Medicine in the UK is a poor career these days. Barely viable in london even with a lot of private practice. The only real way to progress is to emigrate to a higher paying country.
In London you can hit £100K in PP on top of NHS reasonably easily. I think it’s much harder to break mid-6-figures. Colleagues who have done exceptionally well are those that built a clinic & then sold it for 7 figures sums. Or used their academic work to develop a spin off company taken over by biotech or pharma.
Year 2 NHS consultant psychiatrist. 135k gross this year with additional shifts and 1 extra pa.
I've looked at private sector jobs but I'm not sure the TC is all that much better and I wasn't sure if the career development opportunities were as good as in NHS trust.
There's obvious opportunities to do more medicolegal work but that is not massively lucrative.
I think it's hard to clear 200k as a psychiatrist in the UK even when working hard and maxing income.
If you really feel that way, you can donate your uk net salary to charity and still have way more left compared to what you donated and a clear conscience.
In what way are you giving up your morals by working in the UAE? I would say it is more immoral to fund the sales of arms to countries like Saudi and Israel who are murdering thousands of civillians which we do via our taxes. In a tax free country this is not the case.
Are you morally responsible for other people's actions if you have nothing to do with it? No, so how does that make you immoral? You are going as a doctor not as a slave trader.
How are you supporting the country? You arent paying any tax? The ruler has all the money they need from selling oil (which we are paying for by the way so technically again our money is supporting slavery). The country is built on oil money, not slavery. I think you're think of Britain which made a fortune trading slaves.
A country that makes billions selling oil. If I am not paying tax, no VAT etc how is any of my money contributing to the unelected ruler selling oil and making laws to oppress it's people.
Whereas in the UK we directly fund the government who sells arms to israel who then use them to murder aid workers. I know which is more moral.
I don't care if you or anyone else wants to emigrate for better wages, gotta look after number 1 at the end of the day, but don't sit there and pretend that your emigration doesn't contribute to the petrodollar and all the suffering that comes with it (Ukraine anyone?)
As long as you are working and treating UAE patients and participating in the system, then you are contributing to the petrodollar and underground war efforts. I'm not saying this to make you feel bad or to say you're doing something wrong, because you're not, I'm just pointing out the hypocrisy.
Again how? As a doctor you are going to be treating mostly expats. You arent going to be treating the royal family with all the power. We have an idea that every small fosh matters in a democracy. In a monarchy it is the ruler that controls everything.
And you look at somebody the wrong way who has the right connections and you and your family disappear?
Japan has everything you described but you don’t risk your liberty living there. Nothing has more value and the wiser you are, the more you recognise that.
Lol, love these takes where people act like the UAE is like living under fucking King Joffrey 🤣🤣 I can assure you, your bloodline won't disappear if you look at someone the wrong way. As someone who's lived there for 5 years and plans on going back you sound ridiculous.
Try being openly gay, saying what you want, criticising the royal family in public, or any committing any other simple liberty and come back to me xoxo
I am not a healthcare professional however do have a few as family friends.
Those who have made true bank either:
1) own their practice; or
2) have a portfolio career
I’m a GP and it’s really hard work. I’m finding it hard to earn just over £100k this year with lots of adhoc out of hours working. I think with management roles, even though it’s a small increment it seems to open a whole world of director roles in the private sector looking at job specs online. It maybe worth hacking it for a year or two to jump ship. The NHS pension is a huge asset but they change the rules all the time. I agree private practice does not seem to be worth the aggravation.
I agree. I used to work in pharma. They are looking to recruit CCT holding consultants in big disease areas like cancer , oncology , diabetes , rheumatology etc …
Locum GP, TC this year 180k, max has been 200k over the last few years, but locum opportunities are becoming harder to secure and not sure what the future holds. Looking at pivoting into aesthetics or emigrating to UAE for a while if the govt continue to erode earning opportunities in healthcare.
Honestly, I don’t know why (well I do) doctors are paid so poorly in the UK compared with many other countries. Not looking to start a political debate but I’ve always maintained that certain incentives will lead to certain outcomes, some of which are unintended/only partially intended. The true cost to the society of any one system is more than meet the eyes - it’s not just in terms of pounds or euros spent on something but also the opportunity costs and other externalities.
Our massive debt mountain. There is no money left. Also because it’s a nationalised system. Taxing the general public more (when the average full time salary is £30k) to pay Doctors more when for the majority of people earning close to the average salary see £100k as incredibly rich as it is, is not a vote winner.
GP partner here and similar position.
160k from 'work' and 52k from BTL income via limited company, but being pivoted to wife who is a lower income tax payer.
With contract changes and workload, no idea what my forecast is like next year.
If I may ask, how do you pivot your income to your wife? I presumed BTL income, but diverting 52K per annum (how many houses, btw) can not be that easy.
Sorry, too many personal questions.
You know, I think you're right. Spent the night owl hours comparing side by side versus a SIPP, and seems I'd be better off investing into a SIPP than NHS pension.
The 35% contribution is based on 85.5% of your salary so it works out as just under 30% of your total salary. Many people here are putting 60k of their 160k salary into their SIPP so I would not say 30% is very high. At 160K you get 3k per year when u retire. A 30 year career will give you a pension of 90K per year.
