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How Much Do Resident Physicians Earn In UK?

Discussion in 'PLAB' started by Egyptian Doctor, Jan 27, 2019.

  1. Egyptian Doctor

    Egyptian Doctor Moderator Verified Doctor

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    TYPICAL ANNUAL SALARY FOR DOCTORS IN TRAINING
    You’ve probably searched for this before however most sources will only mention the basic pay which is just the starting point of the salary. Basic pay covers working 40 hours per week during normal shift hours or “plain time rates”. Plain time rates include any work done between 7am – 9pm any day of the week.

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    However as mentioned, this is just the starting point of the annual salary. On top of basic pay there is additional pay which depends on the intensity of the workload. This includes:

    • Working more than 40 hours a week
    • Working nights and weekends
    • Working during the hours of 9pm to 7am (any day of the week)
    The vast majority of junior doctor jobs in acute hospital-based medical specialties (ex. A&E, medicine, and surgery) involve working more than 40 hours a week, and include nights and weekends. Therefore looking at the basic pay alone will not give you a realistic idea of what a doctor actually earns.

    For simplicity’s sake, I have listed the basic gross annual pay in the table below taking into account a typical work pattern which generally includes:

    • 47 hours per week on average
    • 4 nights a month
    • 1 weekend a month
    upload_2019-1-27_14-14-31.png

    *All figures are before payments for tax or pension have been deducted.

    Also bear in mind that additional pay is also given for:
    • Being on call from home
    • Working in London or near London (up to £2,162 per year)
    • Training in General Practice
    • Training in a hard-to-fill specialties (Emergency Medicine & Psychiatry)
    This BMA document is very helpful for working out actual salary based on the New Contract. I’ll write another article soon about how to use it to calculate your pay.

    This is the link to the more complicated official NHS document on doctors’ pay.

    Monthly take home pay
    As mentioned in the previous section, all figures provided are before anything has been deducted for tax and pension. I’m sure you’d also like to know what you actually get to keep each month so I have listed the usual take home pay for each grade.

    Please note that this is just a ballpark figure based on your NHS job being your only source of income. The figures can be higher or lower depending on any other sources of income you have, your final tax bracket, whether you opt out of pension, and whether you claim for your tax deductible expenses.

    upload_2019-1-27_14-15-14.png

    *before tax and pension
    **tax and pension deducted, tax rebates for tax deductible expenses not accounted for


    TAX DEDUCTIBLE EXPENSES
    There are several professional expenses associated with working as a doctor that can be deducted from your salary before tax is taken out eg. GMC fees. Claiming for these expenses will increase your monthly take home pay slightly – every little helps right? I will write a more in-depth article about how to do this soon. In the meantime you can review this BMA guide on the matter.

    INCREASING YOUR INCOME WITH LOCUM WORK
    Don’t forget that as well as your regular pay from being an NHS employee, you can increase your earnings by doing extra work. This can either be in the same hospital you work at (AKA internal locum or bank) or at another hospital (AKA external locum).

    If you are working in the UK on a visa, there is usually a restriction of 20 hours per work for external locum work as it counted as a second job. There does not appear to be any restriction for internal locum work. Please check your visa conditions before you take on any locum shifts.
    Locum shifts usually pay by an hourly rate and tend to be higher for external locum work.

    Typical rates for external locum shifts

    upload_2019-1-27_14-15-54.png

    Rates can be higher or lower depending on the following factors:
    1. Notice period: Short notice shifts tend to pay more.
    2. Times: Evenings, nights, weekends and bank holidays may pay more.
    3. Location:
      • London tends to have the lowest rates due to higher supply of doctors.
      • Rural areas tend to pay higher rates – some very understaffed rural areas will offer Registrar rates to work as a locum SHO, and Consultant rates to work as a locum Registrar.
    4. Specialty: Some specialties pay higher than others.
    5. Roles: Specialised roles may pay higher rates than non-specialised roles eg. locum work as a surgical assistant can sometimes pay more than a ward SHO.

    PRIVATE WORK
    Once you are a Consultant (if that’s your goal), you may be able to supplement your income with private work. But you can also engage in private work before you reach Consultant level if you work in a field that does not require you to be a Consultant. Such fields include Aesthetic Medicine (Botox, fillers etc), acupuncture, IV nutrient therapies, etc.

