Guidance

Hospital doctor pay scales for 2018/2019

The Conservative Government awarded a pay rise of 1.5% for 2018/2019 in England for consultants.

However, the uplift for the 2003 consultant contract was only effective from 1 October 2018 and has not been backdated to 1 April 2018.

This means that the effective value of the uplift for this year is 0.75%.

NHS pay was frozen in 2012 and 2013, and since 2014 rises have been limited to 1%.

Consultant pay scales and CEAs are set to change with the launch of a much-delayed new contract in 2019, after years of negotiation between the Government and the BMA.

The Government has been committed to introducing ‘seven-day services’ among medical staff – without increasing the pay envelope.

Consultant (2003 contract) basic salary

Threshold            Years completed  Basic salary (£)  Next threshold

1                             0                               77,913                  1 year

2                             1                                80,352                 1 year

3                             2                                82,792                 1 year

4                             3                                85,232                  1 year

5                             4                                 87,655                 5 years

6                             9                                 93,459                 5 years

7                             14                               99,254                 5 years

8                             19                               105,042                 –

Clinical Excellence Awards

Awarded by local committees

Level 1                  3,016

Level 2                  6,032

Level 3                  9,048

Level 4                  12,064

Level 5                  15,080

Level 6                  18,096

Level 7                  24,124

Level 8                  30,160

Level 9                  36,192

Awarded by ACCEA

Level 9 (Bronze)               36,192

Level 10 (Silver)                47,582

Level 11 (Gold)                  59,477

Level 12 (Platinum)           77,320

Specialty Doctor Pay Scale

Scale value          Basic salary (£)   Period before next pay point

Min                        39,060                  1 year

1                             42,400                 1 year

2                             46,742                 1 year

3                             49,069                 1 year

4                             52,422                 1 year

Threshold 1

5                             55,762                  2 years

6                             59,177                  2 years

7                             62,593                  2 years

Threshold 2

8                             66,009                  3 years

9                             69,424                  3 years

10                           72,840                   –

Trainee Doctors Basic Pay Scales (2016 Contract)

FY1

Nodal Point 1             27,146

FY2

Nodal Point 2             31,422

CT1-CT2

Nodal Point 3             37,191

CT3

Nodal Point 4             47,132

ST1-ST2

Nodal Point 3             37,191

ST3-ST8

Nodal Point 4            47,132

Read the full pay scales, including Weekend Allowances and On-call Availability Allowance.

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186 Responses to “Hospital doctor pay scales for 2018/2019”

  1. OrthoSpR says:

    The problem I fundamentally have is the duplicity and double standards in the way the medical profession has been recently reformed…

    On the one hand, professional autonomy, self governance of our working hours and consequently some pay has been taken away from us…

    …on the other hand people complain when we then insist on being payed for the roles and hours that have been imposed on us…

    Surgical training is a prime example – the reduction in hours means that less junior doctors are on the wards, consequently, more senior doctors that should be training in theatre and clinics are covering their duties and not getting trained. The ‘old-school’ consultants who set the training agenda insist on the old standards still being met in the same timeframe – consequently this year I have worked 22 days of annual leave to gain operating experience plus around 500+hours of day-to-day work which I will never be payed or renumerated for.

    The problem is we’re bent over a barrel – If we worked to rule, people would soon realise the value we get from junior doctors, however no-one would be willing to do this because patients would suffer and at the end of the year you’d be ejected from your training programmes…

  2. Indian Dog says:

    @ Ortho SpR, my sympathies with you. Been in orthopaedics since 1991 and almost an old indian dog! Back in 2004 had a visit from a high ranking official from the RCSE. His vision then was that training would produce candidates suitable to work as part of a team of consultants rather than an independent consultant who could provide all round care. Guess his vision is now coming true. The NHS is going to the dogs were cost cutting at grass root level provides finances to pay for new posts like Deputy Chief Executives and a general proliferation of dandelions called managers!

  3. g says:

    Completely agree with you. Instead of paper monitoring of hours worked, we should have a swipe system which will calculate the hours we worked. This would mean we do not have to beg consultants to sign on the paper, is a more robust system and if we are not remunerated then we should be allowed time in liu. We all know we work atleast one hour extra daily on a minimum, many times without any break for food.This is expected from us and we do it coz our patient concerns

  4. Old dog says:

    Not sure I agree with this. I am 52 and been a consultant 17 years. Worked 1 in 2 for 5 years in training with an average of 104 hours per week. Now faced with covering the exhausted trainees who do less than half of what we did. In paediatrics we are staring resident consultant working right down the barrel. I guess it will vary from specialty to specialty but life for trainees is much better now than it was. Only dilemma is we may all be resident until we’re 60

  5. The_Thinker says:

    When you are discussing hospital consultant salaries in the UK (junior docs – remember this is what you will get in the future), it may be worth comparing the current situation with what is happening elsewhere, such as in Ireland.

    If you look at http://saraburke.wordpress.com/2011/04/08/consultants-dissatisfied-with-cut-backs/, you will find out what consultants are paid in Ireland.

    To quote from the above: “…. consultants working public only starting salary is €166,000 but can earn up to €208,000 if they become a professor with a public only consultant. Those on Type B contracts, which allows public and private work, start at €156,000 but can earn more, if they take on additional roles.”

    What about CEAs you might say? Well, even if you are one of the tiny number of UK consultants who manage to claw there way up to being awarded a platinum CE award (and, remember, only a handful of these are available annually – and anyway CEAs may even be withdrawn this year in the same way as they have already been in Scotland), you can get up to £175,000, but only for the last few years of your career. Remember also that this is the sort of salary that all Irish consultants are receiving from the outset of their taking up a consultant post and, unlike in the UK, not just a few who have managed to get to the top of a very greasy pole.

    Don’t kid yourself that we are well paid in the UK compared to equivalent countries. Take a look at what doctors are paid in Australia and the USA as well.