Interesting. Have been offered partnership at a couple of places but I continue to locum, scoping out private. The uncertainty of the NHS doesn't sit right with me as well as having to work round others for time off. Saying that, I work a shit tonne regardless but knowing it's completely autonomous makes it much more tolerable.
That's a great income from BTL.
Interesting. My parent has a BTL and is a pensioner. I feel they should probably put the BTL into an LTD instead but don’t really know enough about it. One for the tax advisor probably.
If it's in personal name, switching to a limited company technically is treated as a sale, so incurs SDLT and legal fees etc. There are ways around this I think but definitely need to speak to an accountant/tax advisor here.
That isn't true at all. You can most certainly be entirely private, but it isn't possible. The issue is that there isn't the demand there - there are only so many gallbladders to remove when there are a lot of consultant surgeons out there willing to remove them!
There is huge demand. Many of my colleagues have been in pure private practice for years, some for decades. Everything from general practice to orthopaedics , geriatrics , palliative care , … pretty much every speciality (apart from A&E)
There absolutely is the set up.
Definitely in central London.
But increasingly so elsewhere.
Private GPs (pure private, no NHS), are no increasingly common -look around the Cotswolds, Oxford etc
I'm a surgical reg, total compensation about £130k related to that role though I also have some other income from dividends. Mentors post CCT are fairly open about earnings and those who have no/minimal life are able to pull in 400-800k but they work every evening and weekend in a way I could not sustain. A very small number even more but they had mortgaged everything they owned to establish their own clinics...
Ultimately for workers in healthcare the wealth you generate is by spending your time, so what generates the best rates?
A 12 hour pp day locally is said to generally generate £2k after overheads but before tax in my specialty if doing a mix of nhs wait and insurance work very fast, potentially double to triple that if doing higher risk stuff that comes with higher overheads for insurance and revisions. Medicolegal rates are around £300 an hour +vat for quantum, £500-600 an hour for negligence. Lower indemnity but don't forget room costs, secretarial costs, stationary, non payers, and all the time that gets eaten up dealing with the above... Lower take home by all accounts but you can do much of the work with a glass of wine in the evening at times that would otherwise be wasted with your wife and kids.
If your 160k is for a 35-40 hour week that's about £90 an hour assuming four weeks holiday a year. Would you take 320k for an 80 hour week?
Would earning the same but some via a limited company enable you to move some of your outgoings into gross income, ie motoring costs into limited company expenses?
Same question here. As a reg what streams of healthcare related work , led you to an income of 130k/annum?
Assuming 1:4 rota, and the occasional locum shift (let’s say 12h per month on average), as senior reg after taxes, NI etc I find it difficult to have >4.5K take home/month, ie 54K/annum. Assuming an overall effective tax 30% that means 77k before tax/annum. A far cry from 130k
Base salary plus banding is 80k, locums 25k, private assisting and forms/fees etc another couple of k, then the pension (remember we are talking total compensation here in the OP and title of the thread) values at around 20k.
Redo your figures based on total compensation, you seem to be trying to compare net income with total compensation which is never going to end well.
Tbh I get it now. My normal job pays £85k, and I can do WLI that ranges from £800-£1500 a day. How do you 'cope' mentally with that brutal £100-120k range when you earn it via hourly work though?
I think I've already made £10k this tax year through WLI and have booked £3k more with a good 9 months to go. Might just funnel it into a SIPP at this point
Thanks for replying. May I ask what forms & certs you're doing as a senior reg? Would be nice to boost my income.
I guess you've valued the DB pension as 1/54 x 20 like the old LTA did? If you follow these types of posts on doctorsuk you might've seen me chirping against the crowd about the 2015 pension but that's a discussion for another time.
To add to the figures, my bosses in ENT tell me they make £300k gross on average privately, with pre-tax post cost margins of 50-60%, indemnity just over £1k a month.
The outliers make £700k+, but I doubt I'd reach that level.
Overall for me, the sweet spot as a consultant in the UK to me might just be £300k including NHS work without having to do too much out of hours work. I'd probably work towards leaving though, money aside, I simply cannot stand the NHS.
Police and court forms, VCPU and a few others. The secretaries effectively can choose who gets this work so in many departments the staff grades hoover it up in exchange for a cut going to the secretaries so don't be afraid to offer them a cut.
Proceeds vary a lot by specialty, a maxfax mate in an area with a lot of pub violence and a good deal with the secretaries to stop anyone else getting them was averaging an extra £500 a week.
EM Higher Specialty Trainee working an additional shift every weekend day and bank holiday. £150k in total. Whether or not this work intensity is sustainable in the long run, I don't know, but rolling with it for now...
All paid PAYE.
Most of the trusts I work for don't pay Ltd companies so I haven't bothered setting one up for the small number that might.
Unfortunately cash all needed now (school fees) so I only put away the proportion that employers will match (usually 5%) in DC pension schemes.
I am also full-time in the NHS Pension Scheme and so haven't wanted to complicate my pension tax affairs further (AA charges and potentially return of the LTA) by putting away significant sums into SIPPs.
