Junior Doctor Pay 2025/26: What the New Contract Actually Means
After prolonged industrial action in 2023–24, junior doctors in England accepted a new pay deal in 2024. Depending on grade and hours, total pay in 2025/26 ranges from roughly £36,000 for an FY1 to £70,000+ for a senior registrar working out-of-hours.
Background: Why Junior Doctor Pay Changed
From 2023 to 2024, junior doctors in England undertook the longest strike action in NHS history, citing real-terms pay cuts of around 26% since 2008/09 relative to inflation. The BMA's demand was full pay restoration. After months of negotiations following a change of government, a settlement was reached in September 2024 providing a substantial but partial restoration.
The deal covered:
- A consolidated pay uplift phased across 2023/24 and 2024/25
- Revised pay scales from August 2024 (the start of the NHS contract year)
- Ongoing annual uplift in line with the NHS Pay Review Body recommendations for 2025/26
Pay Scales by Grade (England, 2025/26)
Junior doctor pay is set on the 2016 contract. Basic pay by grade in 2025/26 (approximate figures following the settlement):
| Grade | Basic Salary (2025/26) |
|---|---|
| FY1 (Foundation Year 1) | £36,616 |
| FY2 (Foundation Year 2) | £43,923 |
| CT1/ST1 (Core/Specialty Training Year 1) | £55,329 |
| CT2/ST2 | £55,329 |
| ST3+ (Registrar) | £58,398–£70,425 |
| ST7+ (Senior Registrar) | £70,425+ |
Figures are approximate based on the 2024 settlement terms and 2025/26 uplifts. Check the NHS Employers website or your payslip for exact figures, as local variations and incremental progression also apply.
Rota Supplements: Where Total Pay Comes From
Basic salary alone understates most junior doctors' income. The 2016 contract pays rota supplements (formerly "banding") based on the intensity and antisocial hours of your rota:
| Supplement Level | Hours worked outside Mon–Fri 7am–7pm | Supplement (% of basic) |
|---|---|---|
| 0% | Standard Mon–Fri hours | 0% |
| Low intensity | Some out-of-hours work | Variable, typically 10–20% |
| High intensity | Significant evenings/nights/weekends | Typically 40–50% |
An FY1 on a rota with 40% supplement earns:
| Component | Amount |
|---|---|
| Basic salary | £36,616 |
| 40% rota supplement | £14,646 |
| Total gross | £51,262 |
Actual supplement percentages are calculated based on your specific rota pattern — hours, nights, weekends, and on-call intensity. Medical staffing or HR at your trust should provide your actual supplement figure.
Out-of-Hours Pay Breakdown
Under the 2016 contract, additional pay is calculated based on:
- Weekend allowance: 10% of basic for any working at weekends (regardless of intensity)
- Non-resident on-call allowance: where applicable
- Prospective cover allowance: extra for covering unfilled rota gaps
Most junior doctors in acute specialties — medicine, surgery, emergency medicine, paediatrics, obstetrics — work rotas with significant out-of-hours content, resulting in total pay substantially above basic.
Total Pay at Each Grade (Example: 40% Supplement)
| Grade | Basic | With 40% Supplement | Approx Take-Home (monthly) |
|---|---|---|---|
| FY1 | £36,616 | ~£51,262 | ~£3,250 |
| FY2 | £43,923 | ~£61,492 | ~£3,850 |
| ST1/CT1 | £55,329 | ~£77,461 | ~£4,650 |
| ST3+ | £62,000 | ~£86,800 | ~£5,150 |
Take-home is after income tax, employee NI, and standard NHS pension tier contributions. Actual figures vary by supplement level and tax position.
NHS Pension Scheme
All junior doctors on NHS contracts are enrolled in the NHS Pension Scheme — one of the most valuable employer pension schemes available in the UK.
Employee contribution tiers (2025/26)
| Pensionable Pay | Employee Contribution Rate |
|---|---|
| Up to £13,259 | 5.2% |
| £13,260–£26,831 | 6.5% |
| £26,832–£47,846 | 8.3% |
| £47,847–£111,376 | 10.4% |
| £111,377+ | 12.5% |
For an FY1 earning £51,000 gross with supplement, employee pension contribution would be approximately **£5,304/year** (10.4%). The employer contributes 23.7% on top — over £12,000/year of additional pension funding.
The NHS pension is a defined benefit (career average) scheme, providing a guaranteed income in retirement regardless of investment performance.
Pension and take-home impact
The pension contribution reduces your net pay but is building a secure retirement income. For a junior doctor deciding between pension contributions and other savings:
| Option | After-tax cost of £5,304 pension contribution |
|---|---|
| Basic rate taxpayer (20%) | Net cost: ~£4,243/year (£354/month) |
| Higher rate taxpayer (40%) | Net cost: ~£3,182/year (£265/month) |
The NHS pension's employer contribution of 23.7% makes it effectively impossible to replicate with a personal pension at comparable cost.
Scotland, Wales and Northern Ireland
Scotland
Junior doctors in Scotland are employed by NHS Scotland. Pay follows separate Agenda for Change-adjacent negotiations. In 2025/26, Scottish junior doctor pay is broadly comparable to England but not identical — Scottish government conducts independent pay rounds.
Wales
NHS Wales also conducts separate pay negotiations. In 2025/26, Welsh junior doctors received an uplift following their own resolution of industrial action.
Northern Ireland
Pay is set by the Department of Health Northern Ireland. Junior doctors in NI have also undertaken industrial action in recent years over pay parity with England.
Self Assessment for Junior Doctors
Most junior doctors do not need to file Self Assessment, but it becomes relevant if:
- Multiple employers in a year (e.g., working across two trusts or locum shifts)
- Locum income: locum work is often paid without rota supplements but may be on agency terms — check whether PAYE is deducted
- Higher rate taxpayer: if total pay exceeds £50,270, income above that is taxed at 40%; no additional filing is required unless you have other income
- NHS pension annual allowance: the NHS pension can create an annual allowance charge for higher earners — particularly registrars — where pension growth exceeds the £60,000 AA. HMRC notifies through Self Assessment.
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