter what year you are in training.
Locum & Agency Work
That is the pay that you will see during your contracted hours.
Now you can earn an additional income, though small, on the side.
The way you do that as Junior Doctors is by what we call Locum.
A lot of Doctors will work extra shifts within the hospital, or sign up to a Locum agency and work additional shifts in other hospitals.
However, the caveat to that is there is a law that restricts you from working every hour that God gives because you need legally to have, I think, a rest of 11 hours per shift.
That's because if you were working a night shift and went straight to a day shift, your clinical intuition would not be at best.
You would be at risk of missing things and not providing a high level of care to patients.
And believe me, I did a lot of Locum shifts when I was training because it was the way we paid for exams, expensive courses, conferences, traveling to other countries to attend meetings, exams, all the rest of it.
Actually it's an expensive career, so you will find yourself throughout your time as a Junior Doctor taking on additional shifts.
We also now have exception reporting.
It's relatively new.
Essentially what that means is if you are consistently working above and beyond your contracted hours, there is a system in place, usually an app that allows you to log the hours, and the management will see that you're working every day an additional two hours, and you should be financially remunerated for that additional time.
That's great because Doctors spend a lot of time working and actually, frankly, the healthcare relies on the goodwill of Doctors.
Okay, so let's talk about where your salary goes before you actually get to spend it.
You've got mandatory deductions, and you've got somewhat optional deductions.
The main one, which obviously everybody knows, is the only certainty other than death, and that is tax.
You need to roughly understand the tax threshold.
In the UK, any additional salary earned above £50,000 is taxed at 40%.
You'll see Nodal point 4 or STE3 and above, roughly your pay is about £50,000.
So any additional salary earned, perhaps from Locums or additional work, will be charged at 40% tax.
So just bear that in mind.
Most Doctors are on what's called PAYE, which means you don't need to do anything to calculate your taxes.
Taxed at source is pay as you earn.
You don't get a say. It is what it is.
Next, you have your National Insurance contribution.
You don't get a say.
It's dependent on how much money you earn and you can expect to pay a couple of hundred pounds per month towards National Insurance.
The next mandatory is your student loan.
It took me about eight or nine years for me to pay mine off.
But now, obviously, students are coming through with much more debt, and so you need to bear that in mind.
On to the somewhat optional, some of them more optional than others, and those include things like your college memberships.
You can either pay that annually, or you can pay that monthly, and it works out to about £35, £40 a month, something like that.
I'm a member of the Royal College of Surgeons, but I'm also a member of the American Academy of Orthopedic Surgeons and the British Orthopedic Association.
So there were a lot of surgical societies or colleges that you almost have to be a member of, and they have expensive subscriptions and that is going to come out of your salary.
The next big one is your NHS pension.
You'll be paying a few hundred pounds every month into your NHS pension if you sign up for it.
The other not-so-optional is indemnity.
Every Doctor has to pay for legal cover, legal protection, and I pay for the Medical Defense Union, which is probably the most popular.
They become increasingly expensive the further you get on in your career.
General Medical Council
Every Doctor has to be registered with the GMC.
That's the General Medical Council, and that's the body that basically registers Doctors to practice and gives you your license.
You have to pay, no choice.
I pay about £400 per year.
You can either pay that in one lump sum, or you can spread it out throughout the year.
Either way, it's coming out of your salary.
Okay, and perhaps the most optional of all is income protection. It's like an insurance.
For example, if you were to get an injury to your hand and you were no longer able to perform surgery, then your insurance would pay out your salary for the rest of your working career.
What Kind Of Lifestyle Can You Live With This Salary
I guess the other question is what kind of lifestyle can you live with this salary?
And it completely depends where in the UK you choose to live.
Obviously, if you live in London, like I do, the cost of living is substantially higher.
However, I still think you can live okay.
I spent 10 years as a Junior Doctor.
And in that time I bought a home, got married, traveled, spent a lot of money becoming a Surgeon, went on various vacations.
Some Doctors, not all Doctors, are financially savvy and then getting that way and making investments elsewhere or even joining together and building groups.
But that's more on the business side, and we'll talk about that in other videos.
If you like the content, please be sure to like it, subscribe to the channel for more. Let me know in the comment section, if there was anything I missed out or you want to see in future videos. Be sure to check out the other videos, and check out my website, which is drjude.net.
See you in the next one.