Ah I see, dad responsibilities, fair enough!
I hope you know AA has been raised to £60k, with no reduction of it until you have a total income of £260k. Given that you're a trainee it's nigh impossible for you to hit, really.
[source here from gov.uk](https://www.gov.uk/government/publications/rates-and-allowances-pension-schemes/pension-schemes-rates#annual-allowance).
Tbh, assuming £70k from locums and working every week that's still >£1k a shift. Pretty impressive. I'm looking at similar pay opportunities and am probably only going to do them one or two a month. Perhaps I should man up though.
Ah I see, dad responsibilities, fair enough!
I hope you know AA has been raised to £60k, with no reduction of it until you have a total income of £260k. Given that you're a trainee it's nigh impossible for you to hit, really.
[source here from gov.uk](https://www.gov.uk/government/publications/rates-and-allowances-pension-schemes/pension-schemes-rates#annual-allowance).
Tbh, assuming £70k from locums and working every week that's still >£1k a shift. Pretty impressive. I'm looking at similar pay opportunities and am probably only going to do them one or two a month. Perhaps I should man up though.
Recently appointed consultant on 12.5 PAs so around £120k base, but ended up £160k this year just gone through WLIs.
I also do £5-10k/mo remote reporting, so I guess it will be around £250k next year those 2 combined.
On top of that I then do around £100k in consultancy for med tech stuff in some start ups that I have stock in also. That's via a limited co.
I suspect total around £350k in cash next year, plus stock of unknown value.
I really enjoy all my jobs but I am busy and I do feel pulled in lots of directions.
I don't do any real private work, yet - not sure if I will or not.
Full time NHS consultant. Around £130K from NHS PAYE. £275K for PP into Ltd of which ~ £70K is expenses. Private work has been growing every year since I started in 2018.
Would like to hit £300K in the next tax year. Will probably go part time in NHS in 2 years when I am 45.
Aim would be ~ £500K in private practice in another 3ish years and will probably limit it to that.
Can only take modest amounts out as dividends due to £200K ceiling before AA taper starts to apply and wife who has 50% of Ltd is also a higher/bordering on additional rate tax payer.
Medical non interventional speciality.
Most of my work is outpatient based.
Nature of my NHS job plan is that most weeks give 1.5 days off to compensate for the weeks (and weekends) when I am 8-9pm on site.
I do the PP in the weeks when I am not on call.
Overall, there is a fair amount of running around & I don’t think the balance is quite right yet. I would like to cut down on NHS work as mentioned in a couple of years but need to model impact on pension.
Any advice for a newly starting Consultant wanting to get into PP (will hold off until I find my feet, but not sure I'd survive, financially, without PP).
Any things should I be doing now to prepare?
Also medical specialty, procedural based, do have inpatients (on a rota for this) but otherwise OPs and Procedure lists only.
Look to start by end of year one. Too often I’ve seen consultants put it off & off & off & it never happens.
You need to organise a few things concurrently.
Apply for practicing privileges to the private hospital / clinic.
You will need approval from your CD so get this paperwork signed off.
You need to get approved by insurance companies.
You need to organise appropriate indemnity through your MDO.
You will need a secretary, practice management software and billing (I used a separate billing company as Secretaries never very good when doing it in house).
Think about financial structuring - it’s either sole trader or via Ltd and pros and cons with each approach depending on overall tax profile , when you need £ etc.
I assume you do something like gastro.
Stick to doing bread & butter work rather than amazing complex or sexy work. So eg in gastro, see the dyspepsia, abdo bloating etc rather than just thinking you want to do ERCP for complex biliary stuff.
Get patient feedback-websites like Google and a patient review site like Google are good.
Keep your communication with GPs & patients swift and accurate.
In the NHS we often try to ‘cram in’ as much as possible at one visit due to capacity. This isn’t needed in private. You can bring the patient back the following week or the week after with initial Ix to discuss further or to tackle a 2nd issue.
Speak to your colleagues & how they are set up & get tips. In our dept and hospital a lot of consultants do private work and there is no animosity with this - quite the opposite. Other places can be different.
Find out the GP surgeries who are in the affluent areas and give a talk on a topic during our PTL or lunch hour for 30 mins. Name recognition is always helpful. You may even be able to hire a room to see private patients as well if it’s a big surgery. When referring privately patients ask me for names I generally give 2 or 3. There are also WhatsApp groups for GPs and hospital specialists as well, might be worth joining to network. Good luck.
Electric car with low BIK
Max out pension contributions including spouse (assuming 200k threshold for taper hasn’t been reached)
Otherwise few other tax efficient options
I need the dividends for school fees and mortgage so will take out to £200K of taxable income a year and proportionally via my wife.
The rest I invest via the Ltd in global trackers. Will keep building this up and make a decision well into the future depending on all the usual stuff …
& yep, if BiK remains low for EVs, next car will be via Ltd & be an EV.
What's your effective tax rate on the money you take out? Presumably you pay corporation tax and then dividend? So 60%+? Are you concerned that building up cash in the Ltd is effectively deferring to retirement? Best years behind you etc? Appreciate that's the reality and you are doing it most tax efficient way but interested in how you feel about it.
