Salary Comparison: GPST1 vs F3 Locum Doctor
Current UK junior doctors now have more non-training career options than ever before, and many face the dilemma of choosing between a traditional medical career through the training route, or building a new kind of medical career outside of one. However, this decision may have significant financial implications, so we have decided to do a comparison of two hypothetical doctors; a GPST1 and an F3 locum doctor.
🩺 The Doctors’ Situations
For the sake of easy calculations, we have chosen to compare the finances of two hypothetical doctors:
Dr GP is a GPST1 working in a district general hospital (DGH).
A full time GPST1 earns £18.19 per hour, or £24.92 for out-of-hours (OOH work), and is rostered for 40 hours of work per week plus 6 hours of OOH work per month. Their base salary (the amount they earn before the out-of-hours work) is £37,935.00. With the ‘extra’ earnings from the OOH work, they earn them a total annual salary of £39,729.24 (before tax and other deductions). They get 27 days of annual leave, plus 8 days of bank holidays off per year, which is equivalent to 7 working weeks per year.
Dr F3 is an F3 locum doctor working in the same DGH.
They get paid a rate of £40 per hour to work across general medical, general surgical, and elderly care wards at an SHO grade (this is a low estimated hourly rate, and locum rates can vary across specialties and regions. You can learn more about locum rates using our locum doctor salary calculator). They work 5 day shifts per week for 8 hours a day (equivalent to 40 hours per week) and do not do any on call or out of hours (OOH) work. In total, Dr F3 earns £1600 per month. If Dr F3 takes 7 weeks of holiday per year (like Dr GP) then they would earn a total of £72,000 per year before tax and other deductions.
The NHS pension system is complicated and the amount contributed by the employer and the employee changes depending on your salary and role. For the sake of these calculations, we have used the value of 9.8% of total salary cotnributed by the employee to calculate the deductions each month based on the salary of the GPST1. You can read more about NHS pensions here.
Depending on how Dr F3 is registered with the Trust (i.e. if they are working as a PAYE employee) they may be eligible to contribute some of their salary towards their NHS pension, but they may not be eligible for the full pension benefits that Dr GP gets. If both doctors contribute the same percentage of their earnings towards their pension then Dr F3 would be contributing £7056.00 per year to their pension. Dr GP would be contributing only £3893.47 to their pension annually, and their employer would be matching that amount.
🔍 Employment Rights
Employee rights for Dr F3 would depend on the how they are employed by the NHS Trust (i.e. PAYE vs paid as a sole-trader) and how long they had worked for the Trust. You can read more about employment rights for uncontracted workers here.
👉 Annual Leave
A full time GPST1 gets 27 days of annual leave, plus 8 days of bank holidays off per year. This is equivalent to 7 working weeks per year. NHS employees earn additional days of annual leave (and other benefits) through a scheme called Reckonable Service, where after 5 years of completed NHS service, a full time GP’s annual leave allowance increases to 32 days per year. For Dr GP, they won’t see the benefits of that scheme for some time, but their current work will be contributing time towards the scheme for the future.
Dr F3 does not have a cap on the amount of time they can take off work, as they are responsible for organising their own working schedule. However, depending on how Dr F3 works with their Trust, they may be eligible for some pro-rata’d ‘annual leave’ payments after working 12 weeks with the same employer. Most NHS Trusts pay 'holiday pay' at 12.07% of the total pay you earned, in lieu of annual leave entitlement to locum doctors.
👉 Parental Leave
Dr F3 may qualify for the NHS maternity scheme depending on how much work they have done with the Trust in the last 12 months, or they could qualify for the government Maternity Allowance for up to 39 weeks, which is a weekly payment of £172.48 or 90% of your average weekly earnings (whichever is less).
If Dr GP did decide to start a family, they would likely qualify for NHS parental leave provided they had at least 12 months of continuous NHS service prior to the beginning of the 11th week before the expected week of childbirth, and have stated their intention to return to work within the NHS at the end of the leave period. NHS maternity leave pays 8 weeks of full pay, 18 weeks of half pay, 13 weeks of Statutory Maternity Pay or Maternity Allowance, and 13 weeks’ unpaid leave.
