Junior Doctor Hourly Pay 2026/27: What the Salary Really Means

Last updated: 28 September 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Basic hourly rates by grade

Resident doctor salaries are set for a 40-hour week, so the headline hourly rate is simply the annual salary divided by 2,080 (52 × 40):

For the salary context behind these figures, see FY1 and FY2 doctor salary. The two right-hand columns tell the real story of this page: the same salary divided by the hours doctors actually work.

Real hours: the 48-hour week effect

The 40-hour week is the contractual basis for basic pay, but the Working Time Regulations cap the average at 48 hours a week — and most resident doctor rotas sit between 44 and 48 hours on average. That gap between paid-for hours and worked hours is the single biggest reason the headline salary feels different in practice.

An FY1 working 48-hour weeks earns £16.52 an hour before enhancements — about 17% less than the £19.82 headline. Over a year, those extra 8 hours a week add up to roughly 416 unpaid-at-basic-rate hours. This is not a secret or a scandal; it is how the contract is designed, with unsocial-hours enhancements and the overall salary level set in the knowledge that average hours exceed 40. But it explains why hourly comparisons with other professions can look unflattering: a graduate on £35,000 working a genuine 37.5-hour week earns £17.94 an hour — more than an FY1's effective basic rate.

Two qualifiers. First, rota hours include rest: a 48-hour average rota is not 48 hours of continuous intensity — it includes days off, zero days and leave averaged across the rota cycle. Second, enhancements (below) raise the effective rate for the unsocial portion of those hours. The fair comparison is total pay for total hours, which is what the rest of this page builds towards.

Nights, weekends and on-call uplifts

The 2016 contract compensates unsocial hours through enhancements rather than a single overtime rate:

• Night hours attract the highest enhancement on top of the basic hourly rate — night work is where the hourly rate looks best.
• Weekend hours attract a lower but still meaningful enhancement, plus a weekend allowance for those working one in two weekends or more.
• On-call availability earns an allowance for being available, with hours actually worked attracting the relevant enhancement.

The practical effect: a doctor whose rota is heavy on nights and weekends can have an effective hourly rate 15–25% above the basic 48-hour figure, while a doctor on a mostly weekday rota sits close to it. This is why two doctors at the same nodal point can have noticeably different total pay — the rota determines the enhancements, and the enhancements determine the real hourly rate. When comparing rotations, ask for the pay profile, not just the hours.

Salaried vs locum hourly rates

The starkest hourly comparison in medical pay is between salaried rota hours and locum shifts. Published 2026 trust bank rate cards illustrate the gap: FY1 bank shifts from around £22 an hour for days (against £19.82 basic), FY2 from around £30 (against £22.89), ST1/2 from around £33, and ST3+ from around £40 — with nights and weekends higher in each case. Agency rates run higher still.

These are local examples, not national rates — every trust sets its own bank rates, and they vary by specialty, urgency and shift type. But the pattern is universal: locum hourly rates exceed the equivalent salaried hourly rate, often by 10–50%. That premium compensates for the insecurity, the lack of training value, and the fact that agency locum work is usually not pensionable.

The gap explains the economics of the F3 year and of regular locum work during training: an FY2 doing one bank weekend a month at £30–£39 an hour can add £3,000–£5,000 a year. Our locum doctor hourly rates guide covers bank vs agency, how rates are set, and the working-time rules that limit total hours.

Exception reporting: when hours exceed the rota

If you consistently work beyond your rota — staying late every shift, missing breaks, covering gaps — the contract provides exception reporting. You file a report, and the outcomes can include additional pay or time off in lieu, and ultimately rota redesign if the pattern persists. It is the mechanism that stops "48-hour average" from quietly becoming 55.

Exception reporting is underused, partly because trainees worry about being seen as complaining. But it is a contractual right, it is monitored by the guardian of safe working hours at each trust, and the BMA advises using it whenever the rota does not reflect reality. From an hourly-pay perspective, it is the difference between working extra hours for free and working them for pay or time back.

It also matters for your pension: hours that are paid through exception reporting are pensionable, so reporting protects both your hourly rate and your long-term pension accrual. Keep your own log of hours worked versus hours rostered — a simple spreadsheet is enough — so that if a pattern emerges you have the evidence to file and, if needed, to escalate.