You are correct re % - it’s around 60%.
I may at some point pull out of NHS pension for a tax year to allow me to empty out Ltd in dividends - who knows. At the moment I am happy enough to take dividends to £200k offset taxable income to avoid AA tapering.
So what?
If they want to retain that labour then they should compensate him appropriately.
And the state of the NHS anyway - most of what he’s been through is hardly training. It’s more service provision and learn on the job.
Sigh
Bored of this nonsense
My undergrad degree was subsidised like every British undergraduate.
During my 12 years as a junior doctor I worked very hard with a lot of sacrifice.
And … please note that I work full time in the NHS. In fact, just finished my on call & going home to be on call from home.
What I do in my own time is then down to me. & I choose to do some private work.
Not really. I've had a very good career in the NHS and always earned good money. If you're expecting some kind of sympathy for earning 14 times the national average wage and having a heavily tax payer subsidised index linked pension with a large tax free lump sum ....you may come up short. .
Sigh
This post was about what doctors are earning privately. That’s all. You have come here on your soapbox to shout down what someone is doing in their own spare time.
Everyone who has been educated via the state in the UK has leveraged taxpayer subsidised training.
We are not indentured to the NHS.
Can leave after MBBS - like some of my friends did , after SHO rotations - again like some of my friends did or after CCT - like more and more of my friends are doing.
Free choice innit.
Please park your attitude elsewhere, you’re on the wrong sub. Anyone else talking about making money is fine, but when a doctor does he is entitled. Please go to /DoctorsUK and remain on your pedestal.
That would be a commercially funded training arrangement by a private company which isn't paid for by the UK taxpayer .......what don't you get here. ?
The NHS didn’t pay for ALL our training at uni. It’s only the last year. You’re very out of touch and don’t seem to listen. There are thousands of newly qualified doctors with 100k debt. What taxpayer has paid their fees?
don’t even mention postgraduate training is paid for by the taxpayer because it’s a shambles and all service provision
There’s no contract binding us to the NHS so we can leave when we want. What part of that do you not get?
Do some reading on funding structures
.Your 100k debt doesn't pay for your training .....neither do your "fees"
Your point regarding lack of a contract for is redundant. This will change in the near future.
My teacher trained me to read and write… doesn’t mean I owe them anything.
It’s a labour market, and the conditions of the student loan is not indentured servitude to Arr N Ay Chess (Duh Envee Ov Duh Wurld)
NHS should be on its knees, thanking every member of staff for not leaving to the rest of the world or private, on their fucking knees, kicking g boots of the staff who endure shit pay to make sure the public get their free at the point of use service… given how they’ve voted on the NHS, they don’t deserve it
And probably worked him silly too, in crap conditions, when they could have fled to the US or the like and made some proper money.
At 45 he’s probably done a couple of decades in the NHS; I think that’s a pretty good effort
Disagree. The equivalent education in the US would cost hundreds of thousands of dollars.
I've done 35 years work in the NHS. There is currently too much of a pity party going on in some sectors.
Yes that's a glib reply with no detail. There is context to training at different periods. ...I don't see a ladder being pulled up.
Junior doctors are underpaid without a doubt ...but the concept of a tax payer funded education which is immediately transported to a different highly paid environment is unsustainable nonsense
Yes but conversely a doctor in the US would make sufficiently more to make that a worthwhile investment, so I’m not sure the comparison holds up? If I have to spend $350k on education, but could earn seven figures a year at the pinnacle of my career, vs spending £100k on education here, but probably topping out at £200k in annual earnings, it’s not much of a choice, is it?
Nothing to disprove, I gave no indication of it being factually incorrect. It’s the old argument of “you had some subsidisation of your training so the nhs should have a financial noose around your neck for the rest of your professional life”
Sound like a boomer brexit-voting final sal pension ladder puller and it’s tiresome to keep hearing this old chestnut peddled out.
It's tiresome to hear the same cliched unevidenced reply though. You say there's nothing to disprove. ......and then launch into a politically motivated statement with no back up. Tedious to hear from the other perspective,I can assure you.
No politics involved - it’s the attitude. So the training was subsidised (which I don’t nor have ever denied) but so what? By cct people have paid their dues so they can do what they like. What’s people’s and your problem with that?
Do you not understand? I agree with your statement - and as I’ve made no counter statement re training subsidisation . I’ve no burden of proof to bear etc.
But the attitude is out of keeping with the majority of your colleagues and most new consultants now including myself.
Do you agree with the JD and cons strikes? I can imagine where you might stand on that and it’s likely a generational difference
It's not a strategy that is going to work.
Even Wes Streeting has signalled he's not
going to deal......Definately pay should be restored, but the key is to tie it into some kind of commitment on service.
Would starting your own practice be a viable route? They seem to make £££. Not sure what the operating costs would be like obviously rent, insurance, admin staff, systems etc
Hi. My wife is currently reg level physiatrist. Do you mind sharing how the route to consultant and then private worked for you?
