UK Junior Doctor Salary 2026/27

Overview of UK junior doctor pay

"Junior doctor" is the historical name for every NHS doctor below consultant or specialist-and-associate-specialist grade - that is, from the first day of foundation training (F1) up to the last day of specialty training (ST8) before consultant award. In late 2024 the BMA and NHS England formally rebranded the grade to "resident doctor" in recognition that many cohort members are five to ten years post-graduation and not new junior staff. Both terms are in active use across pay circulars, contracts, GMC trainee survey materials and recruitment portals in 2026, and the underlying employment contract (the 2016 Junior Doctor Contract, as amended by the 2023, 2024 and 2025 deals) has not been renamed.

Pay is set on a national pay spine called the nodal pay scale, which replaced the old service-incremental spine in the 2016 contract reform. The nodal system keys basic pay to training grade rather than years of service: F1 sits at nodal point 1, F2 at nodal point 2, core training (CT) or first two years of specialty training (ST1-2) at nodal point 3, registrar entry (ST3-5) at nodal point 4, and senior registrar (ST6-8) at nodal point 5. Pay rises in steps as a doctor progresses through grades; there is no annual increment within a grade. Locally Employed Doctors (LEDs) and trust-grade doctors are paid on the nodal scale at the grade their post is calibrated against.

The annual uplift mechanism is the Review Body on Doctors' and Dentists' Remuneration (DDRB), which takes evidence from NHS Employers, the BMA Resident Doctors Committee and the Department of Health and Social Care, then publishes an annual recommendation. Following the 2023 to 2025 industrial action campaign, the BMA negotiated multi-year deals with both UK Government (England) and the devolved administrations. The 2024 England deal closed with an 8.8 percent average cumulative uplift to nodal pay, taking effect April 2024. The 2025/26 NHS England pay circular consolidated a further 6 percent uplift. Figures on this page reflect the 2025/26 circular as the most recent published settlement; the 2026/27 DDRB review remains open at the time of writing.

Banding supplements and additional pay

The headline nodal basic pay rarely describes what a resident doctor actually earns, because most NHS rotas attract a banding supplement. Banding is a fixed-percentage uplift on basic pay that compensates for unsocial hours, frequency of out-of-hours duty, on-call commitments and weekend work. The supplement is consolidated into monthly pay and is pensionable for NHS Pension Scheme 2015 purposes (meaning it accrues toward retirement income at the standard 1/54 CARE rate).

The current banding categories are:

• Band 1A - 40 percent supplement. The most common rota in busy acute trusts (medicine, surgery, paediatrics, emergency medicine).
• Band 1B - 40 percent supplement, with a softer pattern of out-of-hours work than 1A.
• Band 1C - 20 percent supplement. Lighter rota, typically in specialties with infrequent on-call (some clinical pharmacology, audit posts).
• Band 2A / 2B - 50 percent and 40 percent respectively. Less common; reserved for rotas exceeding very specific frequency criteria under the 2002 contract (legacy population is small in 2026).
• Band 3 - 100 percent supplement. Effectively obsolete; band 3 rotas were non-compliant with the European Working Time Directive and have been redesigned out across the NHS.
• No banding - day-time-only specialties (some GP training rotations, occupational health, public health, some research posts).

The practical impact of banding is substantial. An F2 on the 2025/26 nodal 2 basic of £44,550 working a band 1A rota receives £62,370 total pensionable pay. On a band 2A rota, it is £66,825. The supplement is taxed and NI'd at the marginal rate exactly like base pay, but because banded income is also pensionable, the higher gross also pushes the NHS Pension contribution into a higher tier band, a point readers often miss.

Worked F2 banding example

All figures via the salary engine for England, 2026/27. Pension column shows the NHS Pension 2015 tier appropriate to the banded pensionable total.

Note the impact of the NHS Pension net-pay arrangement: contributing 12.5% on a banded total of £62,370 costs only about £4,522 a year in take-home (versus the £7,796 headline contribution), because Income Tax relief at 20 to 40 percent reclaims the difference. That is the most efficient pension contribution route available to NHS staff, which is why opting out is almost always financially worse over a career.

England vs Scotland vs Wales vs Northern Ireland

All four UK nations have separate resident-doctor pay deals negotiated with their devolved health departments and the BMA. The deal terms diverged sharply after 2022, when the Scottish Government settled first with a multi-year deal that restored real-terms pay to 2008 levels (a cumulative roughly 12.4 percent uplift versus the prior baseline). Wales settled later in 2024 with a deal that closely tracks the England nodal scale. Northern Ireland has been in protracted negotiation through 2025 and no consolidated 2025/26 settlement was in place at the time of writing.

