Junior doctors in the NHS are covered by a separate pay framework from AfC — the Medical and Dental pay scales. Following the 2024 contract settlement after the BMA's industrial action, pay was substantially uplifted. Here's a clear guide to what junior doctors earn at each grade, what they take home after deductions, and how the new contract works.
Junior Doctor Pay Framework
Junior doctors are paid under the 2016 Junior Doctor Contract (revised 2024). Pay is split into a basic salary plus nodal pay points, plus additional payments for out-of-hours work based on rota intensity. The term "junior doctor" covers Foundation Year 1 (FY1) through to Specialty Registrar (StR) grades.
The contract defines pay through a combination of basic salary, weekend allowances, night frequency supplements, and on-call availability payments. Total pay depends heavily on the specific rota pattern.
2025/26 Junior Doctor Pay Scales
| Grade | Basic Salary | With Supplements (est.) | ~Monthly Net |
|---|---|---|---|
| FY1 | £36,616 | £40,000–£46,000 | ~£2,500–£2,850 |
| FY2 | £42,008 | £46,000–£52,000 | ~£2,800–£3,100 |
| CT1/ST1–2 | £49,909 | £54,000–£62,000 | ~£3,100–£3,500 |
| CT3/ST3–4 | £58,398 | £63,000–£73,000 | ~£3,500–£4,000 |
| ST5–7 Registrar | £70,425 | £76,000–£90,000 | ~£4,100–£4,700 |
Supplement estimates include average weekend allowance and banding. Actual take-home varies significantly based on rota intensity.
What Supplements Do Junior Doctors Receive?
• Weekend allowance: 10% for 1 in 4 weekends, up to 20% for higher frequency
• Night supplement: 37% of hourly rate for nights
• Resident on-call: additional payment for being required to stay on site
• Nodal progression: automatic annual pay increase through nodal points
• Flexible pay premia: additional payments for hard-to-fill specialties (Emergency Medicine, Psychiatry, General Practice)
The supplements system means that two FY2 doctors at the same hospital can take home very different amounts depending on their rota. An FY2 in a 1:4 weekend pattern with frequent nights could earn 25–35% more than one on a 9-5 Monday-Friday rotation.
Junior Doctor Pay by Specialty — How Rotas Affect Income
| Specialty Example | Typical Rota Pattern | FY2 Estimated Total |
|---|---|---|
| Emergency Medicine | 1:3 weekends, frequent nights | £50,000–£55,000 |
| Acute Medicine | 1:4 weekends, regular nights | £47,000–£52,000 |
| Surgery | 1:5 weekends, some nights + on-call | £46,000–£50,000 |
| Psychiatry | 1:8 weekends, minimal nights | £43,000–£46,000 |
| General Practice (GP VTS) | Mon-Fri, rare weekends | £42,500–£45,000 |
These are estimates for 2025/26 based on typical rota patterns. Actual pay depends on your specific rota.
Junior Doctor Pension
Junior doctors join the NHS Pension Scheme (2015 CARE scheme) from FY1. Contribution rates follow the same tier structure as AfC staff.
At FY1 basic salary (£36,616), the pension tier is 9.8% = £299/month. With supplements pushing total pensionable pay to £42,000–£46,000, the effective contribution remains at 9.8% but the monthly amount increases to £340–£375.
An FY2 doctor earning ~£42,008 basic pays 9.8% pension (£342/month), reducing their take-home significantly compared to gross figures.
The 2024 BMA Contract Settlement
Following the 2023–2024 industrial action (the longest in NHS history), the government agreed a staged pay restoration deal:
• FY1 pay increased from £29,384 (2022/23) to £36,616 (2025/26) — a 24.5% uplift over two years
• All training grades received above-inflation increases
• New flexible pay premia introduced for shortage specialties
• Weekend and night supplements improved
The BMA and DDRB continue to review ongoing pay levels. The 2026/27 junior doctor settlement is expected in spring 2026.
Less Than Full Time (LTFT) Training
Junior doctors can train LTFT (Less Than Full Time) for a range of reasons — childcare, disability, caring responsibilities, or personal wellbeing. LTFT trainees:
• Receive pro-rata salary based on their percentage of full-time hours
• Progress through training at a proportionally slower rate
• Maintain full access to study leave and educational opportunities
• Are eligible for the same supplements (pro-rata)
LTFT training is increasingly common — approximately 20% of trainees now work LTFT. The financial impact is significant: an FY2 at 80% LTFT earns approximately £33,600 basic (80% of £42,008).
The Road to Consultant — Pay Progression Timeline
| Stage | Duration | Grade | Typical Total Pay |
|---|---|---|---|
| Medical School | 5–6 years | Student | £0 (debt accumulating) |
| Foundation | 2 years | FY1–FY2 | £40,000–£52,000 |
| Core Training | 2–3 years | CT1–CT3 | £54,000–£65,000 |
| Specialty Training | 3–6 years | ST3–ST8 | £65,000–£90,000 |
| Consultant | Career grade | Consultant | £106,000–£155,000+ |
A doctor typically reaches consultant level 13–15 years after starting medical school, by which point they are in their early-to-mid 30s.