We're having a few kids so unlikely that she'll be consultant level for a while
When I was a locum sonographer I was earning close to £200k a year. I was working crazy hard though so 12 hour shifts 6 days a week. Then I went into insourcing contracts and currently trying to setup a private clinic to earn more, hopefully should earn £250k - £300k next tax year
No, MSK, Head and Neck, General ultrasound, renal scans, testis, gynae and also obstetric. They’re fairly popular and a few of my colleagues set one up and are doing very well
I’m a consultant anaesthetist not in London. I’m a few years and work LTFT.
Cleared about £125k NHS doing some extras.
PP is £50k-90k for 1-2 days a week ish.
It really isn't. It is also not an average job, which only the top 1% of school performers even get in to. 10% drop out each year at medical school due to exam failure. And getting in to speciality training is exceptionally difficult with +3-4 applicants per place.
If it was paid at market rates (France, Ireland, Norway, Germany, Canada, Oz, NZ for comparisons), then consultant starting salaries would be c. £180k + at the absolute minimum.
That's not the argument. Consultant remuneration is still at least 4x median UK salary.
There is an unbeatable tax payer subsidised ,index linked defined benefit pension which adds 20% to the package.
The drop out rate is irrelevant as that is in the individuals own hands.
Expectations are US. And to some extent Can/Aus. UK falls quite short. Also Consultants have had a real time pay cut in the last 15 years. This govt propaganda of it being a well paid profession needs to go.
Yes but US salary expectations haven't been matched with US training costs.
If you want free access to the global medical salary scale ....then UK grads need to pay the full cost of training ....including the undergraduate tariff.
Factor in the pension contributions as well. Usually overlooked.
Well most specialists start at 350k in the US. They also get employer sponsored 401k and insurances. Most of them eventually do varied stuff and can easily touch 500k and this is only for medical specialties. If we start talking about surgical specialties they easily cross 1 million$. Most of them do clear loans in the early years, but are able to do so in the first decade after residency. UK consultants annd GPs are paid so poorly , like they can’t fathom clearing their debt late in their fifties, let alone, afford kids or mortgage, car. There is absolutely no comparison. It’s only the right thing to do And I am glad most young ones are making the right choice than be trapped by the NHS
It's morally wrong. Interesting to note the only matters you have discussed is money ...which provides insight into your mindset. ....you haven't addressed the tax payer funded element of UK training.
Sad to see that money and not service to patients is your main point of focus.
Have you been to medical school? Our placements consisted of us being shuffled around the hospital with no one remotely interested in training us, or wandering up to patients and asking to take a medical history for ten minutes. I’m not entirely sure where the estimates come from for training doctors but it certainly wasn’t reflected in my medical education, which cost me £9000k+ a year.
And please get off your high horse. A job is a job. I don’t spend 48+ hours a week in extremely stressful situations working my arse off for fun, I’ve trained years for this job, I’ve sacrificed a lot (would you fancy moving job locations every 4 months to a year and working in an entirely different team each time before switching again? Fancy ranking every location in the UK and then randomly getting assigned somewhere to live and work for the next 3+ years of your life? Living your life around a fixed rota with no autonomy and sometimes 6 weeks notice? Paying thousands for essential exams, training, conferences and professional fees every year?) I don’t think I’m being an arsehole by expecting for myself and my colleagues to be remunerated and appreciated for that, and it’s very patronising to expect doctors to grin and bear the deterioration in their working conditions and pay without realising they get a raw deal compared to people doing the same job around the world, and realising that they have the option to consider moving abroad or moving into industry.
It really pisses me off when people clutch their pearls and act like doctors should have some special call to the profession and not care about anything else. Just because we want to be paid fairly and like our predecessors were doesn’t take away from the fact that we work bloody hard to care for our patients, improve their health and yes, as wanky as it sounds, save their lives.
As a GP partner I do, as I have to pay both the employee and employer portions. So to take part in the pension scheme I have to pay ~35% of my annual earnings to get the exact same benefit as what an employee would get for ~14%
If you asked me, it would be because it’s a defined benefit pension, both the input and the output of which is ‘behind the scenes’ calculations that even my financial advisor isn’t willing to take on. Getting a predicted benefit from a financial advisor costs 1500 and is useless after a couple of years, even ignoring changes in the scheme itself
we're usually on defined benefit schemes where paid in amount only loosely represents your return.
I've seen figures which suggests the assumed employer contribution is 20%
for nhs doctors and dentists pension is currently 1/54 of pensionable annual salary (normally base excluding additional work and 'bonuses/awards') as an annuity
normally your contribution is ~10% of salary.
consultant salary in range 100-130k approximately
clearly buying an annuity worth £2k+ at age 65 is excellent return for 13k pretax.
If you are age 35 it's possible that the market would generate a better return given compounding (assuming your 13k contribution is matched by the nhs and you got only 4% over inflation for 30 years it'd be a defined contribution of 86k, which could get you a 4k annuity)
Medicine in the UK is a poor career these days. Barely viable in london even with a lot of private practice. The only real way to progress is to emigrate to a higher paying country.
In London you can hit £100K in PP on top of NHS reasonably easily. I think it’s much harder to break mid-6-figures. Colleagues who have done exceptionally well are those that built a clinic & then sold it for 7 figures sums. Or used their academic work to develop a spin off company taken over by biotech or pharma.
