Doctor Salary in the UK 2026/27: What IMGs Earn After PLAB
In England in 2026/27, a doctor in the first foundation year (FY1) earns £41,226 in basic pay, and a second-year foundation doctor (FY2) earns £47,610. Doctors in core and specialty training earn £55,355 to £77,348, specialty doctors £63,696 to £102,689, and consultants £113,565 to £150,569. Most international medical graduates start in a non-training post after PLAB, typically advertised at FY2 or core-training level — so a realistic first salary is £47,610 to £55,355 before extras, or roughly £2,840 to £3,250 a month after tax, National Insurance and pension.
Those figures took a real jump this year. The 2026/27 pay award added 3.5% for every doctor, and the deal that ended the resident doctors' dispute in June 2026 reformed the pay scale on top of it — FY1 pay rose 6.2% and FY2 pay 7.1%. This guide sets out the full scales, what IMGs are actually paid in their first NHS post, how nights and weekends change the payslip, worked take-home figures, and what it all means in Pakistani rupees and Indian rupees.
The short answer
- Foundation doctors (England, 2026/27): FY1 £41,226; FY2 £47,610 basic.
- Training grades: CT/ST1–2 £55,355; ST3–ST5 £67,325–£67,998; ST6–ST8 £76,582–£77,348.
- Beyond training: specialty doctor £63,696–£102,689; specialist £104,401–£115,341; salaried GP £78,699–£118,759; consultant £113,565–£150,569.
- Your first post after PLAB is most likely a locally employed "trust grade" or clinical fellow job, typically advertised at FY2 or core-training level.
- Extras on top: 37% more for night hours, a weekend allowance of 3–15% of basic pay, 8% for on-call availability, and pay for rostered hours above 40 a week. London weighting for doctors is only £2,162.
- Take-home: an FY2-level doctor outside London keeps about £2,839 a month on basic pay, and around £3,490 on a typical rota with nights and weekends.
How doctors are paid in the UK
Doctors are not paid on Agenda for Change, the scale that covers nurses and pharmacists. NHS doctors in England sit on separate national contracts, and the Doctors' and Dentists' Review Body (DDRB) recommends the annual uplift for all of them. Which contract applies depends on the job, not on where you qualified: an IMG in a training post is paid exactly what a UK graduate in the same post is paid. "Resident doctors", in case the term is new to you, is the current name for what used to be called junior doctors.
| Grade | Contract (England) | 2026/27 basic pay |
|---|---|---|
| Foundation doctor (FY1–FY2) | 2016 resident doctor contract | £41,226–£47,610 |
| Core and specialty trainee (CT/ST1–ST8) | 2016 resident doctor contract | £55,355–£77,348 |
| Locally employed doctor (trust grade, clinical fellow) | Local contract, often modelled on the 2016 pay points | Set by the trust |
| Specialty doctor | 2021 SAS contract | £63,696–£102,689 |
| Specialist | 2021 SAS contract | £104,401–£115,341 |
| Salaried GP | DDRB pay range | £78,699–£118,759 |
| Consultant | 2003 consultant contract | £113,565–£150,569 |
The 2026/27 award was announced on 25 March 2026: the government accepted the DDRB's recommendation of 3.5% for resident doctors, SAS doctors, consultants and salaried GPs, effective from 1 April 2026. Scotland, Wales and Northern Ireland set their own pay, covered further down.