    If you add to that that the NHS enjoys pretty well a 100% monopoly of our labour, as the UK’s private sector is so tiny (at least outside of London) that you really have nowhere else that you can work, when it comes to negotiating our own pay and conditions we British doctors have managed to put ourselves into a pretty dreadful situation with no aces to play. Where did all those brains that acquired all those A grades at A level to get into medical school disappear to???? Don’t blame governments completely – we are a useless shower when it comes to presenting a collective face and standing up for ourselves.

    There are some compensations however. At least you can take some comfort out of the fact that your pay freeze is helping those nice bankers and captains of industry to earn their justly-deserved millions!!!! In addition, isn’t it fun to live up to all those lavish promises that Labour made on your behalf about how hard you would work.

  6. Paul says:

    The pay for consultants in Ireland as been cut by between 15 and 25% since that report.
    There are no merit awards and income tax is effectively 55%.

    A new consultant on a public only salary starts at 155k, take home per month would be about £4000.
    Look at publicjobs.ie for the pay scales.

  7. JS says:

    Stop with all the moaning! Some poor sods have lost their jobs and families are really suffering (come on The_Thinker don’t confuse “there” and “their” – did you really get straight ‘A’s?). My mate who is a graduate engineer- works all the hours God sends- very much neglecting his family and he doesn’t take home more than £2k a month! He got straight A’s at A-level and a first class degree to boot from a very reputable university. When he hears a mention of a final salary pension he could cry!
    I’m sick of all the moaning. If you don’t like it stop being a martyr and leave. More cash, better lifestyle, glory, fame and the beatiful ladies all await you bigshot geniuses languishing in the NHS overseas!

  8. Nas says:

    Two wrongs don’t make a right JS. Without the “moaning” there’ll be no change and moving overseas is a bad move since the NHS spends thousands training doctors/medical students.

  9. Elkourban says:

    I don’t understand why it takes us long years to train and possibly not enjoy a balanced life for most of our working career, where do we go from here?

  10. Bambam says:

    Your GP colleagues are on a deal that costs the NHS more than it should.They now do far less hours than say 12 years ago and are on much more money. They no longer have to do out of hours or weekends and as most are “self employed” also get major tax breaks.

  11. exploited says:

    All the forums seem to discuss consultants’ pay- do you ever think about the speciality doctors who got the worst deal when contracts were negotiated; then neither consultants nor trainees came out fighting against the injustices the SAS were being subjected. Of course it did not matter then as most SAS were IMGs of a different hue.What was meted to the SAS is now being done (in a way) to us all- so to all those who stayed on the sidelines when SAS doctors were crying for your cooperation enjoy now the humiliation of being told your labour is overvalued.

  12. Alfahad says:

    It’s sad to read all these comments. It does show how frustrated doctors can get. I sympathise with all doctors. It’s hard enough to carry out all that training and learning in and outside your hospital, care and be responsible for the life of your patients. It’s even worse feeling unrewarded, not appreciated by those you care for the most.
    In the UK we trust our NHS doctors. You can’t say the same about bankers or if you lived abroad in some countries where quality of care is depends on how much you are willing to pay.
    Those who think doctors are well paid in the UK need to remember that without them our NHS would not exist and survive the future. It takes over 10 years to turn a bright enthusiastic medical student to become a consultant. It does not take a lot to make that same person lose his enthusiasm, faith and change his career choice or move abroad.
    Doctors have skills that are transferable. Unless we recognise that we will lose them to other countries.
    Our consultants, in order to cope with the decline in their income, will either chose to work abroad for a significantly higher income or start doing more private work at the expense of their juniors training. This could lead to decline in training provision and doctors’ standards in the long run.

    Decisions that have been made by politician will save us money in the short term. Its effect our children will feel in years to come. As current consultants retire; hospitals will struggle to replace them with same quality. Less salary means less competition. The one thing the public would notice is a trend to travel abroad to get a better quality care, or double standards between NHS and private care.

    I am sorry if I sounded pessimistic. My wish is to share my concerns and work to prevent the decline from happening.

  13. Concerned Layman Lawyer says:

    What is clear is that all the money appears to have gone to the GPs who now work effectively part time hours NEVER working evening or weekends and farming out the challenging cases to the hospitalts. AND now, to add insult to injury you’re allowing the GPs to hold the purse strings. When the public get to see how well the GPs have done both in terms of earnings AND pensions they might turn on them a little like the bankers given that they have massively increased their remuneration at the same time as massively reducing their workload. Absolutely mad.

  14. Consultantsurgeon says:

    A dose of reality is required here folks. I have personally done extremely well out of being a hospital doctor. I have a fantastic job, which is varied, interesting and will change over my career to whatever I want – be it more subspecialistation, teaching, research, management, runnning courses, training,examinations etc etc. The possibilities are endless and frankly exciting. I work with great staff and get paid over £100000 for the privilege. Sure the NHS is uninspiring in its management, but its always been like that – why people are trying to derive inspiration from the NHS is beyond me. It is what it is and so just accept it and get on with it, preferably with a smile on your face and a shrug of your shoulders – this works! I’ve always believed in looking after yourself and your patients as best you can, but do not try to change the NHS, its pretty hopeless and it always will be as long as politics are involved.

    My wife’s a GP and its dreadful. She’s always looking for something else to do, and believe me GP practice management is truly awful. I earn more than the GPs I know, and yes they are jealous (not of the money really, but in what I’ve achieved and the job I am doing)

    PS to “the_ thinker “I do private practice outside of London and I my earnings are excellent. Please get your facts right before painting such a bleak picture of things as a Consultant. It is still an excellent job. I would urge SpRs reading this not to lose heart.

  15. tax payer says:

    I find it obscene that you are think you are underpaid.

    I am engineer, I work in highly regulated safety critical industry. Google “bohpal” if you think engineers don’t have lives their hands as as much as doctors. I have 10 years industry experience a degree from Imperial college and 4 As at “A” level. I mange around 6 contact staff, mentor 3 staff engineers and have budgetary responsibility. I suggest that I have roughly equivalent job to a threshold one or 2 consultant but i get paid £47K which is quite good for an engineer. The boys who do the sums and make sure Lewis Hamilton’s car stays on the ground get a little less than this. I repeat, I find it obscene that you are think you are underpaid.