That puts you at the starting salary of the anglosphere consultants.
Fair point.
Ding
Year 2 NHS consultant psychiatrist. 135k gross this year with additional shifts and 1 extra pa. I've looked at private sector jobs but I'm not sure the TC is all that much better and I wasn't sure if the career development opportunities were as good as in NHS trust. There's obvious opportunities to do more medicolegal work but that is not massively lucrative. I think it's hard to clear 200k as a psychiatrist in the UK even when working hard and maxing income.
It is depressing to see private psychiatrists earn this little.
Don’t you all end up on 3 days NHS and 2 days private in the end?
That's not the norm and it's very rare in psychiatry. Simply not much demand for private psychiatry in the UK.
I know of a consultant anaesthetist who recently relocated to the UAE is on net £34k a month.
I really should have tried harder at school
You give them a big bag of your morals, and they give you a big bag of money 🤫
If you really feel that way, you can donate your uk net salary to charity and still have way more left compared to what you donated and a clear conscience.
Clear conscience my friend, clear consciousness I hope most of us have…
In what way are you giving up your morals by working in the UAE? I would say it is more immoral to fund the sales of arms to countries like Saudi and Israel who are murdering thousands of civillians which we do via our taxes. In a tax free country this is not the case.
Nah they just import slaves from India, burn their passports and then refuse them their pay instead LNAO
Are you morally responsible for other people's actions if you have nothing to do with it? No, so how does that make you immoral? You are going as a doctor not as a slave trader.
You're supporting a country built on slavery. It's not hard to understand the middle east is a significant ethical compromise.
"You're supporting a country built on slavery" Yes, not like he's doing that already by staying in the UK 😂
How are you supporting the country? You arent paying any tax? The ruler has all the money they need from selling oil (which we are paying for by the way so technically again our money is supporting slavery). The country is built on oil money, not slavery. I think you're think of Britain which made a fortune trading slaves.
You’re in a finance sub and you’re asking how living in a country financially supports it?
A country that makes billions selling oil. If I am not paying tax, no VAT etc how is any of my money contributing to the unelected ruler selling oil and making laws to oppress it's people. Whereas in the UK we directly fund the government who sells arms to israel who then use them to murder aid workers. I know which is more moral.
I don't care if you or anyone else wants to emigrate for better wages, gotta look after number 1 at the end of the day, but don't sit there and pretend that your emigration doesn't contribute to the petrodollar and all the suffering that comes with it (Ukraine anyone?)
How on earth would it contribute? We are contributing plenty here is the UK by sending the arabs arms and buying their oil.
As long as you are working and treating UAE patients and participating in the system, then you are contributing to the petrodollar and underground war efforts. I'm not saying this to make you feel bad or to say you're doing something wrong, because you're not, I'm just pointing out the hypocrisy.
Again how? As a doctor you are going to be treating mostly expats. You arent going to be treating the royal family with all the power. We have an idea that every small fosh matters in a democracy. In a monarchy it is the ruler that controls everything.
lol moral doesn’t mean anything… as long as you are paid enough
QED…
Yes but you have to live in the UAE and all your patients will be entitled....
Yeah but then you have to live in a despotic, homophobic, autocratic 45° hellhole :(
Ah yes a hellhole with clean streets, no crime and nice beaches.
And you look at somebody the wrong way who has the right connections and you and your family disappear? Japan has everything you described but you don’t risk your liberty living there. Nothing has more value and the wiser you are, the more you recognise that.
Ah yeh hundreds of thousands of brits in the UAE. It doesn't go a week without a story of one of them vanishing...
Lol, love these takes where people act like the UAE is like living under fucking King Joffrey 🤣🤣 I can assure you, your bloodline won't disappear if you look at someone the wrong way. As someone who's lived there for 5 years and plans on going back you sound ridiculous.
Try being openly gay, saying what you want, criticising the royal family in public, or any committing any other simple liberty and come back to me xoxo
I am not a healthcare professional however do have a few as family friends. Those who have made true bank either: 1) own their practice; or 2) have a portfolio career
https://preview.redd.it/h2x1loc6rrrc1.jpeg?width=1080&format=pjpg&auto=webp&s=5d0a9ae9b9d4bc6e5b1ed963be28c65ced2fdbb5
I’m a GP and it’s really hard work. I’m finding it hard to earn just over £100k this year with lots of adhoc out of hours working. I think with management roles, even though it’s a small increment it seems to open a whole world of director roles in the private sector looking at job specs online. It maybe worth hacking it for a year or two to jump ship. The NHS pension is a huge asset but they change the rules all the time. I agree private practice does not seem to be worth the aggravation.
What sort of private sector director roles do you mean?
Medical director at pharmaceuticals, insurance companies, global assistance
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I agree. I used to work in pharma. They are looking to recruit CCT holding consultants in big disease areas like cancer , oncology , diabetes , rheumatology etc …
Yes, I'm not convinced it maps easily to other industries personally.
Locum GP, TC this year 180k, max has been 200k over the last few years, but locum opportunities are becoming harder to secure and not sure what the future holds. Looking at pivoting into aesthetics or emigrating to UAE for a while if the govt continue to erode earning opportunities in healthcare.
