Junior doctor salary UK 2026: the BMA nodal point pay scales from F1 to ST6, and what each one actually pays after tax, NI and the NHS pension.
Doctors ask me a version of the same question every August: the offer letter says a number, so why does the payslip say something so different? For a first year doctor in England on the 2026 scales the gap is roughly £11,000 a year, and almost none of it is a mistake.
Here is the junior doctor salary UK picture for 2026/27, nodal point by nodal point, with what each grade actually leaves in the account once income tax, National Insurance and the NHS pension have taken their cut.
One note on language first. The official term has been resident doctor since 2024, and the BMA and NHS Employers both use it now. Most people still search for “junior doctor”, so both appear below. They mean the same thing.
Doctors in training in England are paid on the 2016 contract against nodal points, not annual increments. You move up when you move into the next stage of training, not on an anniversary.
The structure changed this year. Following agreement between the government and the BMA, the NHS Employers pay circular confirms the nodal pay point system was restructured from five points to ten, aligned to the stages of training, with effect from 1 April 2026. That sits on top of the 3.5% uplift the DDRB recommended for doctors and dentists in training.
These are the BMA pay scales for resident doctors in England for 2026/27, basic pay, full time.
| Grade | Nodal point | Basic pay |
|---|---|---|
| FY1 | 1 | £41,226 |
| FY2 | 2 | £47,610 |
| CT1 and ST1 | 3a | £55,355 |
| CT2 and ST2 | 3b | £55,355 |
| CT3 and ST3 | 4a | £67,325 |
| CT4 and ST4 | 4b | £67,998 |
| ST5 | 4c | £67,998 |
| ST6 | 5a | £76,582 |
| ST7 | 5b | £77,348 |
| ST8 | 5c | £77,348 |
Two things stand out. Nodal points 3a and 3b currently carry the same value, as do 4b and 4c, which is what a part-implemented ten point structure looks like. And the step from ST2 to ST3 is nearly £12,000, by far the biggest jump on the scale.
Scotland, Wales and Northern Ireland negotiate separately and run their own contracts, so the figures above are England only.
Now the part the offer letter does not show you.
Three things come out before the money reaches you. The NHS pension is deducted first and reduces your taxable pay, so it saves you income tax as it goes. Income tax then applies at 20% above the £12,570 personal allowance and 40% above £50,270. National Insurance is charged on gross pay at 8% between £12,570 and £50,270 and 2% above that.
The pension rate depends on your actual annual pensionable pay. For 2026/27 the tiers are 5.2% up to £13,259, 6.5% to £28,854, 8.3% to £35,155, 9.8% to £52,778, 10.7% to £67,668, and 12.5% above £67,669. Your employer puts in 23.7% on top.
Here is the result on basic pay alone, England, no student loan.
| Grade | Basic pay | Pension | Income tax | NI | Take-home | Monthly |
|---|---|---|---|---|---|---|
| FY1 | £41,226 | £4,040 | £4,923 | £2,292 | £29,970 | £2,498 |
| FY2 | £47,610 | £4,666 | £6,075 | £2,803 | £34,066 | £2,839 |
| ST1 and ST2 | £55,355 | £5,923 | £7,372 | £3,118 | £38,942 | £3,245 |
| ST3 | £67,325 | £7,204 | £11,480 | £3,357 | £45,284 | £3,774 |
| ST4 and ST5 | £67,998 | £8,500 | £11,231 | £3,371 | £44,896 | £3,741 |
| ST6 | £76,582 | £9,573 | £14,236 | £3,542 | £49,231 | £4,103 |
Worked example, FY1. Basic £41,226. The pension takes 9.8%, which is £4,040.15, and that comes off before tax. Taxable pay is therefore £37,185.85, less the £12,570 personal allowance leaves £24,615.85 taxed at 20%, so £4,923.17. National Insurance is 8% of the £28,656 above the primary threshold, so £2,292.48. Total deductions £11,255.80, leaving £29,970.20 a year or £2,497.52 a month.
