Junior Doctor Take-Home Pay 2026/27: Monthly Breakdown

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

By the NHS Bands Pay editorial team

How take-home pay is calculated

Four deductions (five with a student loan) come out of a resident doctor's gross pay before it reaches the bank:

1. NHS pension contributions — tiered by pay: 9.8% for FY1/FY2, 10.7% for ST1–ST3, 12.5% for the most senior registrars. Deducted before income tax is calculated, which reduces the tax bill.
2. Income tax — 20% basic rate on taxable income up to £50,270, 40% above. Pension contributions are subtracted first, so taxable income is lower than gross pay.
3. National Insurance — 8% on earnings between £12,570 and £50,270, 2% above. Unlike pension, NI is charged on the full gross including the pensionable amount.
4. Student loan — 9% of earnings above the plan threshold (Plan 2: £28,470). Most doctors have one.

The figures below use 2026/27 thresholds: personal allowance £12,570, basic-rate limit £50,270, NI primary threshold £12,570, and Plan 2 student loan threshold £28,470. If a future Budget changes these, the numbers shift slightly — but the structure stays the same. All figures are for basic pay only; enhancements are covered separately below.

Monthly take-home by grade: the full table

Monthly figures are rounded; annual calculations divide by 12. "With Plan 2 loan" deducts 9% of earnings above £28,470 — the most common student loan plan for doctors who studied in England. Two patterns stand out. First, the pension deduction is the single largest "invisible" cost early on: an FY1 pays £337 a month into the pension — more than the combined NI and student loan. Second, the step from ST1 to ST3 crosses into higher-rate tax territory on total earnings, which is why the tax column jumps disproportionately.

Foundation doctors: FY1 and FY2

An FY1 on £41,226 keeps about £29,970 a year (£2,498 a month) without a student loan, or about £28,820 (£2,402 a month) with a Plan 2 loan. That is roughly 73% of gross pay — or 70% with the loan. The pension contribution (£4,040 a year) is doing heavy lifting here: it cuts the income tax bill by about £808 a year through tax relief, and it buys 1/54 of pensionable pay in guaranteed, inflation-protected pension plus the employer's 23.7% contribution (about £9,770 a year on FY1 basic).

FY2 (£47,610) keeps about £34,070 a year (£2,839 a month), or £32,340 (£2,695) with Plan 2. The £341-a-month uplift over FY1 is the combined effect of the £6,384 basic rise and the slightly higher deductions. In practice, most FY2s also work busier rotas than FY1s, so their actual take-home — including enhancements — is usually further ahead than the basic-pay comparison suggests.

For the full salary picture including nodal points and what changes after FY2, see FY1 and FY2 doctor salary.

A worked month: the FY1 payslip

To make the deductions concrete, here is what a single month looks like for an FY1 on basic pay (£41,226 a year = £3,435.50 a month), with a standard tax code and no student loan:

• Gross pay: £3,435.50
• NHS pension (9.8%): −£336.68
• Taxable pay: £3,098.82
• Income tax (20% above £12,570 pa): −£410.27
• National Insurance (8% above £12,570 pa): −£191.04
• Take-home: £2,497.51

With a Plan 2 student loan, subtract a further £95.65 (9% of the £1,062.80 above the £28,470 annual threshold, divided by 12), leaving £2,401.86. Notice the order of operations: pension comes off before tax is calculated, which is why the tax figure (£410.27) is lower than 20% of (£3,435.50 − £1,047.50). National Insurance, by contrast, is charged on the full gross — the £336.68 pension deduction gives no NI saving.

Now add a busy rota. Suppose the same FY1 earns £400 a month in unsocial-hours enhancements. Gross becomes £3,835.50; pension rises to £375.88 (9.8% of the higher pensionable pay); taxable pay is £3,459.62; tax is £482.42; NI is £223.04; take-home is £2,753.16. The £400 of enhancements yields about £256 of extra take-home — roughly 64p in the pound — while also adding about £39 a month to pension contributions and building additional 1/54 pension. This is the maths to run whenever you compare rotas: enhancements are worth roughly three-fifths of their face value in cash, plus the pension accrual.

Registrars: ST1 to ST8

ST1/CT1 (£55,355) keeps about £38,940 a year (£3,245 a month), or £36,520 (£3,044) with Plan 2. Note the pension tier change: ST1 pay sits in the 10.7% tier, so the monthly pension deduction jumps to £494. ST1 is also the grade where total earnings start brushing the £50,270 higher-rate threshold once enhancements are included — on basic pay alone, taxable income (£49,432) stays just inside the basic-rate band.

ST3/CT3 (£67,325) keeps about £45,280 a year (£3,774 a month), or £41,790 (£3,482) with Plan 2. At this grade the 40% tax band bites properly: about £3,940 a year of the tax bill is at 40%. The pension tier is still 10.7% (£67,325 sits just below the £67,669 threshold for 12.5%) — a quirk worth knowing, since a pay rise crossing that line raises the contribution rate on the whole salary.

ST7/ST8 (£77,348) keeps about £49,620 a year (£4,135 a month), or £45,220 (£3,768) with Plan 2, with the full 12.5% pension tier (£806 a month) and a substantial 40% tax bill. At these grades, salary-sacrifice-adjacent planning (such as buying additional pension or using ERRBO to buy out early-retirement reductions) becomes worth discussing with a financial adviser.

