Joining the NHS as an International Doctor: Understanding Your Earnings
If you’re planning to join the NHS as an International Medical Graduate (IMG), one of your first questions will likely be about your salary. The good news is that NHS doctors in the UK earn competitive salaries, particularly those in senior roles. As a doctor moving to the UK, you can expect to earn well above the national average salary.
But exactly how much can you expect to take home? This is determined by the NHS medical pay scales, which outline your basic pay and any additional earnings for extra hours worked.
What Are NHS Pay Scales?
NHS pay scales are structured frameworks used to calculate salaries for NHS staff, including doctors. These scales vary depending on the role, experience, and responsibilities of the individual. Each pay scale provides a breakdown of:
- Basic salary
- Additional earnings for extra hours, shifts, or on-call duties
For doctors, these additional earnings may include uplifts, bandings, enhancements, or supplements.
How Do NHS Pay Scales Work?
Pay scales are based on several factors, including:
- Your role (e.g., junior doctor, consultant)
- Your level of experience
As you progress in your career, you’ll move up the pay scale. Progression often depends on gaining additional experience, completing specialist training, or advancing to a new role. Each step typically results in a higher salary.
Which Pay Scale Applies to You?
Your pay scale is determined by your specific job offer. When you receive an offer, review the pay scale carefully to understand your basic pay and any additional allowances.
It’s also important to remember that progression within a pay scale may require documentation, such as proof of previous experience or relevant qualifications. This can help you avoid starting at the lower end of the scale unnecessarily.
NHS Pay Scales for Doctors
Here are the key details about pay scales relevant to doctors working in the NHS:
2016 NHS Junior Doctor Contract Pay Scale
This pay scale replaced the older 2002 framework and allows doctors to move up the scale as they advance in their careers.
- Foundation Year 2 (FY2): Starting salary is £32,398 (grade code MF01).
- Specialty Training Year 1 (ST1) and Core Training Year 1 (CT1): Salary increases to £43,923 (grade codes MS01 and MC51).
- Specialty Training Year 8 (ST8): Salary reaches £63,152 (grade code MS08).
While pay increases may not occur frequently, they often involve substantial jumps, offering significant financial rewards as you progress.
Key Takeaways
When considering a role within the NHS, understanding your pay scale is essential. Ensure you review the scale relevant to your position, as it impacts both your starting salary and future earnings. Being informed can help you plan your career and ensure you’re rewarded fairly for your skills and experience.
| Grade | Stage | Grade Code | Nodal Point | Salary |
| Foundation Year 1 | FY1 | MF01 | 1 | £36,616 |
| Foundation Year 2 | FY2 | MF02 | 2 | £42,008 |
| STR – Core Training | CT1 | MC51 | 3 | £49,909 |
| CT2 | MC52 | 3 | £49,909 | |
| CT3 | MC53 | 4 | £61,825 | |
| CT4 | MC54 | 4 | £61,825 | |
| STR – Runthrough | ST1 | MS01 | 3 | £49,909 |
| ST2 | MS02 | 3 | £49,909 | |
| Speciality Registrar – SPR | ST3 | MS03 | 4 | £61,825 |
| ST4 | MS04 | 4 | £61,825 | |
| ST5 | MS05 | 4 | £61,825 | |
| ST6 | MS06 | 5 | £70,425 | |
| ST7 | MS07 | 5 | £70,425 | |
| ST8 | MS08 | 5 | £70,425 |
In addition to your basic salary, you’ll receive extra payments for:
- Additional hours: Paid at 1/40th of your basic weekly pay rate per hour worked.
- Enhanced hours: Paid at 37% above your standard hourly rate for qualifying shifts.
- Weekend allowance: Calculated as a percentage uplift on your basic pay, depending on the amount of weekend work required.
| NHS Weekend On-Call Frequency | Percentage |
| 1 in 2 Weekends | 15% |
| Less than 1 in 2 and greater than or equal to 1 in 3 weekends | 10% |
| Less than 1 in 3 and greater than or equal to 1 in 4 weekends | 7.5% |
| Less than 1 in 4 and greater than or equal to 1 in 5 weekends | 6% |
| Less than 1 in 5 and greater than or equal to 1 in 6 weekends | 5% |
| Less than 1 in 6 and greater than or equal to 1 in 7 weekends | 4% |
| Less than 1 in 7 and greater than or equal to 1 in 8 weekends | 3% |
| Less than 1 in 8 weekends | None |
If you participate in an NHS on-call rota, you’ll receive a flat-rate uplift added to your basic salary. The amount is determined by your nodal point on the relevant pay scale.
| Nodal Point | Amount |
| 1 | £2,592 |
| 2 | £2,985 |
| 3 | £3,514 |
| 4 | £4,427 |
| 5 | £5,053 |
2002 NHS Junior Doctor Contract Pay Scale
The 2002 NHS Junior Doctor Contract Pay Scale, often referred to as the MN37 scale, is an older framework that is no longer assigned to new entrants. However, it may still apply to certain longstanding vacancies, so it’s worth mentioning.