👉 Sick Pay
Dr F3 does not have the same employee rights as Dr GP, and may not be eligible for statutory sick pay (SSP). You can check eligibility for SSP here. If Dr F3 fell ill and did not qualify for SSP they would either have to accept the time off work as unpaid, claim benefits allowance, or check whether they qualify for Employment and Support Allowance (ESA), which is is money for people who have limited capability for work because of their sickness or disability but do not get SSP. Whether or not they qualify for ESA depends on the value of the national insurance contributions they have made while working as a self-employed person.
👉 Rest Breaks
Both doctors should be entitled to rest breaks during the working day. For Dr F3, locum booking terms and conditions should state the rest break policies of the Trust. Most Trusts don't pay for rest breaks and they'll set out rest break requirements per shift. This is usually 1 x unpaid 30 minute break for a 5 hour shift, and 2 x unpaid 30 minute breaks for a shift over 9 hours, as stipulated by the the BMA 2016 contract. Generally, if you work through your unpaid locum break, you cannot claim back money or time owed. As a trainee, you may be able to claim back money or time if you have worked during a rest break through the Exception Reporting system.
👉 Education and Learning
We have decided to include the educational and learning components of both jobs as there is a financial value or cost to certain courses and teaching components that are required of doctors, whether they are in training or not. We have simply listed the differences between what is available in the two roles, but not quantified the value of each as it is so variable.
A full time GPST1 officially gets 30 days of study leave per year, but much of this is pre-allocated to allow the trainee to attend scheduled teaching as part of their training programme (a full time rota of 40 hours per week includes 8 hours of ‘structured educational’ time per week).
As a trainee, Dr GP has to meet the criteria for ARCP that are outlined by the RCGP training programme, which includes a certain number of Continuing Professional Development (CPD) activities, audit, presentations, and other professional development tasks throughout the year.
Instead of an ARCP, Dr F3 would undertake an annual appraisal as they are not in training. Appraisals do not have such strict requirements as ARCP and are much more tailored to the individual interests of the doctor being appraised. Dr F3 would still be expected to attend CPD and learning opportunities, but much of this can be done free of cost. Any attendance to courses or conferences may be tax deductible as professional expenses but would have to be paid for by Dr F3 themselves as they would not qualify for a study budget like Dr GP would.
Both doctors would be required to pass a 5 yearly revalidation assessment, whether they are in training or not.
💷 Actual Take Home Pay after Deductions (*calculated using this tax calculator)
Note that these two comparisons are not exactly the same, as Dr F3 has been calculated using a 40 hour work week with NO OOH work, whereas Dr GP has been calculated as a 40 hour work week with 6 hours OOH work per month.
Dr GP pre-tax annual salary = £39,729.24
Dr GP annual salary after tax, NI, pension (9.8%) = £28,312.04
+ student loan deductions = £26,553.96
Dr GP pension contribution = £3,893.47
Additional benefits = maternity pay, statutory sick pay, study budget and study leave, NHS reckonable service contribution, training leading to CCT (and prospect of increased pay in time).
Dr F3 pre-tax annual salary = £72,000.00
Dr F3 annual salary after tax, NI, pension (9.8%) = £47,045.25
- student load deductions = £42,382.80
Dr F3 pension contribution = £7,056.00
Additional benefits = Unlimited holiday leave, flexible schedule, autonomy in decisions about where you life and work, can work towards CESR consultancy, less rigid professional development demands as no ARCP.
❓ So what does it all mean?
The difference in pay for Dr F3 and Dr GP (after tax, NI, and pension deductions) is £18,733.21.
Both doctors will be doing the same daily work, and it would be expected that the patient care and outcomes would be the same no matter which doctor was performing the role. Therefore, when a doctor faces a decision to take one role over the other, they will be considering pay and additional perceived benefits that make these two jobs drastically different.
We would love to know your thoughts on this, so please feel free to get in touch with us at firstname.lastname@example.org if you have any questions or comments about this article.
This article is part of a wider series of comprehensive guides and information to help doctors ensure their F3 year is a success. We cover everything from initial planning, options for moving abroad, help with finding work, and tips for making the most of the experience.
Click here to visit our F3 Resource Hub to explore the full list of guides and articles.
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