How enhancements change the picture

Everything above is basic pay. Real rotas add unsocial-hours enhancements (nights, weekends), on-call availability allowances and weekend allowances — and these are fully taxable, subject to NI, and mostly pensionable. A foundation doctor on a busy rota might add £3,000–£6,000 a year to gross pay; a registrar on heavy on-call could add considerably more.

Enhancements flow through the deductions in a specific way: they increase income tax (at your marginal rate — 40% for senior registrars on total earnings above £50,270), increase NI at 8% or 2%, and increase pension contributions at your tier rate (which also increases your eventual pension). Roughly speaking, an FY1 keeps about 60–65p of every £1 of enhancement after all deductions; an ST6 on total earnings above £50,270 keeps about 45–50p. Locum shifts follow similar maths — see locum doctor hourly rates and junior doctor hourly pay.

Student loans: the fifth deduction

Most doctors carry significant student debt, and the repayments are material:

• Plan 2 (England, started 2012–2022): 9% above £28,470 — £96/month (FY1), £144/month (FY2), £202/month (ST1), £291/month (ST3), £367/month (ST7).
• Plan 5 (England, started August 2023 onwards): 9% above £28,470 — same monthly figures, but a 40-year write-off instead of 30.
• Plan 1 (pre-2012, Scotland/Wales variations): 9% above £26,065 — slightly higher monthly deductions.
• Postgraduate loan: 6% above £21,000, in addition to the undergraduate plan — doctors with a master's or PhD pay both.

A doctor with Plan 2 plus a postgraduate loan loses an extra ~£100–£150 a month on top of the figures in the table. The loans are written off after the term (30 years for Plan 2, 40 for Plan 5), and most doctors will not clear the balance — but the monthly cash-flow effect during training years is real.

London and other additions

Doctors working in London receive a London supplement on top of basic pay under the national medical terms — check the current pay circular for the value, as it is revised with pay awards. It is taxable, subject to NI and pensionable, so roughly 60–70% of it reaches take-home for most grades.

Other additions that can appear on a resident doctor's payslip include flexible pay premia for hard-to-fill specialties (set nationally for specific training programmes), additional responsibility payments, and relocation expenses. None of these are AfC allowances — they belong to the medical and dental framework, which is why this site's HCAS guide and overtime guide do not apply to doctors.

One practical habit worth building early: check every payslip against your work schedule in your first months. Payroll errors on enhancements are not rare when rotas change mid-month, and an underpaid enhancement is money you never get back unless you spot it. Keep your rota, your exception reports and your payslips together — five minutes a month beats a retrospective pay dispute a year later.

Frequently asked questions

What is junior doctor take-home pay in 2026/27?

On basic pay: FY1 (£41,226) keeps about £2,498 a month, FY2 (£47,610) about £2,839, ST1 (£55,355) about £3,245 and ST7 (£77,348) about £4,135 — after tax, National Insurance and NHS pension, before student loans. Unsocial-hours enhancements increase these figures.

How much does an FY1 doctor take home per month?

About £2,498 a month on basic pay of £41,226, after income tax, National Insurance and 9.8% NHS pension contributions. With a Plan 2 student loan it is about £2,402. Rota enhancements for nights and weekends add to this.

Why is junior doctor take-home pay lower than the salary suggests?

Four deductions come off first: NHS pension contributions (9.8%–12.5%), income tax, National Insurance and usually student loan repayments. Together they remove roughly 28–36% of gross pay depending on grade.

Do junior doctors pay the NHS pension contribution?

Yes — the same tiered NHS pension scheme applies. FY1 and FY2 pay 9.8%, ST1–ST2 pay 10.7%, and senior registrars pay 12.5%. The employer adds 23.7% on top.

How do nights and weekends affect junior doctor take-home pay?

Unsocial-hours enhancements, on-call availability allowances and weekend allowances are added to basic pay and are subject to tax and National Insurance. A busy on-call rota can add several hundred pounds a month to take-home pay.

Do junior doctors pay student loan from their salary?

Most do. Plan 2 loans (English students who started 2012–2022) take 9% of earnings above £28,470 — about £96 a month for an FY1, £144 for an FY2. Plan 5 and postgraduate loans have different thresholds and rates.

What is ST1 take-home pay per month?

About £3,245 a month on the £55,355 basic salary, after tax, NI and 10.7% pension contributions (about £3,044 with a Plan 2 student loan). ST1 is the first grade where some doctors approach the higher-rate tax threshold with enhancements.

Are junior doctors higher-rate taxpayers?

On basic pay, no junior doctor grade reaches the £50,270 higher-rate threshold after pension contributions. But ST3+ doctors with substantial enhancements or locum income can cross into the 40% band on total earnings.

Sources and independence

Source: BMA — Government offer to resident doctors in England (June 2026); GOV.UK — Income Tax rates and bands.

Take-home figures are estimates using 2026/27 tax, National Insurance and student loan thresholds with a standard tax code. Actual pay depends on tax code, rota enhancements, pension tier and loan plan.

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.