Understanding the Junior Doctors Salary: Advertised Pay vs Take-Home Pay in 2026/27

Understanding the Junior Doctors Salary: Advertised Pay vs Take-Home Pay

If you are a medical student about to start your foundation training or a doctor considering a move to the NHS, you have probably seen headlines about the junior doctors salary and wondered what you will actually take home each month. The truth is that the advertised figure – the basic salary – is only part of the picture. Additional payments for unsocial hours, on-call duties, and location can boost your total earnings significantly, while tax, National Insurance, and pension contributions reduce what lands in your bank account.

This guide explains the 2026/27 pay scales for resident doctors (the official term for junior doctors) in England, how to interpret the numbers, and what to expect in practice.

What Is the Advertised Junior Doctors Salary for 2026/27?

From 1 April 2026, the basic pay for a Foundation Year 1 (FY1) doctor is £41,226 per year. This is a 6.2% increase on the previous year’s £38,831. For Foundation Year 2 (FY2), the basic salary rises by 7.1% compared to the old FY2 scale. More experienced resident doctors, such as those in ST8, have a basic salary of £77,348 – a 4.5% increase.

These figures come from the government’s acceptance of the DDRB recommendation combined with a separate agreement between the government and the BMA. The pay structure for doctors in training has also been reformed: instead of five nodal points, there are now ten points aligned with each stage of training, meaning more frequent pay rises as you progress.

Consultants and specialty doctors received a 3.5% basic pay increase for 2026/27.

How Location Affects Your Pay

If you work in London or the surrounding fringe areas, you receive a Higher Cost Area Supplement (HCAS) on top of your basic salary:

• Inner London: 20% of basic salary (minimum £5,794, maximum £8,746)
• Outer London: 15% (minimum £4,870, maximum £6,137)
• Fringe: 5% (minimum £1,346, maximum £2,270)

For an FY1 doctor in inner London, that means an extra £8,245 on top of the £41,226 basic – a total of £49,471 before any other extras.

The Gap Between Advertised and Take-Home Pay

Your advertised salary is the gross basic pay for a standard 40-hour week (including some built-in unsocial hours). But most resident doctors work additional contracted hours, nights, weekends, and on-call shifts. According to the Department of Health and Social Care, these extras can increase earnings for FY1 doctors by 26% on average.

So a typical FY1 doctor might earn:

• Basic salary: £41,226
• Unsocial hours and on-call: ~£10,700 (26% of basic)
• Total gross: ~£51,926

From that, you deduct:

• Income tax (20% on earnings above £12,570 personal allowance)
• National Insurance (8% on earnings between £12,570 and £50,270)
• NHS pension contribution (9.3% of pensionable pay)

Your monthly take-home might be around £3,000–£3,200, depending on exact hours and deductions.

Other Payments That Boost Your Salary

The 2026 offer also includes:

• Flexible Pay Premia: up to £10,000 for trainees who complete an approved higher degree and return to clinical training.
• Reimbursement of mandatory Royal College portfolio fees and examination costs – often worth thousands of pounds.
• Less-than-full-time allowance: £1,000 per year for doctors training part-time.

These are not included in the advertised salary but can significantly improve your overall compensation.

How the Junior Doctors Salary Compares to Other NHS Roles

For context, the National Living Wage for 2026/27 is £12.71 per hour for workers aged 21 and over. An FY1 doctor’s basic hourly rate (based on a 37.5-hour week) is about £21.10 – well above the minimum. But remember that junior doctors often work longer hours and have significant responsibilities.

Other NHS staff on Agenda for Change bands earn less: for example, a Band 5 nurse starts at £38,488 (entry) and tops out at £46,852. A Band 6 nurse starts at £47,951. Resident doctors’ pay is comparable to or higher than many clinical roles, especially when extras are included.

Key Takeaways for Job Seekers

• The junior doctors salary advertised is basic pay only. Always ask about expected additional earnings during recruitment.
• Take-home pay depends on your tax code, pension choice, and student loan repayments.
• Location supplements can make a big difference – inner London adds up to £8,746.
• The new pay structure means more frequent pay rises as you progress through training stages.

For more detailed pay data, see our pay data page. If you are comparing NHS roles, our pay guides explain how different contracts work.

Frequently Asked Questions

What is the starting junior doctors salary for 2026/27? For Foundation Year 1 (FY1) doctors starting in August 2026, the basic advertised salary is £41,226 per year. This is a 6.2% increase from the previous year. However, most FY1 doctors earn significantly more through additional payments for unsocial hours, on-call duties, and location supplements. On average, these extras can boost total earnings by around 26%.

How does the advertised junior doctors salary compare to take-home pay? The advertised salary is the basic full-time rate before deductions. Take-home pay is lower after income tax, National Insurance, and NHS pension contributions (typically around 9.3% of basic pay). However, additional earnings from unsocial hours, weekend work, and on-call allowances are paid on top of basic pay, so total gross pay can be substantially higher than the advertised figure. For example, a FY1 doctor earning £41,226 basic might see total gross pay of £51,000 or more if they work regular unsocial hours. After deductions, take-home might be around £3,000–£3,200 per month, depending on individual circumstances.

What additional payments can increase a junior doctors salary beyond basic pay? Junior doctors can receive several additional payments: unsocial hours enhancements (e.g., nights, weekends, bank holidays), on-call allowances (which have been recalculated under the new pay structure), Higher Cost Area Supplements (HCAS) for London and fringe areas (up to 20% of basic salary), flexible pay premia of up to £10,000 for completing an approved higher degree, and reimbursement of mandatory Royal College portfolio fees and examination costs. These extras mean that actual earnings often exceed the advertised basic salary.

Sources

• NHS Employers: Pay scales for 2026/27
• Department of Health and Social Care Media Centre: Government offer to resident doctors – explainer
• BMA: A guide to the June 2026 offer from Government
• NHS Employers: Pay and Conditions Circular (M&D) 1/2026 R2
• GOV.UK: National Minimum Wage and National Living Wage rates