Resident doctor pay scale 2026/27
Resident doctors in England are paid on the 2016 contract, and this is the year its scale changed shape. The five old pay points have been split into ten, so doctors now move up during core and higher training rather than waiting years between rises. This is the scale that applies from 1 April 2026, with the previous year alongside:
| Grade | Pay point | 2025/26 | 2026/27 | Rise |
|---|---|---|---|---|
| FY1 | 1 | £38,831 | £41,226 | 6.2% |
| FY2 | 2 | £44,439 | £47,610 | 7.1% |
| CT1/ST1 | 3a | £52,656 | £55,355 | 5.1% |
| CT2/ST2 | 3b | £52,656 | £55,355 | 5.1% |
| CT3/ST3 | 4a | £65,048 | £67,325 | 3.5% |
| CT4/ST4 | 4b | £65,048 | £67,998 | 4.5% |
| ST5 | 4c | £65,048 | £67,998 | 4.5% |
| ST6 | 5a | £73,992 | £76,582 | 3.5% |
| ST7 | 5b | £73,992 | £77,348 | 4.5% |
| ST8 | 5c | £73,992 | £77,348 | 4.5% |
The reform is the product of a long dispute. Resident doctors struck from 7 to 13 April 2026 after rejecting an earlier offer; a new government offer in June suspended further action, and BMA members accepted it on 29 June 2026. The deal restructured the pay points on top of the 3.5% award; together they are worth an average of 6.6% across the scale once fully delivered in April 2027, and the backdated arrears were due in September 2026 salaries. A second step lands in April 2027, before any 2027/28 award is added: CT2/ST2 rises to £56,925, ST5 to £71,415 and ST8 to £80,730. Progression between the new points depends on your annual review of competence progression (ARCP) if you are a trainee.
Where IMGs actually start: non-training posts
After GMC registration, most IMGs do not walk into foundation or specialty training. Their first NHS job is usually a non-training post — advertised as trust grade, clinical fellow, junior or senior clinical fellow, trust SHO or trust registrar. The NHS calls these doctors locally employed doctors, and NHS Employers notes that a large proportion of them are international graduates. The Medical Training (Prioritisation) Act 2026, which prioritises UK graduates for foundation training — and UK graduates plus doctors with significant NHS experience for specialty training — from the August 2026 recruitment round, makes that first non-training post even more central to the plan. We explain what the Act changes in our guide to whether the UK is closing to international doctors.
The catch is that locally employed doctors are not on a national contract, so each trust sets their pay. What that means in practice:
- The recommended rates mirror training pay. NHS Employers publishes ten pay codes for these posts whose 2026/27 values match the ten resident doctor points above, and recommends that trusts use them — though there is no requirement to. SHO-level posts are commonly advertised at FY2 (£47,610) or core-training level (£55,355), and registrar-level posts at ST3 level or above (£67,325+).
- Read the advert, not the job title. "Clinical fellow" can mean anything from FY2 to ST3 pay. The advert or the job description should name the pay point or salary; if it does not, ask before you interview.
- Flexible pay premia are for trainees only. Supplements such as the £11,508 GP registrar enhancement or the £4,679 psychiatry premium need a national training number, so a non-training post does not attract them.
- Terms are improving. The June 2026 agreement also covers locally employed doctors: trusts are expected to offer contracts modelled on the 2016 terms, permanent contracts are becoming the default, pay progression will follow an enhanced appraisal, and national terms for these posts are due by April 2027. The BMA has warned that some employers may resist passing on uplifts where local terms do not closely follow the national contract — another reason to check the pay point in writing.
If you have substantial postgraduate experience from home, raise it at offer stage and ask whether it counts towards your starting pay point. It is far easier to agree before you sign than to reopen afterwards. Our guide to getting shortlisted for NHS jobs from overseas covers the application itself.
What adds to basic pay
Basic salary on the 2016 contract covers an average 40-hour week. Most ward-based rotas are built to average more than that, include nights and weekends, and sometimes on-call — and each of those is paid separately. These rules apply to trainees, and to locally employed doctors whose contracts follow the national terms.