    PS my boss manages 10 staff engineers (2 like me, 6 more junior and 2 world experts) and a 2-3 million budget he gets around £68k. The world wide experts, i.e. no-one anywhere knows more than them get around 50k and 59 k. Consultants seem to get this on top of their salary for national expertise.

  16. GP registrar says:

    enough slagging of GPs. I used to think GP are overpaid and do very little until I was placed in a GP job. All those people not been in a GP job, please don’t talk as if you “know it all”. My typical day starts at 8.30am walking into surgery with 10mins apt booked for patients until about 12pm, at times with extras slotted in between patients and calls to take in between causing my surgery apt to run late. that’s at least 6 patient seen within one hour at least. although last patient listed about 12pm, usually finishes morning surgery around 12.40pm or 1pm, then rushing out from surgery to search for patient’s home for home visit typically 2-3homes and rushing back to surgery having patient waiting from 2pm appointment until about 5.40pm. again 10mins apt slots. typically finish about 7pm most evenings.

    GP job is worse than being in a hospital post. Time is full packed. In between, I am expected to fill medical insurance forms, read hospital discharge letters, do referal letters, sign millions of prescription scripts, “attempting” to do audit to fulfill my educational needs,etc. luckily as GP trainee we get half day each week, and that is a life saver, I don’t know how else I could have survived.

    I recall when in hospital post, I had time for lunch, chit chat with other colleagues. when no admission to clerk in, able to rest and sit in doctor’s lounge and watch tv. when on call at night, able to sleep through the night. dream compared to a GP job.

    Now I am at the end of my training as GP, I understand how other’s (non-GPs) view GP’s being overpaid as they thought GP sits around in front of computer and do nothing apart from “referring and passing on patient to secondary care”. (naive)
    The amount of patient seen by GP is non-comparable and workload and paper work, including admin stuff if “everest” comparable to other hospital job. GP is hard work.

    Now average pay for a salaried GP if £59-79K for a 9 session job which is 5 days’ a week. GP’s MDU fee is about £5000/year. This is pretax profit. thus take home monthly pay wound be about £3500/month. All the big huuhhaahh about GP being paid £350 000 was some monkey in the media picking few of the top GP “PARTNER” in the whole UK who probably manages a few GP practices and worked many many years to reach that figure. and that figure is gross earning before deduction of salary to receptionist, electricity, building maintenance, nurse,etc etc etc It might surprise you but average PARTNER GP in UK earns about £100000 after all that deduction pre-tax, thus after tax earning about £5000/month, not very much is it considering how much effort and training that one has to go through…

    Despite all this, if one wants to work under NHS, doctor’s salary in this country is non-comparable to other countries as NHS is public owned, thus we are likened to a civil servant.

    I once heard on radio about BBC staff’s pay(top ladder). I was in awe when BBC (which is also government owned-we pay tv licences) felt that they need to pay their staff members well as comparable to private sector,otherwise they would loose them ?? funny how things works. 85% owned government bank(bank of scotland) also have similar debates comparing the staff’s pay to private sectors.. Too bad there is not much opportunity for doctors to do that at present

    salary of a childminder is even more extortionate. I have to pay £1000/month to my child minder due to my long hours as a GP registrar (7.30am-7.30pm Mon-Fri) This childminder takes care of 4 other childrens. She earns much much more than myself big time. Some times makes me wonder why even bother studying so hard through university and suffering through all the unsociable hours…

    all in all, as long NHS is a free service, we have a job, a salary to bring home, a home to return to, children to raise and not having to worry about forking out expensive medical bills in time of ill health..

    If money is everything, then UK is really not the place to be at present. Tax is too high, yet don’t know where they are spent. council bills which is unheard of in other countries I have been; as usually is funded from central government from tax?? where are these money?? the harder you work in UK, the more you will be taxed; what a funny culture. God knows what it would be like in the next few years.

  17. will says:

    @Tax Payer
    I, like you am an engineer. Engineers could do a medical degree, but not necessarily the other way around. My brother has degrees in Mech Eng, Law, and did 3 years of Medicine. Law was simplest. At the risk of simplification, Medicine is largely stuffing a big dictionary in your head, and being able to apply logical thinking.
    There is one aspect however, that is paramount. Only in Medicine is it often a life and death matter where a decision can swing it, and for that, Im glad that Medicine attracts the best minds. Imagine who would become doctors if the salary was £15K ? Would yo seriously want to get medical advice from them ?

    I am happy that my tax goes to such people, and its a shame there are not more, rather than bureaucrats with no medical expertise inside the NHS milking it while they can.

  18. academic medic says:

    Friends, please don’t get caught up in debates about GPs vs hospital doctors. It’s classic divide and conquer politics and we must not engage.

    As it goes I think that we’re pretty well paid. The real problem is actually the rising cost of living in the UK, particularly housing. Was anybody around in the 1970s? My father raised a family during these troubled times on a lecturer’s income alone. We had two cars and a small detached house in an affluent commuter town. Doctors lived in even bigger houses in even better areas and sent their children to private schools.

    At the moment the house that I grew up in would cost about 7x the starting salary of a consultant. Disposable income has fallen at the same time – we’re taxed more, particularly via indirect routes such as VAT and council tax, energy prices have increased, childcare is more expensive etc etc

    A key reason for this situation was a centrally-engineered credit explosion that hid the fall in disposable income and allowed people to feel ‘rich’ for a while. The side-effect was inflation in house prices and in the pay of those working in finance. This process reached its logical conclusion and is being slowly but surely wound up. We are now much poorer than we would have been without the credit expansion in the first place. The money must be paid back, but it’s difficult to compete in this global market. Another problem facing us is servicing promises made to the retired/ retiring population. This demographic population bulge decides the outcome of elections for at least a decade and will mostly receive their money.

    So to get back to us, listen to consultant surgeon, he’s right. Enjoy what you have and enjoy your job. It can be grind, but it’s a fabulous career. And if you don’t feel rich despite earning well above the UK median salary, at least you now know why!