    This would involve setting up a limited company, getting certified, and finding work in these fields which is a whole different story!

    If you do any work in a private hospital or private clinic it would also be tax efficient to work through a limited company. If you are interested in this please let me know and I can write about how I set up my limited company and how you can too.

    NHS EMPLOYEE BENEFITS

    You may feel that the salary for doctors is much lower compared to other English-speaking countries. This is a fair observation, but it’s important to mention some of the benefits of being an NHS employee that the salary packages of other countries may be lacking.
    • Annual leave– you are entitled to paid annual leave every year + 8 days of bank holidays. The longer you work in the NHS, the more annual leave you get. The table below summarises the entitlement:
    upload_2019-1-27_14-17-0.png


    • Study leave – Trainees from FY2 and above, and sometimes even non-trainees (with negotiation), will have entitlement to paid study leave. For trainees this is usually 30 days a year with the majority allocated to compulsory teaching sessions provided by the training programme, and 10 days for the trainee to decide what to do with. This is typically used to attend courses, conferences, and study for exams.
    • Study budget– Trainees and sometimes even non-trainees (with negotiation) will have access to to some amount of money to attend courses and conferences. It usually does not cover all the expenses but it certainly helps. See here for more details.
    • Study sessions– Separate from study leave, trainees and sometimes even non-trainees (with negotiation) will have a half day or 2 half days a week for study which can be used to work on audits, presentations, publications, research etc.
    • Sick leave– you are entitled to paid sick leave separate from your annual leave. Your sick days will not be deducted from your annual leave days. If you get sick during annual leave you may be able to claim it back so you can use the annual leave for another time. Please note that if you are off sick for too many days in a year, you may need to extend your training or repeat a year.
    • Maternity leave – regardless of how long you’ve been working in the NHS, all pregnant employees are entitled to 1 year maternity leave. It is illegal for your employer to fire you during this time. Depending on how long you’ve been working in the NHS during pregnancy, you may also be entitled to maternity pay. Please see this article for more details.
    • Paternity leave – fathers are entitled to 2 weeks paternity leave. This is actually called “Maternity support” leave and applies to same-sex partners as well as nominated carers for single mothers. It can be paid leave if the father/same-sex partner/nominated carer has been an NHS employee for a year before the baby was born.
    • Shared parental leave – The one year maternity leave can in some cases be shared between the parents.
    • Part-time training – You can request to complete your training part-time in order to balance work and other commitments like caring for children or an elderly family member. This is known as “less than full time training” or LTFT training. The least you can work is 50%, this will mean you will take twice as long to complete your training. For example, GP training is 3 years long if you work full time or at 100%. If will be 6 years long if you work LTFT at 50%. Your annual pay with LTFT training will be considerably less than a full time job and this may have implications for those on a Tier 2 visa where you generally need to earn more than £30,000 per year.
    • Parental leave – You are also entitled to 18 weeks parental leave for each child until your child reaches 18 years of age. Some weeks may be paid but most of this leave is unpaid. It can be used for various things such as helping your child settle in school, staying with them in hospital, or just to spend more time with your children.
    • NHS pension – many financial advisors will tell you that the NHS pension is a good deal and you won’t find a better private pension plan out there to replace it – at least that’s what several have advised me! You can read more about the NHS pension on this BMA page and decide for yourself whether you want to opt out of it.
    • NHS discounts – NHS employees also enjoy some discounts with shops and services. Don’t forget to ask any shop, restaurant, hotel or any service whether they offer and discounts to NHS employees.
    For the full terms and conditions of working in the NHS, please read through the employee handbook.

    SUMMARY
    • Pay depends on the intensity of the job.
    • Additional pay is given for working in London and in hard-to-fill specialties.
    • Monthly take home pay is dependent on deductions such as tax, pension and tax-deductible expenses.
    • You can increase your pay by working additional shifts. There are limits to this if you are working in the UK on a visa.
    • Private work is also an option, again there may be limits on this if you are working in the UK on a visa.
    • There are numerous NHS employee benefits that may entice you to work in the UK as these can help you reach your goals of work-life balance.
    Now you know the pay and benefits of UK doctors in training, I hope this helps you decide whether or not to pursue training in the UK.

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