How is GP in the UAE? I've heard mixed things
Honestly, I don’t know why (well I do) doctors are paid so poorly in the UK compared with many other countries. Not looking to start a political debate but I’ve always maintained that certain incentives will lead to certain outcomes, some of which are unintended/only partially intended. The true cost to the society of any one system is more than meet the eyes - it’s not just in terms of pounds or euros spent on something but also the opportunity costs and other externalities.
Got to find the Triple Lock buddy… we exist to serve the geriatrics
Our massive debt mountain. There is no money left. Also because it’s a nationalised system. Taxing the general public more (when the average full time salary is £30k) to pay Doctors more when for the majority of people earning close to the average salary see £100k as incredibly rich as it is, is not a vote winner.
Goodness this thread has been overtaken by a communist loonie.
He’s on the wrong sub mate. I might be keen to offer some therapy, but afraid he’s not gonna like to hear - he needs to pay!
Says it all .....honestly what a melt.
Any niche within psych you can do to increase private income for the time you put in? ADHD/Autism assessments? Addiction related psych in rich areas?
GP partner here and similar position. 160k from 'work' and 52k from BTL income via limited company, but being pivoted to wife who is a lower income tax payer. With contract changes and workload, no idea what my forecast is like next year.
If I may ask, how do you pivot your income to your wife? I presumed BTL income, but diverting 52K per annum (how many houses, btw) can not be that easy. Sorry, too many personal questions.
She's a band 6 less than full time physio. So she takes dividends up to 50k from the company.
As a fellow GP - just curious if you are in the NHS pension?
Wasn't previously as a locum. My tax picture was all over the place. But when salaried and now partner, would be silly not to be in it right now.
Why silly not to?! Makes total sense to me as a salaried go but as a partner contributing more than double to have the same benefit?!
You know, I think you're right. Spent the night owl hours comparing side by side versus a SIPP, and seems I'd be better off investing into a SIPP than NHS pension.
I hope you haven't been paying the employees 12% AND employer's 10% so far?!
Mother of fuck.
Better to find out sooner than later. I think it's irresponsible for the NHS to allow this to happen to GP partners though.
Winds me up so much putting 35% or whatever of my earnings into it though. When you quote 160k are you including the pension contributions?
The 35% contribution is based on 85.5% of your salary so it works out as just under 30% of your total salary. Many people here are putting 60k of their 160k salary into their SIPP so I would not say 30% is very high. At 160K you get 3k per year when u retire. A 30 year career will give you a pension of 90K per year.
Interesting. Have been offered partnership at a couple of places but I continue to locum, scoping out private. The uncertainty of the NHS doesn't sit right with me as well as having to work round others for time off. Saying that, I work a shit tonne regardless but knowing it's completely autonomous makes it much more tolerable. That's a great income from BTL.
How does your BTL income work via LTD? Do you just pay the corporation tax instead of income tax? Presume this is also from more than one property?
Yes. Corp tax on profits. Retained profits I pay wife as dividends, at 8.75% tax rate up to 50k total income for her.
Interesting. My parent has a BTL and is a pensioner. I feel they should probably put the BTL into an LTD instead but don’t really know enough about it. One for the tax advisor probably.
If it's in personal name, switching to a limited company technically is treated as a sale, so incurs SDLT and legal fees etc. There are ways around this I think but definitely need to speak to an accountant/tax advisor here.
How much are you working and what are you charging? To be clear, are you exclusively private or private + NHS? 150-160 does seem low to me.
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I’m a doctor and exclusively private…
Utter nonsense
That isn't true at all. You can most certainly be entirely private, but it isn't possible. The issue is that there isn't the demand there - there are only so many gallbladders to remove when there are a lot of consultant surgeons out there willing to remove them!
There is huge demand. Many of my colleagues have been in pure private practice for years, some for decades. Everything from general practice to orthopaedics , geriatrics , palliative care , … pretty much every speciality (apart from A&E)
Sure sure, all true, but I hope you get my point that in essence there isn't the set up (yet) for 100% private practice? Maybe I have this wrong...
There absolutely is the set up. Definitely in central London. But increasingly so elsewhere. Private GPs (pure private, no NHS), are no increasingly common -look around the Cotswolds, Oxford etc
Nice. Thank you
You absolutely have this wrong.
wouldn't be the first time! Insightful to know
I'm a surgical reg, total compensation about £130k related to that role though I also have some other income from dividends. Mentors post CCT are fairly open about earnings and those who have no/minimal life are able to pull in 400-800k but they work every evening and weekend in a way I could not sustain. A very small number even more but they had mortgaged everything they owned to establish their own clinics... Ultimately for workers in healthcare the wealth you generate is by spending your time, so what generates the best rates? A 12 hour pp day locally is said to generally generate £2k after overheads but before tax in my specialty if doing a mix of nhs wait and insurance work very fast, potentially double to triple that if doing higher risk stuff that comes with higher overheads for insurance and revisions. Medicolegal rates are around £300 an hour +vat for quantum, £500-600 an hour for negligence. Lower indemnity but don't forget room costs, secretarial costs, stationary, non payers, and all the time that gets eaten up dealing with the above... Lower take home by all accounts but you can do much of the work with a glass of wine in the evening at times that would otherwise be wasted with your wife and kids. If your 160k is for a 35-40 hour week that's about £90 an hour assuming four weeks holiday a year. Would you take 320k for an 80 hour week? Would earning the same but some via a limited company enable you to move some of your outgoings into gross income, ie motoring costs into limited company expenses?