  19. js says:

    Nas,

    I would object to your reasoning. I have frequently seen the suggestion that it costs many thousands of pounds to train doctors and medical students. I have seen a figure of approximately £250k quoted for training medical students to full registration. This figure is incredulous. When has a medical student ever delayed a theatre list to the point that productivity dropped and fewer operations took place? Never- the students stand meekly at the back of a theatre or if they are exceptionally lucky they get to hold a retractor! If students are on the wards they are cannulating, performing ecg’s or taking bloods. Students can be seen wheeling patients to the x-ray department or to some other such area for investigation. Students sit at the back of outpatient clinics looking at the prettier side of most consultants (the back of their head) and “observe”. If the student is exceptionally lucky the consultant will throw them an inappropriate referral to clerk so the patient feels they have got their two pence worth. This apparently costs £250K? Don’t make me laugh. Students make an exceptional financial contribution to the NHS free of charge and thus I suspect the figure is nothing like £250K. Students are nothing more than a front for the greedy medical schools and SHA’s and Trust’s who coin it in on the back of students. Time to put students in charge of their own finances and allow them to commission their own clinical education. It is time abolish the opaque financial arrangements of SIFT.

  20. Bear says:

    I’ve been a doctor since 1985. As is common in this profession, I’ve been through a divorce. Look at a solicitor’s bill per hour to put things in perspective! You can”t fight city hall. Get on with it, quit moaning and just work together to return the NHS, the envy of the world, to the clinicians and dispose of excess administration. Simple.

  21. Bob The Builder says:

    The way I see it is that two types of medic exist: altruist and Eton boy. About a 50/50 split.

    Most professionals in the real world dont get close to 80k. Im a teacher so I am doing extrememly well to get 40k after 10 years. (Finally got a weekend off and came to this site by chance.) A headmaster gets about 57k and I might get there by the time I’m 50 if Im lucky (in charge of 50-100 staff).

    Altruists: keep working hard you didnt come into this for pay so I take my hat off to you for the work you do. (remember only 50% of you or less are altruists).

    To Eton boys: Comparison always leads to dissatisfaction (cars, attactiveness of spouse, holidays, member length), so dont want for more – appreciate what you have. Realise that most people will never get halfway to the 80-100k you get even though they have equivalent job difficulty, and are also asked to work for free often. Medicine is not meant to be a gentlemens club. I work hard to correct children at school so they dont grow up with the same overly demanding nature as the comments I am reading here, but I cant reach all the children I teach. Some slip through the system and end up as Eton boy type medics (ie arrogant, with no real grounding in the real world).

    Bottom line, appreciate the salary you get. Even it was halved, its still more than most people will ever get.

  22. DrP says:

    Its hilarious how people without any/much knowledge of the realities of the medical profession think they know best how much medics should get paid.

    Do your research before posting garbage here and comparing medics to teachers etc

  23. Spooky says:

    Calm down and learn some manners before you start referring to other people’s opinions as ‘garbage’. I think medicine is a very unique profession that is difficult to compare to almost anything else. It’s not just the experience and knowledge required to perform the job, but the physical and emotional demands. To work long hours (many of which are unofficial), fluctuating between night and day, the pressure of life/death decision making, the pressures of time and management targets. The stress of breaking bad news and comforting the recently bereaved. Added to this, the pressure of additional study, portfolio improvement, clinics and examinations… And the worry that just around the corner is a potential legal battle… Like I said before, it’s a tough job and there’s not many like it.

    That being said, we all knew the deal before we set out to become doctors. For all it’s pressures, I live and love my job. I don’t think I could do anything else. The wages are acceptable (yes, less than elsewhere, but working for the NHS is not about money). What does distress me, is the seeming lack of appreciation for the hard work NHS workers put in. The extra hours, the missed lunches, the unattainable targets, the implication of inefficiency over sheer inadequate resources… Never have I seen wards stretched so thin with staff, nor morale so low.

    I’d be much happier accepting pay freezes and pension cuts if current working conditions were improved and hard working NHS staff rewarded.

  24. Or Well says:

    Becoming a doctor involves at least 5 years at Med school, I did 7, then years of training, I did 15 in order to become a specialist in intensive care. I will reach the top of the pay scale 1 year before I retire, on a pension that gets no where near the 54k quoted in the press. There is virtually no private work in my field. No one else spends as long in training, and I did 100+ hours week being paid less than the cleaners for overtime. I was criticised for going off sick with burnout, how could I when so much had been spent on my training. How many years does it take to pay back these sums spent! Why do people think it reasonable to pay company directors large amounts but feel doctors are being paid enough, in fact too much for what we do. Yes, I am demoralised, undervalued, and worry who is going to look after me when I’m old! Peanuts=monkeys, and the Torygraph readers whose paper slags us off won’t have anyone in the private sector suitably skilled or trained to look after them either!

  25. Surg SpR says:

    It’s not just about the pay. So the pay for SpRs is not what is was – my pay has dropped year on year as a result of banding changes, not just in relation to inflation either. This is bad enough but it’s the conditions which really get to me:

    a.) Expected to commute 100+ miles a day with a tiny stipend from the deanery for 5 years. Can’t move because of children.
    b.) Minimal personal choice in hospitals to aid (a)
    c.) Hospitals remove on call rooms – I have had to sleep on the floor of my boss’ office at times – this really grates.
    d.) Tiny, tiny study grant that doesn’t even cover the cost of travel to a conference let alone the exorbitant fees the college charges for courses which we are required to go on.

    Sometimes, while resting in my sleeping bag on the floor I do just wonder what the hell I’m doing. I’ve done everything been asked of me, audit, research, PhD, top tier publications and it seems to count for diddly squat. Over the years whilst trying to be as professional as possible it seems that I’m treated increasingly like a commodity. On the other hand I love operating and seeing patients so much I just keep on going

  26. Penguin says:

    I agree with so many of the comments above. It is a brilliant profession but we are not all paid equally and often we don’t really know what are colleagues are paid so how on earth do the government and media come up with a median doctor salary of £122 K when top salary for Speciality doctors is £68 K after 17 years of entering that grade and starting salaries of consultants are £74K,is anybody’s guess.