| Element | How it is paid | At FY2 level (£47,610) |
|---|---|---|
| Additional rostered hours | Basic hourly rate for rostered hours above 40 a week | About £22.83 an hour |
| Night hours | +37% of the hourly rate between 9pm and 7am | About £84–£97 extra per long night shift |
| Weekend allowance | 3% of basic (1 weekend in 8) up to 15% (1 in 2) | £1,428 to £7,142 a year |
| On-call availability | 8% of basic pay | £3,809 a year |
| London weighting | Fixed £2,162 (London) or £149 (fringe) | £2,162 a year |
The weekend allowance works in steps: 15% of basic pay for one weekend in two, 10% for one in three, 7.5% for one in four, 6% for one in five, 5% for one in six, 4% for one in seven and 3% for one in eight. Working weekends less often than one in eight earns no allowance. A long night shift that starts in the evening and runs to the morning is enhanced for most or all of its hours, which is why a block of nights shows up so clearly on a payslip.
One figure deserves a warning. London weighting for doctors on the 2016 contract is a fixed £2,162 a year — an amount that has not been uprated in two decades. Compare that with the 20% High Cost Area Supplement a nurse in inner London receives, set out in our Band 5 nurse salary guide. For an FY2-level doctor it adds about £115 a month to take-home pay, which will not touch a London rent. For the first years after PLAB, the rest of England usually leaves you far better off.
Take-home pay: worked examples
Here is basic pay converted to monthly take-home for the grades IMGs most often start in or move through. The figures assume England outside London, the 2026/27 income tax and National Insurance rates, a standard tax code, no student loan, and the NHS Pension contribution tier each salary falls into (9.8% up to £52,778, then 10.7% up to £67,668, then 12.5%).
| Grade (basic pay) | Pension | Income tax | National Insurance | Take-home a month |
|---|---|---|---|---|
| FY1 (£41,226) | £337 | £410 | £191 | £2,498 |
| FY2 (£47,610) | £389 | £506 | £234 | £2,839 |
| CT/ST1–2 (£55,355) | £494 | £614 | £260 | £3,245 |
| Specialty doctor, entry (£63,696) | £568 | £849 | £274 | £3,618 |
| ST3 (£67,325) | £600 | £957 | £280 | £3,774 |
Now add a typical rota. Take an FY2-level post averaging 44 hours a week, with one weekend in four and about 35 long night shifts a year. On 2026/27 rates that adds roughly £4,760 for the extra hours, £3,570 in weekend allowance and £2,960 in night enhancements — about £11,300 in all, taking gross pay to around £58,900. The extras are not pensionable, but they push part of your income into the 40% tax band, so take-home rises by about £650 a month rather than the full £940 — to around £3,490 a month. Treat every number in this section as illustrative: your rota, tax code and pension choices will move it.
Two costs come off that take-home and are worth planning for. The GMC annual fee is £481 from April 2026, or £184 if you qualify for the GMC's fixed-term discount, which is aimed at recently qualified doctors — and if you pay it yourself, it is tax-deductible, so claim the relief from HMRC. And the pension deduction is not money lost: the NHS Pension Scheme is a defined-benefit scheme, and the employer contributes substantially on top of what you pay.
Specialty doctor and specialist pay: the SAS route
Not every doctor wants — or gets — a training number, and the NHS relies heavily on specialty and specialist (SAS) doctors. For IMGs these posts are a serious long-term career rather than a fallback: many arrive with years of postgraduate experience that counts towards the entry criteria, and the pay overlaps the higher training grades.
| Grade | Pay point | 2026/27 basic pay |
|---|---|---|
| Specialty doctor | 0–2 years | £63,696 |
| Specialty doctor | 3–5 years | £73,383 |
| Specialty doctor | 6–8 years | £81,804 |
| Specialty doctor | 9–11 years | £90,548 |
| Specialty doctor | 12+ years | £102,689 |
| Specialist | 0–2 years | £104,401 |
| Specialist | 3–5 years | £108,484 |
| Specialist | 6+ years | £115,341 |
Under the 2021 contract, a specialty doctor needs at least four years of full-time postgraduate training, two of them in a relevant specialty — or equivalent experience and competencies, which is where overseas experience can count. The specialist grade sits above it, for senior doctors working autonomously. A common IMG path is two or three years in non-training posts, then a specialty doctor post, and from there either specialist grade or — through the GMC's portfolio pathway — the specialist register and consultant posts.
