The Short Answer
NHS doctor pay in one paragraph
Basic only
£36k – £145k
Foundation Year 1 to top of consultant scale.
With banding
+20% to +50%
Out-of-hours uplift, weekend allowance, locum work.
Pay rises
Yearly
Annual DDRB award plus one nodal-point increment per year.
Doctor Grade Ladder
From FY1 to consultant — how the ladder works
| Grade | Basic start | ||
|---|---|---|---|
Foundation Year 1 (FY1) Provisionally registered. Equivalent to internship year. | £36,616 | £36,616 | Provisionally registered. Equivalent to internship year. |
Foundation Year 2 (FY2) Full GMC registration achieved. Eligible for IMG entry post-FY2. | £42,008 | £42,008 | Full GMC registration achieved. Eligible for IMG entry post-FY2. |
Core / Speciality Trainee (CT1–ST2) First years of speciality training. Pay rises one nodal point per year. | £49,909 | £49,909 – £57,923 | First years of speciality training. Pay rises one nodal point per year. |
Higher Speciality Trainee (ST3–ST8) Registrar grade. Includes most IMGs joining via MTI or post-PLAB. | £61,825 | £61,825 – £70,425 | Registrar grade. Includes most IMGs joining via MTI or post-PLAB. |
Specialist / Specialty Doctor (SAS) Career-grade non-training role. Popular IMG entry point. | £59,175 | £59,175 – £95,400 | Career-grade non-training role. Popular IMG entry point. |
Specialist (2021 contract) Senior non-training career grade introduced in 2021. | £96,990 | £96,990 – £107,155 | Senior non-training career grade introduced in 2021. |
Consultant 8-point scale; CEAs & private practice on top. | £109,725 | £109,725 – £145,478 | 8-point scale; CEAs & private practice on top. |
Figures: NHS Employers Pay & Conditions Circular (M&D) 1/2026 — England. Verify the live figure before contract signing.
2026/27 Resident Doctor Scale
The nodal-point system, explained
Since the 2016 contract reform, resident doctors (formerly "junior doctors") move along a 5-point nodal-point scale rather than a per-year incremental ladder. Each nodal point corresponds to a stage in training, not a year of service. You stay on the same point across each training stage and step up when you progress.
- Nodal point 1 — FY1: £36,616
- Nodal point 2 — FY2: £42,008
- Nodal point 3 — CT1/2, ST1/2: £49,909
- Nodal point 4 — ST3/4: £61,825
- Nodal point 5 — ST5+: £70,425
Older 2002 contract incremental pay (with annual rises within a grade) still applies to some long-serving doctors. SAS doctors on the 2021 contract have their own scale.
Agenda for Change
NHS pay bands — what they are (and aren't)
NHS bands apply to non-medical staff — nurses, AHPs, scientists, managers — under Agenda for Change. Doctors are not on banded Agenda for Change pay. This table is for IMGs working alongside NHS colleagues so you understand who earns what.
| Band | Typical role | Min | Max |
|---|---|---|---|
| Band 2 | Healthcare assistant, ward clerk | £24,169 | £25,674 |
| Band 3 | Senior HCA, medical secretary | £24,937 | £26,598 |
| Band 4 | Assistant practitioner, pharmacy technician | £26,530 | £29,114 |
| Band 5 | Newly qualified nurse, AHP, paramedic | £29,970 | £36,483 |
| Band 6 | Senior nurse, specialist AHP, midwife | £37,338 | £44,962 |
| Band 7 | Advanced practitioner, ward manager | £46,148 | £52,809 |
| Band 8a | Consultant nurse, principal pharmacist | £53,755 | £60,504 |
| Band 8b | Head of service | £62,215 | £72,293 |
| Band 8c | Deputy director, divisional lead | £74,290 | £85,601 |
| Band 8d | Service director | £88,168 | £101,677 |
| Band 9 | Executive lead, chief AHP/nurse | £105,385 | £121,271 |
Source: Agenda for Change pay rates 2026/27 (England). HCAS supplements in inner/outer London add £4,888 – £7,694 to Bands 1–9.
Banding & Supplements
What gets added on top of basic
+37% to +90% of basic
Out-of-hours uplift
Resident doctors on the 2016 contract receive a percentage uplift on top of basic pay for nights, evenings, weekends, and on-call.
+1% to +15%
Weekend allowance
Paid if you work 1 in 8 weekends or more frequently. Tiered by frequency.
+£2,162
London weighting
Flat supplement for posts inside the M25. Applied as a non-pensionable allowance.
£3,016 – £37,470
Clinical Excellence Awards (CEA)
Consultant-grade national awards for above-and-beyond clinical work. Pensionable. Highly competitive.
£40 – £100+ /hr
Locum & WLI rates
Waiting List Initiative shifts and bank locum work are paid above contracted rate. Common income boost for IMG SAS doctors.