    We have been very cleverly manipulated in the press to look like greedy moaners.
    If we just worked to rule it would bring the NHS to a standstill but very few of us have the desire to do that but recognition for the years of long hours and pace of work should be remunerated but I think forcing us to do that until the age of 68 will undoubtably sort out the pensions problem, as most won’t live to enjoy it!

    I have seen one quote that expects doctors to live to an average age of 94 not quite sure why we are so special! The £68K that juniors will expect to recieve when they retire is in 43 years time what on earth will that be worth then.

    If we don’t make some stand now I feel further erosions to pay and conditions will be around the corner and I am sure these won’t be replaced once the economic climate improves and public sector pay seems less important!

  27. penyjen says:

    I am a medical student at the end of my training. According to Bob The Builder 50% of my cohort are “Eton boys” just in it for the money. If he were to visit his local University Hospital and see the medical students there he would realise how wrong he was. At midnight students can be found in A&E, on the maternity ward and in theatre trying to get the requisite number of deliveries under their belt, or because their consultant tutor told them of a really rare emergency surgery about to happen.

    We train for 5 hard years 8am – 6pm on the wards, then evenings and weekends in the library, followed by 2 years graft as a junior doctor/dogsbody. No-one would go through that just for the money. The few students that were clearly pushed into medicine with no interest in patient care, have either crumbled under the pressure and left, or more usually, have softened with the intimate exposure to people’s lives. What did I do last Saturday night? I was in A&E doing CPR and then up 7 hours later at 7am on a Sunday morning revising for exams. You don’t do that just for the money (or for the privilege of amassing £50,000 of debt in training!) .

    Bob The Builder, please visit your local University Hospital and try and find one of your “Eton boy type medics (ie arrogant, with no real grounding in the real world).”

    I apologise for going of theme, but I felt rather strongly about that particular comment.

  28. LondonDoc says:

    I have just completed my medical education and graduated as a Doctor and am now excited about starting my job as a junior doctor.

    All of this comes down to attitude, I want to be a doctor and a fine one at that and I believe the first step to achieving this is to immerse oneself in the job 100% and forget entirely about money and reward. We have been trained to a high level and we can enjoy a privileged position in society that many others cannot. Be grateful not greedy. I entered this field because I thought it was one of the few professions not obsessed with money, we deal with what really matters on a daily basis.

    penyjen: I kind of agree with bob the builder, I’m not sure where you went to medical school but I certainly encountered some of the ‘Eton Boys’ described and they all graduated no problem. But the next stage of foundation years will further weed out the money obsessed types who will end up in the banking profession. I was probably similar to yourself with regards to the hours spent on the ward but I was aware of many students who spent very little time on the wards and still graduated. So even if bob the builder spent time on the wards he is likely to only encounter the likes of you and I….the altruists. There would be no Eton boys in sight as they are busy attending dinner parties and playing polo. [My personal opinion is that many banking, corporate lawyer types are probably secretly jealous that we get to do this fantastic job and they would not last 2 minutes because they have neither the character or humanity to perform such a role!]

    I also reflect another comment about the 250K of tax payers money spent on medical students. This figure may be accurate but I would have expected a lot closer supervision and feedback from senior doctors if this is true. I personally think starting work will be a baptism of fire and will be nothing like it was being a medical student…the training needs an overhaul but I think that may be the topic of another thread….

  29. SPUD says:

    I am a fairly successful business man, employing circa 90 people, from an engineering background. I measure my success by the fact I love my job, but that’s easy to say when the house is paid off and I have no debt.

    I was browsing this site as my son is interested in pursuing a medical career, starting in A & E with a view to surgery long term.

    He did ask “Would I earn more working for you” to which I replied never work for money at the outset. You will work for circa 30 years so choose your career on what you love and what interests you. If you want to earn more, move up in your chosen profession or cover additional shifts.

    Earnings as a “regular” Doctor … And I say that with 100% respect as I admire no profession more .. Will never create a life of luxury, but they will not mean a life of poverty either. I think the continuing professional development of Doctors is something many Norma folk do not appreciate has to be done “on top of your normal workload”. To then study additional specialities or surgery is probably similar to climbing the management ladder in the private sector, or making a success of a private business, with many unpaid hours, additional stress and tension with potentially no gain. The end game is the same with increased job satisfaction, responsibility and renumeration in many cases. Is the reward equal to the effort for medics, looking at the pay scales and years of stufy I would say not in the UK.

    If you do reach the consultant post you train for and desire I think your job satisfaction must be immense. If it’s not then maybe you made a poor career, or path choice, but that’s not unique to medics or the NHS; hindsight is a wonderful thing.

    My son will take Medicine as he is 100% sure it is what he wants to do. I know it’s very difficult to gain entry but he will do it, even if not successful as his first entry. He is determined for all the reasons most of you guys entered the profession …. Money is not on the list. Yes, we would all like a bankers pay for risking someone else’s money with no penalty if the risk does not pay off …. But it’s unrealistic work and reward and that why they are considered leeches rather than respected like all Doctors are.

    I’ll leave you with a wonderful line that is bound to provoke some debate .. A good friend of mine responded to my statement that “Money is not everything!” with “No, Power is everything, money is just the way of keeping score”. The Power to preserve or save a life is a wonderful thing and deserving of huge respect … I guess this debate blows my friends theory clean out of the water!

  30. sia says:

    is it true that the consultants starting salary (74k/annum) boils down to £3800/- per month after tax and NI

  31. Sanjeanradiologist says:

    @sia: correct, that’s including the pension contribution.

  32. Caz says:

    Military lads getting shot at in Afghan get minimum £18,000. i think doctors get paid well.