Add a student loan and it moves again. On Plan 2, with a £29,385 threshold in 2026/27 and 9% above it, an FY1 repays about £1,066 a year, roughly £89 a month.
Look again at the two middle rows. ST3 takes home more than ST4, on a higher grade with higher basic pay. This is not a rounding error and it is worth understanding before you assume payroll has made a mistake.
The NHS pension contribution tier moves from 10.7% to 12.5% at £67,669 of pensionable pay. ST3 basic is £67,325, which is £344 under the line. ST4 basic is £67,998, which is £329 over it. So a £673 pay rise moves the whole salary into a higher contribution band, not just the extra £673.
The arithmetic: an extra £673 of gross pay, against an extra £1,296 of pension contribution. Net effect on basic pay alone is about £387 a year worse off, or £32 a month.
The pension money is not lost, of course. It buys extra benefits in the 2015 scheme and the employer still adds 23.7%. But your monthly cash goes down, and nobody warns you. If you are rotating to ST4 this year, that is the line to look for on the first payslip.
Any junior doctor salary UK figure quoted as a single number is basic pay, and basic pay is a floor rather than a salary. On the 2016 contract most resident doctors earn meaningfully more than the table above, through a set of additions that vary by rota.
None of these are pensionable in the same way as basic pay, and the rules differ by element, so a doctor on a heavy rota and a doctor on a light one can sit on the same nodal point and take home very different amounts.
Changed: the nodal point structure, expanded from five points to ten and aligned to stages of training, with new values from 1 April 2026 and backdated pay. Exam, portfolio and membership fees are also being covered in future under the June 2026 agreement, which for a trainee heading towards a haematology CCT the BMA costs at up to £5,775.
Not changed: the tax thresholds. The personal allowance is still £12,570 and the higher rate threshold still £50,270 for 2026/27, both frozen. Every pay rise therefore gets taxed at your existing marginal rate with no offsetting band uplift, which is why a 3.5% rise on paper is worth less than 3.5% in the account.
If you want your own number rather than a table, the NetPay app takes your nodal point, your rota enhancements and your student loan plan and works out what should actually land each month. Free to download.
See your real take-home pay in seconds
NetPay does this maths for every shift, invoice and payslip, automatically.
Download the app now
On the 2016 contract in England for 2026/27, basic pay runs from £41,226 at FY1 to £76,582 at ST6, with ST7 and ST8 at £77,348. These are the BMA nodal point values that took effect on 1 April 2026 after the nodal point structure was expanded from five points to ten. Scotland, Wales and Northern Ireland run separate contracts.
On basic pay of £41,226 with no student loan, an FY1 in England pays roughly £4,040 in NHS pension contributions, £4,923 in income tax and £2,292 in National Insurance across the year. That leaves about £29,970, or around £2,498 a month. Rota enhancements and any weekend allowance are paid on top.
The NHS pension contribution tier jumps from 10.7% to 12.5% at £67,669 of pensionable pay. ST3 basic is £67,325 and ST4 basic is £67,998, so a £673 rise pushes you over the boundary. On basic pay alone that leaves an ST4 about £387 a year worse off than an ST3, which is a genuine cliff edge rather than a payroll error.
No. Basic pay is the floor. On the 2016 contract you can also receive a weekend allowance if you work weekends at least one in eight, an availability allowance for on-call rotas, a 37% enhancement on qualifying night hours, a flexible pay premium in some specialties, and £1,000 a year if you train less than full time.
Want to see your actual take-home pay?
NetPay UK works out your real net pay after tax, NI, pension and salary sacrifice, for hourly, shift and variable-income workers. Free to download.
Download the app now
A note on financial advice: NetPay UK calculates take-home pay based on official HMRC tax rules. This article reflects rules in force at the time of publication (19 September 2026). Tax rules change. For complex situations, consult a qualified UK accountant or visit gov.uk/income-tax.
