Resident Doctor Pay 2026/27: Take-Home Pay from FY1 to ST8

Resident doctors, until recently called junior doctors, are paid under a separate contract from Agenda for Change staff. Their basic pay is set by grade, with large allowances for nights, weekends and extra hours paid on top. This guide covers basic pay and take-home pay for 2026/27 in England.

Basic pay by grade

Under the 2016 contract, basic pay covers a 40-hour week. From April 2026:

The 2026/27 award was larger for the early grades as part of a reform of the pay structure. Doctors' pay can also change mid-year, so check the latest pay circular from NHS Employers or the BMA.

Monthly take-home pay

Full time, tax code 1257L, NHS Pension and a Plan 2 student loan:

Why ST4 takes home less than ST3

The NHS Pension charges one rate on all of your pay, based on which tier your pensionable pay falls in. ST3 pay of £67,325 sits in the 10.7% tier. ST4 pay of £67,998 crosses the £67,669 threshold into the 12.5% tier.

The salary only rises by £673, but the higher contribution rate applies to the whole salary. The result is that take-home pay falls by about £37 a month. The doctor is building more pension, so it is not money lost, but it can be a surprise on the first ST4 payslip.

What is not included

Basic pay is only part of a resident doctor's income. On top of it, most doctors receive:

• Additional rostered hours above 40 a week, paid at the basic hourly rate
• Night enhancement for hours worked overnight
• Weekend allowance, based on how often you work weekends
• On-call availability allowance if you are on an on-call rota
• Flexible pay premia for some specialties and less than full time training

These can add a significant amount, and they are taxed in the same way as basic pay. Your work schedule sets out which apply to you.

Less than full time training

Doctors training less than full time are paid in proportion to their hours, with some allowances also scaled. Because the pension tier uses actual pay, a less than full time doctor may also pay a lower contribution rate.

Student loans

Many doctors have large student loans, often on Plan 2 or Plan 5, and some also have postgraduate loans. Repayments rise quickly with pay. The student loan guide explains each plan.

How allowances change the picture

Allowances can add a lot to basic pay. For example, the night enhancement adds a percentage to every hour worked overnight, and the weekend allowance adds a percentage of basic salary depending on how often you work weekends. A doctor on a busy rota with frequent nights and weekends can earn considerably more than basic pay. Your work schedule should show your expected pay, so check it against your payslips.

Common questions

Is the 2016 contract the same across the UK? No. Scotland, Wales and Northern Ireland have different contracts and pay scales.

Do resident doctors get London weighting? Doctors in London receive a London weighting allowance under their contract, which is a flat amount rather than the Agenda for Change high cost area supplement.

What is the exception reporting system? If you work beyond your rostered hours or miss training, you can submit an exception report. This can lead to extra pay or time off in lieu.

Is less than full time training paid pro rata? Basic pay is pro rata, and some allowances are adjusted too. Flexible pay premia may be paid differently.

Common mistakes to avoid

• Comparing basic pay between grades without allowing for the pension tier.
• Not checking your work schedule against your payslips.

Try your grade

The resident doctor pay calculator shows take-home pay on basic salary for each grade, with any working pattern and student loan plan.