  33. BoredWithIgnorance says:

    It is interesting that we live in a society that has been turned upside down by ‘celebrities’ and living well on credit. The value of education and professional degrees has been slowly eroded and being a medic is a viewed as being as easy as some non-skilled professions in the above comments.
    At the end of the day, medics are humans being as well, and professionals. After all the hard work from age of 16 onwards taking constant exams and stress of real ‘life and death’ decisions having to be made (not hiding behind corporate safety of group decisions), long work hours, huge amounts of work outside normal working hours for re-validation….don’t we deserve to be paid our worth and contribution in monetary terms ?
    At the end of the day, if you take the level of responsibility involved and most importantly, the direct PERSONAL responsibility, then the average real consultant take home pay is ridiculous. This is not so much looking at the number, but more at what it equates to in terms of lifestyle ( property, hours off, work/life balance).
    Personally, I think like some other posters, that we will just have to get on with it in this generation as there are no brave politicians willing to take on the problem that is the NHS (they would rather do short-term cuts of staff and salaries, rather than look to investment in people and growth for the future). However, the new medical students in years to come with their increased debt burden will look at it differently and will vote with their feet – i.e. leave the NHS. I predict that there will be a shift in society as the NHS deteriorates towards a private medical insurance/private medical care culture with more companies offering the same in employment packages. This will lead to better pay being offered to doctors in the private sector, and the slow shift away from the NHS for medics at the beginning of their working lives. The NHS will become the ‘poor’ relative of the the private medical care system in the future and will pay less to all staff, and end up with staff who care less, and (hate to say it) not as good.

    When that happens all those moaning about doctors’s pay will see the true cost of destroying the NHS system because of short-term political foolishness with underhand rigging of pension contributions for doctor’s salaries. Strange how judges and other civil servants do less, work less, no ‘life and death’ decisions, and then get away with no increase in their pension contributions.

    As we don’t have a world currency based on ‘respect or appreciation awards’ for doing good jobs, so fiat monetary currency will have to be the compensation for ‘work’ done in our society. So simply most doctors are saying just pay us a fair due overall ! Otherwise, it will go the way of an insurance based system as we see in the USA….and we all know how brilliant that is !! And that is everyone’s problem when you have a trillion dollar deficit.

  34. Jamie says:

    God this is ridiculous…comparing a teachers salary lifestyle to a doctors…I’m sorry, but you work 8-4 hours week days, I’m sure you need to do marking, create lesson plans etc…but you also only work around 35weeks max of the year (actually in school). I think for 16 weeks holiday, no nights, no weekends a 40k salary with 3 years of education plus 1 year of teaching training you are well renumerated.

    Compare this to me a CMT1 (medical SHO)…similar salary (thats total not basic) I’ve been a doctor 3 years, but I also have trained longer than you have. I complete at least one 12 hour shift per week, I also work one set of weekends (3 x 12 hr shifts) per month also add in 4 night shifts (4 x 12 hr shifts) per month…so my hours are 48 on paper, prob closer to 55-60 in reality…I get 27 days of holiday…

    Don’t compare your workload to mine Bob the Builder as yes, you may need to disipline children and I’m sure that is stressful….try resuscitating them when they are born (which I did as an FY2)…also if I worked the same hours as you I’d only be paid my basic salary, which is £29k…the grass doesn’t look much greener now does it?

    Caz, Military lads do get shot in Afgan for £18k….but that is their choice…and equally it doesn’t take 5 years of education and minimum of 5 additional years for GP or 9 years for consultant training…its about the skills you provide, anyone off the street could do their job with minimal training, anyone off the street couldn’t do mine.

  35. medstud says:

    As a medical student about to enter the profession now, and having done a PhD, I am despondent.

    The point is not the numbers. The point is what can I buy for that? Can I afford a home in a reasonable location and with enough space for my family?

    The real issue is that there is no link between pay and effort.

    The system is biased toward the mediocre.

    Life is too expensive for the usual “its a vocation, you shouldn’t be thinking about money” trash talk.

    Its a great job and its a privilege. But society has fixed it so that I don’t get properly rewarded financially for it.

    I also think that pay between specialties needs to be changed. And much bigger incentives to be good.

  36. prad says:

    This is regarding the ridiculous pay’s of the specialty doctors…!
    First of all majority of the specialty doctors do hold a post graduate degree ( although it might or it might not be recognised in the UK…!) and the amount of work they do as they become more senior in the cadre becomes more and more independent ( so called distant supervision…! may be by some one who may be less experienced than them…!).
    Secondly they do work same number of ours or may be even more than what a trainee (sPR) works.
    Thirdly,Majority of the newly appointed specialty doctors are deprieved of their years of experience worked (outside UK) by the trusts while joining and they are bluntly put in the lowest salary point in the salary scales at the beginning of their job to add to their discomfort.
    Their work probably carries more responsibility on their shoulders than the trainees(which is reflected in their high indemnity premiums…! – about 4-5 times higher than the corresponding trainees)
    Despite all these facts, their pay scales are pathetic..! Plus they do not have banding for those antisocial hours worked .
    I wonder in the midst of the busy schedule if any of the authorities have taken some time out yet to sort out this discrepancy in the pay structure…!
    Any positive step will be highly appreciated..!

  37. anna says:

    prad, I’m in the same situation but I’d guess the answer would be ‘go home if you don’t like it…’
    my question is though what it means if you don’t get a rise at an expected time point? that you are underperformer?

  38. BlueLightView says:

    Dear All

    its not the wage particularly but the unfair destruction of our pensions that should cause us all the greatest concern. Equivalent civil servants get the same benefits for a thrid of the contrubutions. Charge them more or us less – just make it fair across the public sector.

    PS. Salary scales are better in Wales – get higher faster – training is brilliant, as is the lifestyle : dare you to look outside the M25 and cross the bridge and see what you are missing. Google Welsh Deanery.

  39. Anna says:

    Hi, don’t complain about pensions – at least you get something! In Poland NHS pays nothing apart from mandatory NI (which gives you some £200 pcm pension) – and no one would even dare to think it could be otherwise!

  40. petrophysicist says:

    I think Doctors are underpaid. I earn more than most doctors with 5 years experience working for an oil and gas major as a petrophysicist. I dont think doctors can get paid enough. especially having to deal with all the puke, poo and blood. Good on them.

  41. Chalky says:

    @Anna

    But we don’t live in Poland…

  42. Anna says:

    Chalky -so what? Or even more – aren’t UK doctors paid enough to pay their own pension?

