Doctors income and the real reason most doctors don’t use private healthcare
“I don’t care what I’ll be earning, I just want to be a doctor!”
One of the common findings, when speaking to applicants to medical school is a complete lack of awareness about doctors incomes or how a career in medicine will affect them financially.
In an age of so called austerity, this is worrying.
Some people, particularly certain undergraduates currently doing their A-levels, but also graduates, have told me that money is irrelevant. They seem sure that doctors get paid well enough, and the non-financial rewards of the career along with the job security on offer should make it worthwhile regardless of the actual numbers on your pay slip.
This is undoubtedly true for some people, but can you be sure it will be the case for you? What if these so called ‘non-financial rewards’ of the career turn out to be a vain hope and a false dream?
If you end up hating medicine, your pay cheque will kick you whilst you’re down.
And similarly, if you feel your pay does not reflect the work you do, unhappiness will creep in eventually.
I would urge any applicant to medicine to look into the financial aspect of the career ahead and at how this may vary across different specialities as well as at how things compare to other industries that currently recruit A-grade students.
Not quite poverty
The average F1 or house officer straight out of medical school will make about £26000 pa (perhaps a little more or less depending on banding and other factors).
As long as you don’t compare that to a year 1 salary in investment bankng that doesn’t seem too bad. It’s actually considered pretty good by most F1 docs who are usually single, have minimal expenses to cover and are too busy to squander vast sums in any case.
The picture changes when you look at the same doctor a few years down the line.
Let’s say, for argument’s sake, that five years later this F1 has gained plenty of experience within the medical specialities. He has also passed the MRCP (Membership of the Royal College of Physicians) at the first sitting, published a few papers in key journals, presented at international level and is now a year two speciality registrar in respiratory medicine. To get this post he has, reluctantly, had to move to London. He is also married and his wife has stopped working to look after their new baby.
Note the details from this doctors CV. In many other industries, particularly within the private sector, he would be considered at or near the top of the career ladder and would be rewarded or promoted accordingly.
Now, in between making major decisions about some of the sickest patients in the hospital, conducting research for his various consultants, running overbooked clinics, teaching medical students and trying to keep up to date with the field he must make sure he stays solvent.
So let’s have a look at some figures for him. These are all rounded off to give a rough idea.
Annual post tax income £36000
That equates to a monthly post tax income of £3000
- Mortgage repayments and insurance etc on a two bed flat in Zone 4 £800
- Council tax £120
- 1 x family car (Audi A4 or equivalent bought whilst F1!)
- Petrol £300
- Insurance (£1200 per year / 12) £100
- Road tax (£180 per year / 12) £15
- Food etc for family of three. £600
- Eating out (2-3 times a month) £150
- Utilities (water, phone, mobile, gas and electricity) £200
- Other travel, taxi, trains, tube etc for two adults £150
- Other daily stuff (coffee newspapers etc) £60
Holidays per year
- 1 long weekend in Europe (flights to Rome, 4 star hotel etc) £2300 equivalent to £191 per month
- 1 week ski trip to French Alps for two £2600 equivalent to £216 per month
Total monthly income £3000
Total monthly (averaged) expenditure £2902
Net savings per month £98
Actually, banking £98 is rather optimistic bearing in mind I have not included clothes, nappies, prams, student loan repayments, credit card bills, unsecured borrowing, compulsory courses that cost more than the ever shrinking study budget etc.
Now this doctor is hoping that once he becomes a consultant his earning potential will increase substantially and perhaps with some extra private work he may be able to pocket a little more each month.
That’s a nice theory but may not quite happen for the following reasons:
Earnings, in the UK and US at least, are not likely to go up substantially in the near future. The UK public sector is being cut for better or worse, doctors salaries are being frozen, and even before the current round of cuts, we medics were awarded below inflation pay rises ever since I graduated.
Consultant posts themselves are difficult to obtain in some specialities. There are multiple reasons for this. In some areas (ophthalmology and orthopaedics) there have been too many specialty registrars appointed without a corresponding expansion at consultant level. In other areas (cardiothoracics) the workload has begun to decrease due to changes in disease management. In all areas a number of existing consultants would rather cash in their pension and keep their consultant post as a locum rather than retire and let a new junior doctor take over.
A further point to be made here is that earnings as a junior doctor are related to hours and years of experience but as a consultant they are much more dependant on speciality.
In trauma and orthopaedics as well as plastic surgery, neurosurgery, cardiology and dermatology, private sector earnings are potentially huge, especially in London. These are the only people that may be banking £250,000 or more per annum, but the work is hard, the hours long and the astronomical defence fees for the more lucrative surgical specialities make it difficult for newcomers to get a foothold.
In all this there are two other groups of doctors that are doing very well financially.
- GPs who have been business minded enough to have multiple parterships and ‘other’ interests. Again newer entrants are finding GP partnerships difficult to obtain because existing partners prefer to employ salaried doctors. The reasons for this are largely financial.
- Doctors in any field who have managed to get a useful patent under their name. This is probably more common than you think. Some (very rare) doctors are innovative. In my career I have met intensivists who sell novel sports training devices, orthopaedic surgeons who have designed new joint replacements and physicians who sell their own brand of ward management software to an international market. In all these cases the individuals concerned work part time for the nhs and are able to fund expensive hobbies. Like heli-skiing.
So if you want to be rich there are easier routes to wealth than studying medicine. If you’re lucky or calculating enough you may still be able to join the higher earners within medicine. However, expect to be in your mid thirties at least, before you get there.
NB. The above is useful for potential entrants to medical school but should not be mentioned in an inteview or application form.
Please leave a comment if you have other ideas about finances in medicine. Oh, and please do share this article with anyone else that may benefit from it.
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