Consultant and GP pay
Consultants in England are paid on the 2003 contract, with pay thresholds that rise with years in the grade:
| Threshold | When reached | 2026/27 basic pay |
|---|---|---|
| 1 | On appointment | £113,565 |
| 2a | After 3 years | £120,249 |
| 2b | After 4 years | £123,672 |
| 3 | After 8 years | £135,645 |
| 4 | After 14 years | £150,569 |
Salaried GPs in England are paid within a DDRB range of £78,699 to £118,759 for 2026/27, set by each employing practice; GP partners are self-employed and earn from the practice's profits instead. For an IMG, both destinations are years away and run through either UK training or a portfolio pathway application to the GMC's specialist or GP register — the application fee for which is £1,974 from April 2026.
Scotland, Wales and Northern Ireland
Health pay is devolved, and in 2026/27 the four nations genuinely differ:
| Nation | 2026/27 position for resident doctors | First-year starting basic |
|---|---|---|
| England | 3.5% award plus pay-point reform | FY1 £41,226 |
| Scotland | 3.75% from 1 April 2026, the second year of a deal accepted in February 2026 | FY1 £39,649, plus a banding supplement for out-of-hours work |
| Wales | 3.5%, and a new resident doctor contract from 1 August 2026 | F1 £41,400 (F2 £51,750) |
| Northern Ireland | The 3.5% recommendation had not been implemented as of late June 2026, pending a budget | FY1 £35,704 (2025/26), plus banding |
Scotland and Northern Ireland still pay resident doctors under the older banding system, where a supplement for out-of-hours work sits on top of basic pay — so a basic-to-basic comparison with England understates what doctors there are paid. Compare total offers, not headline scales.
What a UK doctor's salary means in rupees
At late-September 2026 exchange rates — roughly PKR 367 and INR 127 to the pound — the numbers look like this:
| Salary | In pounds | In Pakistani rupees | In Indian rupees |
|---|---|---|---|
| FY1 basic pay, a year | £41,226 | About PKR 1.51 crore | About ₹52 lakh |
| FY2 basic pay, a year | £47,610 | About PKR 1.75 crore | About ₹60 lakh |
| FY2-level take-home, a month | £2,839 | About PKR 10.4 lakh | About ₹3.6 lakh |
| Core-training take-home, a month | £3,245 | About PKR 11.9 lakh | About ₹4.1 lakh |
Exchange rates moved by around 2% in September alone, so treat these as orders of magnitude. The more useful sum is what is left after UK costs. In a mid-cost English city such as Birmingham, Leeds or Coventry, a single doctor renting a one-bedroom flat should budget roughly £1,350–£1,750 a month for rent, council tax, energy, food, phone and transport. On an FY2-level take-home that leaves around £1,100–£1,500 a month to save or send home; on a rota with nights and weekends, more. Families should plan on the tighter end — our guide to moving to the UK with school-age children covers schooling costs.
Is PLAB worth it financially?
On the fees alone, the payback is fast. PLAB 1 is £283 and PLAB 2 £1,036; add GMC registration at £184–£481, an English test, a visitor visa and the trip to Manchester, and a first attempt at every stage typically comes to £2,300–£4,000. That is no more than about six weeks of FY2-level take-home pay. The line-by-line figures are in our PLAB cost breakdown, and the full route from home is mapped in our guide to PLAB from Pakistan.
The real cost is time, and the real risk is the job, not the fees. Most candidates spend 12–24 months between starting PLAB preparation and a first NHS salary, including four to eight months between passing PLAB 2 and starting work, with no UK income. Competition for non-training posts is heavy, and the 2026 Act has narrowed the training pipeline behind them. So PLAB is financially worth it for a doctor who can fund that gap, secure a first post and commit to building a UK career. It is a poor bet if you are relying on finding a job within weeks of passing.