  43. Mike says:

    I have many friends who are doctors and really enjoy their company. I arrange financial matters for them and guess what? They are all really well paid! Most contributors here believe their own rhetoric that they are poorly done by, but the majority earn twice and more of the average national wage, have good houses, quality cars and take great holidays. Most (and I mean the other 90%) can’t afford these lifestyles but don’t ‘bitch’ about it and do the ‘poor me’! Many people study, learn their trade and get less but why do doctors feel they are superior and that ” austority, it doesn’t apply to me?” “I’m special!”

  44. watabi says:

    I believe that given the development of allied health professionals and specialist nurses, doctors are pricing themselves out of an increasingly competitive market. Don’t get me wrong, as a specialist clinician currently practicing clinically and managing a clinical team i have worked with many doctors that do a great job. However over the time that i have worked in the NHS i have noticed that many enjoy the status and assume a level of unconditional respect. This characteristic prevalent in the medical profession (as well as many other professions, sadly) coupled with the pay expectation has naturally led many service providers and people seeking health services to look for alternatives to the traditional Doctor led service. Doctors may claim to provide the gold standard in healthcare but there are increasing numbers of health services which are not doctor led and are recognised for their quality and value.Doctors do not have the monopoly that they once claimed and as they are approaching a more level field they will have to face the market place in a more realistic way like many other professions. I don’t think that doctors are in the position to have their cake and eat it, and have an extra slice or two any more.

  45. TheGrassIsAlwaysGreener says:

    I am a surgical registrar. I have achieved 8A* and 2A for GCSE, 4 A for A level, 1st class degree for BSc, Medical degree at a leading UK medical school and MRCS exam (Membership of the Royal College of Surgeons). I work hard and am proud of what I do. Do I think I am well paid? It depends how you look at it. It is now 14 years since I went to university.

    In my argument for the “No” response to that question “Am I well paid?” I should probably start off by telling you my regular routine. I work 65+ hours a week (paid 48 hours) and am on call 2 weekends out of seven. I also work two 24 hour shifts every three weeks. If we work the weekend we do not get time off to compensate. Hence my annual leave entitlement of 30 days actually equates to 6 days if I take off the weekend days I have worked. I also graduated owing student loans £35k and £5k on credit card. I still owe £10k of that even now! My job is stressful. I am constantly under pressure to fit in more cases in theatre, to see more patients and faster in clinic, to help out the junior doctor who doesn’t know anything, to fill in all the endless assessment forms and on top of this to find time to study for yet another exam (despite being in my mid-thirties). Mostly my patients are quite well but every so often they deteriorate rapidly and I have to resuscitate them, perform emergency surgery etc. So yes, I do “save lives”. I also write research papers and help train medical students. So what is my reward for academic success, coping under extreme stress, working extra hours for free, multi-tasking and saving lives? 2500 take home money a month.

    So I return to that question again. Am I well paid? How do I know if I would earn more or less in other jobs? Yes there are some people who earn huge amounts of money for little effort (mostly celebrities). Would I want to trade with one of them? No, absolutely not. I like my job. I love to operate and I enjoy making a difference. I agree that there are problems in medicine but I would choose a surgical career above all others again. Am I well paid? I guess the answer to this is that I am paid enough for me to continue working as a surgeon. Sometimes we should all look at the positive aspects of our jobs rather than assuming that the grass is always greener.

  46. newly qualifed GP says:

    naive is someone who said we don’t work for money. You can say that when you are single but not when you have started to have a family. eventually work is work and we should be paid for what we are valued at. In UK, as it is a “public service” for NHS employee, we are not valued as it would be in private sector. I have just finished my GP training and I am offered salaried job of £68000 pre tax, pre expenditure working full time with hours of 8am-7pm. medical insurance £6000 per year. travel expenses, medical equipment, due to long hours, my nursery bill £1000/month. I still have debt on credit card due to my GP exams up to £10000, mortgage payment, high energy bills, I’m left with just £200 per month to save at some months none or -negative.
    my colleague recently also similar situation but became wiser and decided to move to canada. He’s now offered $500,000 (canadian dollar) a year as a GP there with less hours and cheaper living expenses and taxes.
    I’ve heard another colleague of mine going to australia and getting paid AUD 300,000 per year again with better lifestyle, better school, cheaper nursery bills, less tax… actually can live a life and have family and possibly planning for more children.

    At present, I can’t afford another child as can’t afford it. As I am not “british” although lived in this country for 10 yrs, I am not entitled to any benefit/child credit.

    Foreign Doctors are NOT valued in this country. You can’t have family/children here with such extortionate expensive nursery bills taking up to 40% of my salary per month. hearing my patients on benefits, unemployed but happily having 4-6 children easily with full support for government makes my teeth grit; yet complaining about government cutting their benefits. All my tax which I’ve paid, not able even to support my own family nor having more children myself; but this country is robbing us doctors or other foreigners who works hard in this country and pays their tax bill in full each month–>funding their socialist ideas! I have no problem helping the poor/sick and needy, but too often I don’t see that, but what I see are those exploiting the system and “claiming” for their rights to the benefit. THIS IS SO WRONG!

    If things don’t change, I believe there will be brain drain from this country to US/Canada/Australia. Not just my colleagues who are foreigners in UK thinking about it; some have left UK so that they can start building a family. My British colleagues are also doing the same, most went to Australia–>better weather/better training/better life/less tax.

    This country needs to wake up!! Education and hardwork should pay. I can’t believe having a plumber or electrician call pays as much as me as a GP, nearly. (comparative of education/work/stress/hours/responsibilities–>not comparable)and moreover, they are paid in cash thus possibly might not even have to pay tax on what they earn. unfortunately doctors are never paid by cash thus all tax traceable and tax liable.

    manual labour costs/nursery/etc are toooo expensive and tooo highly rated. Even lecturers in universities are not paid very well compared to other countries. something is wrong with the pay scale in this society.

    I am definitely making plan to move so that I can start “saving” for my family and possibly have 2-3 more childrens which I can afford so as to be able to work and yet not having to face a big nursery bills! Unbelievable.

