Financial guidance for junior doctors at every training stage
Junior doctors navigate a uniquely complex financial situation: rotating between trusts mid-year, managing student loan repayments that interact oddly with the tax system, picking up locum shifts on top of a main salary, and trying to understand an NHS pension scheme that nobody explains properly. Getting the basics right from foundation year sets good habits that matter more and more as income grows.
Note: Statutory figures for the tax year shown. Your own position is what decides the answer.
What we hear
What we hear from junior doctors
The questions and concerns that come up most in the first conversation.
I did locum shifts on top of my main salary. Do I need to file a tax return?
Yes, if your total income from all sources exceeds the higher-rate threshold, or if you have income outside PAYE (locum shifts paid to you directly, not via your Trust bank). Locum income paid directly to you is self-employment income and must be declared on self-assessment. Whether you need to file is identified, and the return handled.
How does my student loan repayment work with my salary?
Repayment is 9% of income above the repayment threshold for your plan, and nothing at all below it. The threshold is different for each plan and is re-set every April, so a headline figure goes stale fast. If you earn above it in employment, repayments come out through PAYE. If you also have self-employment income from locum shifts, further repayments are collected through self-assessment. Run your own salary through the locum tax calculator rather than working from a remembered number.
I moved trust mid-year. How does tax work?
Moving between NHS trusts mid-year can result in two employers applying the wrong tax code, particularly if neither knows about the other's PAYE records. You may end up underpaying or overpaying tax on a cumulative basis. Your P60s and PAYE records are reviewed at year end and any overpaid tax reclaimed from HMRC.
What is the NHS pension actually giving me?
Junior doctors are enrolled in the 2015 NHS Pension Scheme, which is a career average revalued earnings (CARE) scheme. Your pension accrues at 1/54th of your pensionable pay each year, revalued annually by CPI plus 1.5%. Many junior doctors think the 2015 scheme is less valuable than the older sections. It is still an exceptionally good scheme, but understanding what you are accruing helps you plan supplementary saving.
What expenses can I claim during training?
BMA membership (if you are self-employed for locum work, and relief is restricted to 85% of the subscription under the BMA's List 3 entry), GMC retention, MDU or MPS indemnity if paid personally, exam fees for postgraduate qualifications (GMC/MRCS/MRCP etc., subject to conditions), professional journals, and motor between separate clinical sites. What is claimable is read against your employment status and whether you are doing any self-employed work.
I am starting to do medico-legal or teaching work. What do I need to do?
Income from expert witness work, medico-legal reports, or private teaching is self-employment income. You need to register with HMRC as self-employed, file a self-assessment return, and pay Class 4 NI. There is a small earnings threshold below which NI is not due, but the self-assessment requirement applies from the first pound of self-employed income. This is handled alongside your main salary return.
How it works
How we work with junior doctors
- 01
Self-assessment for junior doctors with locum income
Return combining your NHS PAYE salary, locum income, and any other self-employed or investment income. Student loan repayment reconciled. Class 4 NI calculated correctly on self-employed income. Filed on time, no January panic.
- 02
Tax code review and overpayment recovery
Your PAYE records across all NHS employers are reviewed and your tax code checked, especially after a trust move or a change of grade. Where HMRC owes you a refund from overpaid PAYE tax, it is reclaimed.
- 03
Student loan repayment review
Your student loan plan type is checked, along with whether PAYE repayments are being applied correctly against your balance and whether any additional self-assessment repayments are calculated on the right income figure.
- 04
Expense claim setup for locum and self-employed work
For junior doctors doing self-employed work, a clear, HMRC-compliant expense framework is set up from the start. This covers professional registration, indemnity, CPD, exam fees (where qualifying), and motor between clinical sites.
- 05
NHS pension understanding and modelling
What you are accruing in the 2015 CARE scheme is set out plainly, your projected benefit is modelled at different retirement ages, and whether supplementary contributions (AVCs or a personal pension) make sense alongside the NHS scheme is worked through.
- 06
Foundation to consultant financial planning
Support runs from foundation year through specialist training, tracking the financial implications of grade changes, gap years, academic posts, and the transition to consultant grade where income complexity increases sharply.
Free calculators
Run the numbers before you send anything
Free to use, on 2026/27 rates. If you want one of our specialists to confirm your figure, say so at the end; you see the result either way.
- Locum Doctor Tax CalculatorWork out the tax on locum shifts taken alongside your NHS salary, including the student loan repayment.
- Salaried Doctor Take-HomeSee what a training grade salary leaves after tax, National Insurance, pension contributions and student loan.
Free consultation
Get your junior doctor tax sorted
Send your position and we will match it to one of our medical accountants who works with doctors. The first call covers your current tax position, your locum income setup, and your student loan situation. Scope and fees are agreed with you, and enquiring commits you to nothing.
- Medical work onlyNHS pension, practice accounts and private practice
- Read by a medical accountantYour enquiry goes to our accountants who work with doctors
- One position, not threePractice, pension and personal return read together
No obligation. If our specialists think your position is already right, they will tell you so.
Book your free consultation
FAQ
Common questions from junior doctors
If your only income is PAYE NHS salary and you have no self-employed income, investments above the savings threshold, or income over £100,000 (which triggers the personal allowance restriction), you do not strictly need to file a self-assessment. However, it is worth reviewing your P60s and tax code annually to check for overpayments, and it is useful to understand the student loan situation. Many junior doctors find it helpful to start the relationship early so the transition to consultant-grade complexity is smooth.
Not necessarily. Bank shifts through your own Trust are usually processed through your existing employment contract via PAYE. However, bank shifts through an external locum agency, or direct agreements with other practices, are treated as self-employment. The distinction matters for NI, for whether you receive PAYE deductions, and for your self-assessment obligation. The nature of the arrangement is what settles it, so it is checked before it reaches your return.
The tax implications depend on your fellowship structure. An NHS academic clinical fellowship or a university-hosted fellowship may be treated differently: one may be employment, the other self-employment or a bursary. The interaction with NHS pension membership also differs. The correct treatment for your specific fellowship is worth settling before you start, so there are no surprises.
Plan 2 (post-September 2012 entry) takes 9p in every pound you earn above the Plan 2 repayment threshold, and nothing below it. The threshold moves each April, so the only figure worth acting on is the current one applied to your own salary: the locum tax calculator does that, and your payslip shows what is actually being deducted. As your salary grows through the training grades, repayments increase proportionally until your balance is cleared or written off 30 years after your first repayment due date.
Many junior doctors face mortgage challenges because their employment contracts are fixed-term and their income varies year to year with locum shifts and allowances. Specialist mortgage brokers who understand NHS employment can usually find suitable products. On the accounting side, clean SA302s and two years of accounts for any self-employed income can be produced where a lender asks for them, and the tax implications of ownership structures matter if you are buying with a partner.