Up to £8,000
Relocation package
Trusts may reimburse relocation costs; check before signing. IMG-friendly trusts often include flights, first month's rent, and shipping.
Take-Home Reality
What lands in your account each month
Worked example — ST3 doctor, no London weighting
| Basic pay (ST3 nodal point 4) | £61,825 |
| + Out-of-hours uplift (37%) | £14,841 |
| + Weekend allowance (1:6 weekends) | £3,709 |
| Gross annual | £80,375 |
| − Income tax | −£18,565 |
| − National Insurance | −£4,275 |
| − NHS pension (12.5%) | −£7,728 |
| Net take-home (annual) | £49,807 |
| Net monthly | ~£4,150 |
Illustrative only. Assumes standard tax code, no student loan, full NHS pension opt-in. Use an official HMRC or NHS take-home calculator for your exact circumstances.
IMG Reality Check
What you'll actually earn as an IMG joining the NHS
IMG Entry Point
Post-PLAB Trust Grade SHO
£49,909
~£62,000 with banding
Most common IMG first post. Equivalent to ST1–ST2 nodal point.
IMG Entry Point
Specialty Doctor (SAS)
£59,175
~£73,000 with banding & locum
Career grade. Stable, no rotations, IMG-friendly trusts.
IMG Entry Point
ST3 in shortage specialty
£61,825
~£80,000 with banding
Psychiatry, geriatrics, EM, GP — fast-track IMG routes.
10-Year Trajectory
What an IMG earns over a decade in the NHS
Year 1
Post-PLAB SHO
Total gross: ~£62,000
Year 2–3
CT1–CT2 / Trust Grade
Total gross: ~£68,000
Year 4–5
ST3–ST4 registrar
Total gross: ~£80,000
Year 6–7
ST5–ST6 registrar
Total gross: ~£91,000
Year 8
CCT — Consultant year 1
Total gross: ~£120,000
Year 10
Consultant + 1 CEA + locum
Total gross: ~£145,000+
FAQ
Salary questions IMGs ask us most
+How much does an NHS doctor earn UK?
Basic NHS doctor pay in 2026/27 ranges from £36,616 (FY1) to £145,478 (top of consultant scale). Most IMGs joining post-PLAB enter at ST3–ST5 (£61,825–£66,127) or SAS grade (£59,175+). Total earnings rise 30–50% above basic once out-of-hours uplifts, weekend allowance, and locum work are included.
+What is the salary of an IMG doctor in the NHS?
An IMG taking up a Trust Grade or SAS post after passing PLAB typically starts at £59,175 (Specialty Doctor minimum) plus banding. Those entering training at ST1 start at £49,909, while doctors with substantial overseas experience may negotiate ST3+ (£61,825+). Add 20–37% for typical on-call commitments.
+What are NHS pay bands?
NHS pay bands (Band 2 to Band 9) apply to non-medical NHS staff under Agenda for Change — nurses, AHPs, managers, scientists. Doctors and dentists are paid on a separate medical pay scale, not on Agenda for Change bands. Confusing this is the most common mistake IMGs make when researching salary.
+How does NHS doctor pay compare to private practice?
Consultants typically earn 30–60% more by combining NHS work with private practice. Common private earnings sit between £15,000 and £200,000+ per year on top of NHS basic. Resident doctors cannot legally undertake private medical work outside their contract.
+What is the new resident doctor contract?
The 2016 contract — renamed in 2024 from 'junior doctor' to 'resident doctor' — pays nodal-point basic plus percentage uplifts for non-standard hours. The BMA and government continue to negotiate pay restoration. Figures here reflect the 2026/27 deal; check the NHS Employers pay circular for live updates.
+Do IMG doctors get paid the same as UK graduates?
Yes. Pay scales are determined by grade, not country of qualification. An ST3 doctor earns £61,825 whether they qualified in Mumbai, Lagos, or Manchester. Where IMGs sometimes lose out is via slower CV-to-grade matching — IMG2NHS helps you avoid being placed below your true experience.
+What's the take-home pay for an NHS doctor?
An ST3 on £61,825 basic typically takes home around £43,000–£46,000/year after income tax, National Insurance, NHS pension (9.8–12.5%), and student loan (if applicable). Add £8,000–£14,000 net for typical banding. Use an NHS-specific take-home calculator for an exact figure.
+How often does NHS pay rise?
Pay scales are reviewed annually by the Doctors' and Dentists' Review Body (DDRB). 2025/26 brought a 6% award for resident doctors; 2026/27 added a further 4% with separate negotiations ongoing on pay restoration. Within a grade, you also move up one nodal point each year.
Your next step
Find the NHS grade that matches your background.
Take our 2-minute eligibility quiz. We'll tell you which NHS grade your overseas experience maps to — and which IMG entry route gets you there fastest.
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