    I brought money to this country. I paid £100,000 private international university tuition fees to study in this country 10 years ago, and now I’m in worse state then when I started as a student. I still haven’t manage to pay back any amount of sum to my parents and they couldn’t understand why I stayed this long in UK. My honest answer to them, I love UK, I love the people, I love the NHS system, it is so ideal. My opinion changed once I got married and had one child. The reward/pay/expenses are pushing me away from remaining here. I can’t sustain the bills for the peanuts they pay. Now that I’m married and wants to have more children, I can’t afford it. If I’m single, I will most definitely stay and live on but I feel ashamed not able to support my own family. I haven’t even mentioned the amount of money we have to pay just to apply for UK VISA –>extortionately expensive, just find out for yourself on UKBA website.

    Foreigners who works hard/long hours/pays full tax; can u believe it, a doctor; can barely just support his own family; nor can one make plans to expand his family. I am just so frustrated in my current financial position. I’m barely breathing above the surface water. I want what’s best for my family, I’m not a craze for wealth or want to be rich. Just to survive and do well for my family.

    Foreign doctors in GP training are also unfairly treated by the system. A must read story:

    (1) http://www.pulsetoday.co.uk/story.aspx?storyCode=20001442&preview=1#.UPCEbXwgGSM

    (2) http://www.pulsetoday.co.uk/practice-business/practice-topics/education/bma-wades-into-row-over-mrcgp-failure-rates-for-international-medical-graduates/20001441.article#.UPCFjXwgGSM

    Some will agree with me, some will disagree. This is my current REAL situation and REAL frustration. This is NOT a discussion.

    As for discussion, what is IDEALISM. Good for those who felt they can continue to build UTOPIA for everyone. I feel those who work hard/study hard should be paid accordingly. Education should pay. Socialist idea is like communism robbing everyone else especially the middle class/income. I love UK, but not the current system. I believe the government is working hard to change and correct the errors in the system. We know it’s wrong, but it will take time… God bless United Kingdom.

  47. Gynae says:

    What a lot of unhappy people! Any trainees or med studs reading this take heart! A hospital career is a fab job; fascinating, worthwhile and well paid (very well paid if you also do private practice). Half the kids at my children’s private schools have medical families so pay can’t be that bad! Very interesting to read the comments from the non medics visiting this site; I agree with them. Job security, pension, decent pay, travel, grateful patients. What’s not to like? (apart from awful politically driven management; just let that nonsense wash over you and you will be fine!!). Stop the self absorbed whingeing.

  48. MKM says:

    As a Consultant of 15+ yrs I can honestly say the financial rewards of being a Doctor are still good at the top. However this state of affairs is deteriorating rapidly and so if now entering medicine you should plan to emigrate whilst those jobs still exist. It is all very well loving the job but as pointed out above once you have family,mortgage,uni debts etc the salary becomes much more relevant and only the very top/senior docs will make a decent amount. If considering medicine now dont do it- you will be a slave to politicians whims and paid as little as they can get away with in this socialist utopia of the UK!!
    Life is not about money but it certainly buys a better form of misery!!

  49. oh-my says:

    After hearing in a Parliamentary committee hearing that consultants got a 27% salary rise in a 2003 deal meant to raise their productivity, which it failed to achieve, I googled ‘consultants’ and ‘pay’ out of interest and landed on this site. I am shocked and disgusted by the greed on display here from some people. There are two separate issues voiced it seems. One is that medics in general feel suffocated and unappreciated by managers and undervalued by the public. With this point I think most members of the public are highly sympathetic and most do appreciate the value of doctors’ work, as evidenced by countless opinion polls of trusted professions. But that reserve of sympathy is running out when it comes to doctors’ remuneration, especially at a time of economic hardship, job insecurity and high unemployment. Many people on this thread seem to live on planet Warp, but here on earth the vast majority are neither bankers, nor top managers on bonuses. And to put things into perspective for some, management consultants work 15 hour days and get paid 40-50K in a pressure cooker environment of constant performance appraisal and routine hiring and firing. Oxbridge graduates with PhDs earn circa 35k, and as several people have pointed out, the rest of society earns a lot less, work all hours, are put upon by bullying management, and can’t even rely on old-age pensions. It’s apparent that doctors’ attitudes have become corroded by greed and the chorus seems unable to serve up anything else than endless winging about money. Expect zero sympathy. If the wingers could only pack their bags and go to the USA to quench the dollar signs in their eyes, then good riddance because I would not want to entrust my health them. Just don’t forget to pay back your tax-funded medical school fees.

  50. TRC says:

    It is predictable that people will defend themselves when something is being taken away from them. The effect of a prolonged pay-freeze and of renegotiating the pension deal on tougher terms is two-fold. Firstly, people feel injustice that they are not going to receive something which they signed up to at the start of their working lives. Secondly, people working in the profession now feel less valued. The same would be true of any profession, and hospital doctors seem to have been more acutely affected than many in the public sector (in a relative comparison). I don’t think that much of the emotion being conveyed in this discussion is in fact greed, it’s more people’s instinctive reaction to defend their worth mixed in with the anxiety of a gloomy economic outlook for us all.

    Wealth is relative – you may earn what you consider to be too little or too much money depending on your circumstances e.g. family, dependents, debts – and so there will always be a variety of opinions about this. But we live in a free market economy and so pay relates to whatever the demand is for your skills. I think that’s as near as you are likely to get to fairness. If some people do move abroad for a better deal then that’s a healthy part of the flux of the global economy and may eventually lead to greater demand for such skills in our own economy and thus improved renumeration. So by all means work out what’s best for you and your families. I don’t think that medics or anybody else should be expected to work for return of goodwill or for moral satisfaction and certainly should not be lambasted, as above, for seeking better working conditions. Respect for patients, ethical practice and continuous re-appraisal of these values are very firmly embedded at the heart of the professional code to ensure that only suitable people provide care in these roles. This is quite a separate principle and it is almost belligerent to call this into question because workers care for their livelihood. Don’t use the ‘pedestal of nobility’ to elevate doctors above their station or similarly to denigrate them for behaving as would any other working profession.

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