Salary and your Health and Care Worker visa
Almost every IMG in an NHS post is sponsored on the Health and Care Worker visa, which carries lower fees than a standard Skilled Worker visa and exempts you and your family from the Immigration Health Surcharge. For doctors the salary test is straightforward. Medical practitioners are a national pay scale occupation, so the offered salary must be at least the "going rate" — the relevant NHS pay scale for the post — and never below a £25,000 floor. The Home Office's going-rate table was still using 2024/25 pay in September 2026 (FY1 £36,616, FY2 £42,008, core training £49,909), well below the 2026/27 rates, so posts paid on the national scales pass comfortably.
Two details matter. Only guaranteed basic pay counts — not nights, weekends, on-call or extra hours — and no more than 48 hours a week is counted. So check that a locally employed post's basic salary, not its rota-inflated total, meets the relevant scale. Time on this route also builds towards settlement; how long that takes under the 2026 changes is covered in our guide to the 10-year ILR rule for healthcare workers.
Frequently asked questions
How much does a doctor earn in the UK in 2026?
In England in 2026/27, basic pay runs from £41,226 for an FY1 doctor to £150,569 for the most senior consultants. FY2 doctors earn £47,610, trainees £55,355–£77,348, specialty doctors £63,696–£102,689 and salaried GPs £78,699–£118,759. Nights, weekends, on-call and extra rostered hours add to basic pay for most hospital doctors.
What is the FY1 salary in the UK in 2026/27?
£41,226 in England from 1 April 2026, up 6.2% from £38,831, which is about £2,498 a month after tax, National Insurance and pension outside London. In Scotland the FY1 basic is £39,649 plus a banding supplement, and in Wales F1 doctors earn £41,400 under the new contract from August 2026.
How much do IMGs earn after PLAB?
Most IMGs start in a locally employed non-training post — trust grade or clinical fellow — usually paid at FY2 level (£47,610) or core-training level (£55,355) in England in 2026/27. That is about £2,839–£3,245 a month take-home before extras. Pay rises with experience and grade, and specialty doctor posts start at £63,696.
What is the take-home pay of a junior doctor in the UK?
On basic pay outside London in 2026/27, about £2,498 a month at FY1, £2,839 at FY2 and £3,245 at CT/ST1–2 after tax, National Insurance and NHS Pension contributions. A typical rota with nights, weekends and some extra hours can lift an FY2-level doctor's take-home to around £3,490 a month.
How much is a UK doctor's salary in Pakistani rupees?
At about PKR 367 to the pound in late September 2026, FY2 basic pay of £47,610 is around PKR 1.75 crore a year, and FY2-level take-home of £2,839 a month is around PKR 10.4 lakh a month. Exchange rates move, and UK living costs of roughly £1,350–£1,750 a month for a single doctor come off that before savings.
Do doctors in London earn more?
Only slightly. Doctors on the 2016 resident doctor contract receive a fixed London weighting of £2,162 a year — about £115 a month more in take-home pay at FY2 level — which has not been uprated in two decades. London rents are far higher, so most new doctors are better off financially outside London.
Does a doctor's salary meet the Health and Care Worker visa requirement?
Yes, for posts paid on the national NHS pay scales. The salary must meet the going rate for the post and at least £25,000, and the Home Office's going rates were still based on 2024/25 pay in September 2026, below the current scales. Only guaranteed basic pay counts, so check the basic salary of a locally employed post rather than its total with rota extras.
The pay scales are generous by any international standard, but they only start once you hold GMC registration and a sponsored post — and that sequence is where most IMGs lose months. Global Pathways plans the PLAB route end to end for doctors from Pakistan, India and beyond, from English test and EPIC verification to PLAB 2, GMC registration and the visa. See our PLAB support service or book a free consultation.