NHS doctor salary and pay scales for IMGs
NHS medical pay in England is set nationally. IMGs entering as F2-equivalent SHOs sit on nodal point 2 (~£43,900 basic, ~£52k–£62k total with rota supplements). Core and specialty trainees start at nodal point 3 (~£55,300 basic, ~£62k–£74k total). Registrars at nodal point 4 typically earn £74k–£92k total. Non-training specialty doctors range from ~£70k to £110k. Figures exclude London weighting.
This page has not yet been through a formal review. Always confirm figures against the linked official source. How we keep content current.
How NHS medical pay is built
NHS doctor pay in England has three layers: a basic salary (fixed nationally by grade / nodal point), a rota supplement (usually 30–50% of basic, driven by the intensity of the working pattern), and additional payments for on-call availability, weekend work above threshold, and antisocial hours. The same nodal point can produce very different total earnings depending on the rota code.
Pay by grade — England, 2024/25 scales
| Grade | Basic | Typical total* |
|---|---|---|
F2-equivalent (first NHS SHO post) Nodal point 2 — trust-grade SHO / clinical fellow Most IMGs enter here after PLAB and GMC registration. Full-shift or 1-in-8 on-call rota drives the enhancement. | £43,923 | £52,000–£62,000 |
CT1 / ST1 (core or specialty training entry) Nodal point 3 — 2016 junior doctor contract Applies once you match into a national training programme via Oriel. Same nodal point covers CT1, ST1 and second-year SHO posts. | £55,329 | £62,000–£74,000 |
CT2 / ST2 Nodal point 3 (continued) Basic pay does not increase between CT1 and CT2 under the 2016 contract; increments come from rota changes. | £55,329 | £63,000–£75,000 |
ST3+ (registrar) Nodal point 4 Registrar-level roles usually carry 1-in-8 or 1-in-6 rotas and more weekend work — enhancements are proportionally higher. | £63,152 | £74,000–£92,000 |
Specialty doctor (non-training career grade) Specialty doctor 2021 contract — 9 pay points A common long-term route for IMGs who do not enter training. Progression requires evidence of practice at threshold criteria. | £59,175–£95,400 | £70,000–£110,000 |
Specialist grade (2021 contract) 3 pay points — 12+ years total experience required A newer non-training grade positioned between specialty doctor and consultant. Entry criteria are strict. | £96,990–£107,155 | £110,000–£130,000 |
*Total earnings include typical rota supplements and on-call availability but exclude London weighting (~£2,600–£3,300 per year in eligible posts) and locum work. Scotland, Wales and Northern Ireland use slightly different scales — check the BMA page for your nation.
What take-home pay looks like
Take-home pay is typically 65–72% of gross earnings after Income Tax, National Insurance and the 9.8–12.5% NHS pension contribution. A first-post SHO on ~£55,000 gross usually receives £3,000–£3,300 per month after deductions.
- Income Tax: 20% band up to £50,270, 40% above.
- National Insurance: 8% between £12,570 and £50,270, 2% above.
- NHS pension: tiered 9.8%–12.5% at doctor earnings levels.
- Student loan: most IMGs will not have a UK student loan; overseas loans are outside PAYE.
What to check on any NHS job offer
- The grade and nodal point — this fixes the basic pay.
- The rota code (e.g. 1A, 1B, full-shift, 1-in-8) — this fixes the enhancement percentage.
- Whether London weighting applies.
- Whether the post is training or non-training — this affects both pay progression and portfolio value.
- On-call frequency and any additional programmed activities (APAs) offered.
Official sources
Every fact above should be confirmed against the controlling source before you act on it.
Authoritative basic pay figures per nodal point under the 2016 junior doctor contract.
Pay points and progression criteria for the 2021 specialty and specialist grade contracts.
The current pay circular — the definitive employer-side reference.
Use with a take-home calculator to model net pay from the basic + supplements figures.
Tiered contribution rates (9.8–12.5% for the earnings bands in this guide).
This guide is a factual summary, not financial or career advice. Every figure should be confirmed against the linked official source before you rely on it.