How do junior doctor basic salaries compare between NHS trusts and private sector roles?
This fact-check may be outdated. Consider refreshing it to get the most current information.
Executive summary
Junior (resident) doctors’ basic NHS pay ranges from about £32,397–£63,162 depending on grade, with average first‑year full‑time earnings near £41,300 and specialty registrars averaging around £71,300 (Nuffield Trust) [1]. Foundation doctors’ agreed salary bands reported in recent coverage are roughly £38,831–£44,439, with specialist trainee salaries rising to about £73,992 (The Independent, BBC, Nuffield Trust) [2] [3] [1].
1. Pay scale basics: what “basic salary” means in the NHS
NHS basic pay for resident (junior) doctors is a nationally set scale that rises with grade and years of service; it excludes overtime, banding supplements for unsocial hours, night enhancements and local London weighting, all of which commonly make up a significant portion of take‑home pay (Health Careers; Nuffield Trust) [4] [1]. Official guides and pay circulars set the national ranges each year; recent rounds of uplifts changed headline basic rates from 1 April 2025 (BMJ Careers; BDI Resourcing) [5] [6].
2. What published numbers say about NHS junior basic pay
Nuffield Trust’s analysis places junior doctors’ basic pay between about £32,397 and £63,162, with average full‑time earnings around £41,300 for newly qualified doctors and about £71,300 for specialty registrars nearing the end of training [1]. More granular reporting cites foundation doctors’ agreed salary band at roughly £38,831–£44,439 and specialist trainee top points near £73,992 (The Independent; BBC) [2] [3].
3. How employers (trusts) can change take‑home pay in practice
NHS trusts typically advertise posts by grade using national basic salaries but total pay varies widely by rota. Banding (premium pay for onerous rotas) can increase gross pay substantially — some guidance and recruitment commentary estimate banding can boost pay by 20–50% depending on the rota — so two identical basic salaries at different trusts may yield very different total earnings (academically.com; Health Careers) [7] [4]. Recruitment agencies also note trusts sometimes top‑up offers for hard‑to‑fill posts, but the basic scale remains the negotiating baseline (IMG Connect) [8].
4. The private sector comparison: what reporting does — and doesn’t — say
Sources note private sector earnings for fully qualified specialists can be “vastly” higher than NHS pay in some settings, but direct comparisons for junior/trainee grades are limited in the cited reporting (britbrief; Nuffield Trust) [9] [1]. The BMJ argues pay has fallen further in real terms for doctors than for many private sector workers historically, but it cautions against cherry‑picking the best private roles as representative of the whole private market [10]. Available sources do not present a systematic, source‑backed table comparing basic junior pay across individual private employers versus NHS trusts.
5. Average vs advertised: survey and market signals
Survey and job‑site aggregates put typical junior doctor pay in a midrange: Glassdoor’s UK junior doctor average is roughly £44,167, with wide interquartile spread driven by grade and extras; such figures mix basic pay and reported extras and should be treated as market snapshots rather than contractual guarantees [11]. Nuffield Trust stresses juniors remain above median UK incomes on several measures but have fallen down the income percentiles over time relative to other professions [1].
6. Politics, recent uplifts and the real‑terms story
Government pay uplift rounds (2023–2025) delivered multi‑percent increases — 4% and sectoral top‑ups have been applied — but Nuffield Trust and media reporting conclude junior doctors’ real‑terms pay remains below 2010–11 levels by single‑digit to double‑digit percentages depending on the measure [12] [3]. The BMA disputes the sufficiency of these rises and has used comparative private‑sector and historical loss arguments in industrial action coverage (The Guardian; BBC) [13] [3].
7. How to interpret differences when choosing between NHS and private roles
If you compare “basic salary” alone, NHS national scales give transparent ranges (Nuffield Trust; Health Careers) [1] [4]. If you compare likely total earnings, rota banding, extra hours, on‑call, local supplements and private sector fee‑for‑service or locum opportunities can shift outcomes dramatically; some private posts or locum work can outpay equivalent NHS basic salaries, but reporting warns this is not universal and depends on contract type and demand [7] [8] [9].
Limitations: reporting in these sources gives strong coverage of NHS scales and averages but does not provide a systematic, audited dataset directly comparing junior doctors’ basic pay at each NHS trust with equivalent private employer offers; that comparison is therefore not found in current reporting (available sources do not mention a comprehensive trust‑by‑trust vs private‑sector basic pay table) [1] [9].