For comparison purposes the table below holds the gross figure constant at the England 2025/26 ST3 nodal-4 basic (£65,565), which isolates the income-tax-system delta rather than the basic-scale delta. In practice a Scottish ST3 will be paid on a slightly different (typically higher) basic scale, so the headline gross comparison would be even more favourable to Scotland than the table suggests.

Scotland's 42 percent intermediate rate kicks in at £43,663 (significantly below the rUK 40 percent higher-rate threshold of £50,270), and the 45 percent higher band starts at £75,000, so a Scottish ST3 on equivalent gross takes home less from the same headline figure. The Scottish basic scale offsets this through the 2024 deal uplift: a Scottish ST3 is paid more in gross than the comparable England point, so total take-home is typically close to par. Wales follows rUK Income Tax under the 2022 Welsh Rates of Income Tax framework (which currently mirrors England percentage-for-percentage) and is functionally identical to England take-home at the same gross. Northern Ireland uses rUK rates exactly.

NHS Pension Scheme 2015 (CARE)

Every resident doctor working for an NHS trust in England, Scotland, Wales or HSC Northern Ireland is automatically enrolled in the NHS Pension Scheme 2015. This is a Career Average Revalued Earnings (CARE) defined benefit scheme, which means each year of service earns a defined slice of guaranteed retirement pension, rather than building up a capital pot like a defined contribution scheme. The accrual rate is 1/54 of pensionable earnings per year. Each accrued slice is revalued annually in line with CPI plus 1.5 percent during active service, and CPI alone after leaving.

Employee contributions are tiered by pensionable pay. The tier you fall in is set against your pensionable earnings each year, including banding supplements (since banding is pensionable). The current tiered table from April 2024 is:

The employer contributes a further 23.7 percent of pensionable pay (rate set by the quadrennial actuarial valuation; the 23.7 percent figure applies from April 2024). Combined with the employee tier, total contribution to the scheme is around 33 to 37 percent of pensionable pay, substantially higher than any private-sector defined contribution arrangement. An F2 on banded pay of around £62,370 effectively receives roughly £14,782 a year in employer pension contribution, which does not appear on the payslip but accrues toward retirement income.

Contributions are taken under the net-pay arrangement, meaning they reduce taxable income before PAYE deducts Income Tax. This gives full Income Tax relief at the marginal rate. NI relief is not given on net-pay contributions, only Income Tax relief, so an additional rate taxpayer effectively receives 45 percent of every contributed pound back as Income Tax relief, while a basic rate taxpayer receives 20 percent back. Normal Pension Age in the 2015 scheme equals the member's State Pension Age (currently rising from 66 to 67 between 2026 and 2028 and to 68 between 2044 and 2046 under the Pensions Act).

The McCloud remedy resolved age discrimination in the 2015 transition: pre-2015 1995 and 2008 Section members who were not moved across to 2015 (because they were within 10 years of legacy retirement age) were retrospectively given a choice of accruing benefits in their legacy section or in 2015 for the remedy period 2015 to 2022. New joiners from 1 April 2022 onward are all on the 2015 scheme only; the McCloud choice applies only to legacy members.

Comparison vs similar public-sector roles

Resident doctor pay sits noticeably above the UK median full-time salary at all grades from F2 upward. An F1 on £38,831 basic is comparable to a newly-qualified NHS Band 5 nurse plus modest enhancement, or a chartered accountant trainee finishing ACA. An F2 on banded £62,370 is well above the public-sector mid-career average and broadly equivalent to a Civil Service Grade 7 or a senior teacher on the upper pay range. An ST3 registrar on £65,565 basic (or roughly £91,791 with band 1A) is in the same band as a senior software engineer in London tech or a senior solicitor at 5 years PQE.

What sets NHS pay apart from comparable salaries elsewhere is the pension scheme. The combined 23.7 percent employer plus 9.8 to 14.7 percent employee contribution to the NHS Pension 2015 (so roughly 33 to 38 percent total) is approximately four to five times the typical private-sector workplace DC pension contribution of 8 percent combined. Over a 35-year career this builds a defined benefit pension that is inflation-linked, guaranteed, and not subject to investment market risk. The deferred value of this is rarely surfaced in headline pay comparisons but represents a substantial portion of true total compensation.

• Police officer pay - federated police pay scales, London weighting, Police Pension 2015.
• Experienced teacher (UPS) - upper pay range teacher comparable to F2 plus banding.
• Civil Service Grade 7 - mid-career civil servant similar to F2 banded total.
• Senior NHS Consultant - consultant pay scale, what F1 to F2 to ST3 to ST8 ultimately leads to.
• NHS Band 7 nurse - advanced nurse practitioner pay, similar Agenda for Change framing.
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