ST3-5 Specialty Trainee Salary 2026/27
ST3-5 covers mid-specialty training, typically registrar grade. Basic pay in England for 2026 to 2027 is £67,325 at ST3 (nodal point 4a) and £67,998 at ST4 and ST5 (4b and 4c). Rota supplements are paid on top of basic.
Typical pay & take-home
- Median gross
- £67,998
- Typical range
- £67,325–£67,998
- Take-home at median
- £49,996 England, no pension applied — use the salary calculator for your scheme.
At the median for this profession, you earn about 74% above the UK full-time median (£39,039), placing you in the top 16% of UK earners.
What influences st3-5 specialty trainee doctor pay
The step from ST3 to ST4 is worth £673 of basic pay, and it costs money. £67,998 is above the £67,668 NHS pension threshold, so the contribution tier jumps from 10.7% to 12.5% - and the tier applies to all pensionable pay, not just the slice above. Take-home falls from about £45,284 at ST3 to about £44,896 at ST4, a loss of £388 a year on a pay rise.
Getting back past that cliff takes about £1,118 of additional pensionable pay: take-home does not recover to the ST3 figure until gross reaches roughly £69,116, and a rota supplement will usually cover the gap. It is a real effect of banded contributions rather than a quirk of this particular scale, and it recurs at every tier boundary.
Basic pay is above the £50,270 higher-rate threshold even after the pension contribution, so the marginal rate on rota supplements is 42% - 40% Income Tax plus 2% National Insurance.
Career progression
- FY1 £41,226, FY2 £47,610.
- ST1 and ST2: £55,355.
- ST3 £67,325, ST4 and ST5 £67,998.
- ST6 £76,582, ST7 and ST8 £77,348.
- Consultant (2003 contract): £113,565 rising to £150,569.
Frequently asked questions
- What does an ST3-5 doctor take home 2026/27?
- At ST3 on £67,325 with the 10.7% pension tier, take-home is about £45,284 a year or £3,774 a month. At ST4 and ST5 on £67,998 the 12.5% tier applies and take-home is about £44,896 - lower, despite the higher basic. Rota supplements are paid on top of both.
- When should I think about Lifetime Allowance / pension annual allowance?
- Pension annual allowance (£60,000) becomes a real consideration at ST3-5 because rota uplifts can push pensionable pay high enough that the DB-scheme pension input amount exceeds the allowance in some specialty/year combinations. Senior trainees should request a Pension Saving Statement annually from NHS Pensions if concerned.