Under this pay scale, the basic salary is determined by years of experience. International Medical Graduates (IMGs) must provide evidence of equivalent overseas experience to qualify for placement at the higher end of the scale.
| Years of Experience | FY1 | FY2 | Core Trainee | Speciality Registrar |
| Minimum | £32,082 | £39,222 | £41,750 | £41,750 |
| 1 | £33,936 | £41,632 | £44,159 | £44,159 |
| 2 | £35,790 | £44,041 | £47,524 | £47,524 |
| 3 | £49,559 | £49,559 | ||
| 4 | £52,013 | £52,013 | ||
| 5 | £54,468 | £54,468 | ||
| 6 | £56,923 | |||
| 7 | £59,377 | |||
| 8 | £61,833 | |||
| 9 | £64,288 |
This pay scale is unique in that it applies banding to determine additional allowances. Banding calculates the uplift percentage based on the hours worked and whether they fall within more or less antisocial hours. For instance, Band 1A applies to shifts of 40-48 hours, predominantly during antisocial hours, and provides a 50% uplift.
| Band | Average Amount and Nature of Hours | Uplift |
| 3 | More than 56 hours per week or not achieving required rest | 100% |
| 2A | 48-56 hours per week – most antisocially | 80% |
| 2B | 48-56 hours per week – least antisocially | 50% |
| 1A | 40-48 hours per week – most antisocially | 50% |
| 1B | 40-48 hours per week – moderately antisocially | 40% |
| 1C | 40-48 hours per week – least antisocially | 20% |
| No Band | No more than 40 hours per week on average | 0% |
2021 NHS Specialty Doctor Pay Scale
This pay scale is designed for doctors who have completed their foundation and early core/specialty training years, typically applying to doctors at the equivalent of grade ST3 and above.
The 2021 NHS Specialty Doctor Pay Scale (MC75 scale) consists of various pay increments, determined by years of experience. Doctors usually begin at the lower end of the scale and progress over time unless they can demonstrate equivalent experience from their home healthcare system. For example, with one year of experience at the ST3+ level, you would earn £55,825; with 18 years of experience, you could earn around £90,000.
Pay and Conditions Circular (M&D) 9/2024
| Grade Code | Years of Experience | Basic Salary |
| MC75-01 | 0 | £59,175 |
| MC75-02 | 1 | £59,175 |
| MC75-03 | 2 | £59,175 |
| MC75-04 | 3 | £68,174 |
| MC75-05 | 4 | £68,174 |
| MC75-06 | 5 | £68,174 |
| MC75-07 | 6 | £75,998 |
| MC75-08 | 7 | £75,998 |
| MC75-09 | 8 | £75,998 |
| Threshold | Threshold | Threshold |
| MC75-10 | 9 | £84,121 |
| MC75-11 | 10 | £84,121 |
| MC75-12 | 11 | £84,121 |
| MC75-13 | 12 | £95,400 |
| MC75-14 | 13 | £95,400 |
| MC75-15 | 14 | £95,400 |
| MC75-16 | 15 | £95,400 |
| MC75-17 | 16 | £95,400 |
| MC75-18 | 17 | £95,400 |
Other allowances are calculated in Programmed Activities (PAs), which are four-hour work blocks. Your basic salary includes ten PAs, equating to a 40-hour work week. Any additional PAs beyond that are paid with a 10% uplift.
Specialist Doctor Pay Scale
The Specialist Doctor Pay Scale (MC70 scale) was introduced in 2021 to offer a more attractive option for recruiting highly experienced senior doctors.
To qualify for this scale, you must demonstrate that your experience matches the level of an NHS specialist doctor. Once confirmed, you’ll begin on the scale according to your relevant years of experience.
Pay and Conditions Circular (M&D) 9/2024
| Grade Code | Years of Experience | Basic Salary |
| MC70-01 | 0 | £96,990 |
| MC70-02 | 1 | £96,990 |
| MC70-03 | 2 | £96,990 |
| MC70-04 | 3 | £100,784 |
| MC70-05 | 4 | £100,784 |
| MC70-06 | 5 | £100,784 |
| MC70-07 | 6 | £107,155 |
Other allowances include any additional PAs beyond the initial ten, which are paid with a 10% uplift. There is also an on-call allowance, which comes with an uplift. The percentage of the uplift depends on the nature and frequency of the on-call duties.
| Frequency | Category A | Category B |
| More frequent or equal to 1 in 4 | 8% | 3% |
| 1 in 4 through to 1 in 8 | 5% | 3% |
| Less frequent than 1 in 8 | 3% | 1% |
Consultant Pay Scale
A consultant is the most senior position in NHS hospitals. Consultants begin at the lowest point of the pay scale (YC72-00 or YC73-00) once they qualify at that level and then progress with experience over the years. If you prefer not to start at the bottom, you’ll need to provide evidence of equivalent experience to be placed at a higher point on the pay scale.
| Grade Code | Years of Experience | Basic Salary |
| YC72 / YC73 Point 00 | 0 | £105,504 |
| YC72 / YC73 Point 01 | 1 | £105,504 |
| YC72 / YC73 Point 02 | 2 | £105,504 |
| YC72 / YC73 Point 03 | 3 | £111,714 |
| YC72 / YC73 Point 04 | 4 | £114,894 |
| YC72 / YC73 Point 05 | 5 | £114,894 |
| YC72 / YC73 Point 06 | 6 | £114,894 |
| YC72 / YC73 Point 07 | 7 | £114,894 |
| YC72 / YC73 Point 08 | 8 | £126,018 |
| YC72 / YC73 Point 09 | 9 | £126,018 |
| YC72 / YC73 Point 10 | 10 | £126,018 |
| YC72 / YC73 Point 11 | 11 | £126,018 |
| YC72 / YC73 Point 12 | 12 | £126,018 |
| YC72 / YC73 Point 13 | 13 | £126,018 |
| YC72 / YC73 Point 14 | 14 | £139,882 |
| YC72 / YC73 Point 15 | 15 | £139,882 |
| YC72 / YC73 Point 16 | 16 | £139,882 |
| YC72 / YC73 Point 17 | 17 | £139,882 |
| YC72 / YC73 Point 18 | 18 | £139,882 |
| YC72 / YC73 Point 19 | 19 | £139,882 |
For any additional PAs beyond ten, you’ll receive a 10% uplift.
