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.

Does the pension annual allowance affect ST3-5 doctors?

Rarely on training pay. The £60,000 annual allowance is tested against the growth in the promised pension, not the contribution paid, and the 2015 scheme accrues 1/54th of each year of pensionable pay, so a trainee on these points builds a pension input amount far below the allowance. It becomes a question with a very large jump in pensionable pay in one year, such as arrears or a move to consultant pay, rather than with rota supplements.

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

Basic pay, nodal points 4b and 4c (ST4 and ST5): £67,998
Basic pay, nodal points 4a to 4c (ST3 to ST5): £67,325–£67,998
Take-home on that salary: £44,896 England, after the 12.5% NHS pension contribution, Income Tax and NI.

At £67,998, you earn about 74% above the UK full-time median (£39,039), placing you between the 75th percentile (£54,009) and the 90th percentile (£76,903) of UK full-time earnings.

See exact take-home for £67,998 →

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 £767 of additional pensionable pay: take-home does not recover to the ST3 figure until gross reaches about £68,765, 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.
Does the pension annual allowance affect ST3-5 doctors?: Rarely on training pay. The £60,000 annual allowance is tested against the growth in the promised pension, not the contribution paid, and the 2015 scheme accrues 1/54th of each year of pensionable pay, so a trainee on these points builds a pension input amount far below the allowance. It becomes a question with a very large jump in pensionable pay in one year, such as arrears or a move to consultant pay, rather than with rota supplements.

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Sources

NHS Employers - Pay and Conditions Circular (M&D) 1/2026 R2
DHSC, offer to the BMA UK resident doctors committee, June 2026
NHS Employers - NHS Pension Scheme member contribution rates
ONS - ASHE 2025 Table 14.7a, annual pay by SOC 2020 occupation (occupational pay)
ONS — Annual Survey of Hours and Earnings 2025 (UK full-time median and percentiles)
HMRC — Rates and thresholds 2026/27
Our full methodology & calculation sources →