How it compares

Context matters. At £16.52 an hour effective (FY1, 48-hour week, before enhancements), a foundation doctor earns well above the National Living Wage — the "doctors earn less than baristas" framing is rhetorical, not arithmetic. The meaningful comparisons are:

• Other graduates: many graduate schemes pay £28,000–£35,000 for ~37.5-hour weeks (£14.35–£17.94 an hour) — comparable to or slightly above the FY1 effective basic rate, though without the pension (23.7% employer contribution) or the steep pay progression.
• The pay trajectory: the FY1 effective rate roughly doubles by ST7 (£30.99 on 48 hours), and consultant basic starts above £113,000. Few graduate careers match that slope.
• Locum alternatives: as shown above, the market values a doctor's hour more highly than the training salary does — the difference is the price of training, supervision and career progression.
• Take-home reality: hourly rates are gross. For what actually reaches the bank each month, see junior doctor take-home pay.

The honest summary: resident doctor hourly pay starts modestly for a graduate profession, is lifted significantly by enhancements and locum opportunities, and is back-loaded — the real payoff comes with progression. The pension, at 23.7% employer contribution on every hour worked, is the hidden hourly bonus most comparisons miss.

The full journey: hourly pay from FY1 to consultant

The hourly figures earlier on this page cover the resident doctor grades. But the training pathway continues, and the hourly story only makes sense across the whole journey:

Two things stand out. First, the consultant jump: moving from ST7 (£37.19) to Threshold 1 consultant (£54.60) is a 47% rise in the hourly rate — the single biggest step in a medical career, reflecting the consultant's ultimate clinical responsibility. Second, the long game: an FY1's £16.52 effective rate roughly triples by late consultant career (£60.32 on 48 hours), and that is before additional PAs, on-call supplements and private practice, which can push a senior consultant's effective hourly earnings considerably higher.

This back-loaded shape is the economic logic of medical training. The early years — medical school debt, foundation salaries, long registrar hours — are an investment: roughly a decade of below-market hourly pay in exchange for a subsequent three decades at rates few professions match, plus the 23.7% employer pension contribution compounding throughout. Whether that trade is "worth it" depends on the specialty, the individual and their alternatives — but it is the trade every doctor is making, consciously or not, from the first day of FY1. For the salary detail at each stage, see FY1 and FY2 salary and NHS consultant salary.

Frequently asked questions

What is the hourly pay of a junior doctor?

On 2026/27 basic salaries for a 40-hour week: FY1 £19.82 an hour, FY2 £22.89, ST1 £26.61, ST3 £32.37 and ST7/ST8 £37.19. On the 48-hour weeks most doctors actually work, the effective rates are lower — FY1 £16.52 an hour.

What is FY1 hourly pay?

FY1 basic pay of £41,226 equals £19.82 an hour on a 40-hour week, or £16.52 an hour averaged over a 48-hour week. Nights and weekends attract enhancements that raise the effective hourly rate.

Why is junior doctor hourly pay lower than the salary suggests?

Because the salary is set for 40 hours but most rotas average 44–48 hours a week. Dividing the same salary by more hours gives a lower effective hourly rate — though unsocial-hours enhancements partly compensate.

Do junior doctors get paid overtime?

Not as hourly overtime in the Agenda for Change sense. Extra hours are handled through rota design, exception reporting (which can trigger pay or time-off remedies), and enhancements for unsocial hours. Additional shifts are usually done as locum work at bank or agency rates.

How does junior doctor hourly pay compare to locum rates?

Locum bank rates are substantially higher per hour — for example, published 2026 trust bank cards show FY1 bank shifts from around £22 an hour for days, above the £19.82 basic equivalent. That gap is why many trainees do locum shifts.

What is the junior doctor night shift hourly rate?

Night hours attract an unsocial-hours enhancement on top of the basic hourly rate under the 2016 contract. The exact enhancement depends on the rota and is set out in the national terms and conditions.

Are junior doctors paid for all the hours they work?

Rotas are designed around average hours, and the exception-reporting system exists for when actual hours exceed the rota. If you consistently work beyond your rota, exception reporting can lead to pay adjustments or rota changes — use it.

How does junior doctor hourly pay compare to minimum wage?

Even the effective FY1 rate on 48-hour weeks (£16.52 an hour) is well above the National Living Wage. The comparison that stings is with locum rates and with other graduate professions' hourly pay, not with minimum wage.

Sources and independence

Source: BMA — Government offer to resident doctors in England (June 2026); GOV.UK — Government offer to resident doctors explainer.

Hourly rates are calculated from 2026/27 nodal basic salaries. Effective rates assume average rota hours; actual rotas vary. Locum rates cited are published trust bank examples, not national rates.

This is an independent guide and is not affiliated with the NHS. Doctors are employed on medical and dental terms, not Agenda for Change. Always confirm pay with your employer's payroll.