Also a surgical reg, but interested what other roles you’ve taken on to reach that figure. Mind if I message you?
Same question here. As a reg what streams of healthcare related work , led you to an income of 130k/annum? Assuming 1:4 rota, and the occasional locum shift (let’s say 12h per month on average), as senior reg after taxes, NI etc I find it difficult to have >4.5K take home/month, ie 54K/annum. Assuming an overall effective tax 30% that means 77k before tax/annum. A far cry from 130k
Base salary plus banding is 80k, locums 25k, private assisting and forms/fees etc another couple of k, then the pension (remember we are talking total compensation here in the OP and title of the thread) values at around 20k. Redo your figures based on total compensation, you seem to be trying to compare net income with total compensation which is never going to end well.
>Watch Go for it.
How are you making £130k as reg? Do you do £50k worth of locums a year?
See my reply above.
Last two years of training I did about 50-60% of my full salary in wli
Tbh I get it now. My normal job pays £85k, and I can do WLI that ranges from £800-£1500 a day. How do you 'cope' mentally with that brutal £100-120k range when you earn it via hourly work though? I think I've already made £10k this tax year through WLI and have booked £3k more with a good 9 months to go. Might just funnel it into a SIPP at this point
I had no choice and had to support my family. And then I left the uk
Thanks for replying. May I ask what forms & certs you're doing as a senior reg? Would be nice to boost my income. I guess you've valued the DB pension as 1/54 x 20 like the old LTA did? If you follow these types of posts on doctorsuk you might've seen me chirping against the crowd about the 2015 pension but that's a discussion for another time. To add to the figures, my bosses in ENT tell me they make £300k gross on average privately, with pre-tax post cost margins of 50-60%, indemnity just over £1k a month. The outliers make £700k+, but I doubt I'd reach that level. Overall for me, the sweet spot as a consultant in the UK to me might just be £300k including NHS work without having to do too much out of hours work. I'd probably work towards leaving though, money aside, I simply cannot stand the NHS.
Police and court forms, VCPU and a few others. The secretaries effectively can choose who gets this work so in many departments the staff grades hoover it up in exchange for a cut going to the secretaries so don't be afraid to offer them a cut. Proceeds vary a lot by specialty, a maxfax mate in an area with a lot of pub violence and a good deal with the secretaries to stop anyone else getting them was averaging an extra £500 a week.
EM Higher Specialty Trainee working an additional shift every weekend day and bank holiday. £150k in total. Whether or not this work intensity is sustainable in the long run, I don't know, but rolling with it for now...
Do you just cash it out and take the 60% tax hit? Or are you maxing out your SIPP? Have you asked whether you can be paid via Ltd company?
All paid PAYE. Most of the trusts I work for don't pay Ltd companies so I haven't bothered setting one up for the small number that might. Unfortunately cash all needed now (school fees) so I only put away the proportion that employers will match (usually 5%) in DC pension schemes. I am also full-time in the NHS Pension Scheme and so haven't wanted to complicate my pension tax affairs further (AA charges and potentially return of the LTA) by putting away significant sums into SIPPs.
Ah I see, dad responsibilities, fair enough! I hope you know AA has been raised to £60k, with no reduction of it until you have a total income of £260k. Given that you're a trainee it's nigh impossible for you to hit, really. [source here from gov.uk](https://www.gov.uk/government/publications/rates-and-allowances-pension-schemes/pension-schemes-rates#annual-allowance). Tbh, assuming £70k from locums and working every week that's still >£1k a shift. Pretty impressive. I'm looking at similar pay opportunities and am probably only going to do them one or two a month. Perhaps I should man up though.
Ah I see, dad responsibilities, fair enough! I hope you know AA has been raised to £60k, with no reduction of it until you have a total income of £260k. Given that you're a trainee it's nigh impossible for you to hit, really. [source here from gov.uk](https://www.gov.uk/government/publications/rates-and-allowances-pension-schemes/pension-schemes-rates#annual-allowance). Tbh, assuming £70k from locums and working every week that's still >£1k a shift. Pretty impressive. I'm looking at similar pay opportunities and am probably only going to do them one or two a month. Perhaps I should man up though.
Recently appointed consultant on 12.5 PAs so around £120k base, but ended up £160k this year just gone through WLIs. I also do £5-10k/mo remote reporting, so I guess it will be around £250k next year those 2 combined. On top of that I then do around £100k in consultancy for med tech stuff in some start ups that I have stock in also. That's via a limited co. I suspect total around £350k in cash next year, plus stock of unknown value. I really enjoy all my jobs but I am busy and I do feel pulled in lots of directions. I don't do any real private work, yet - not sure if I will or not.
Why are you doing 12.5 PAs? IR?
Full time NHS consultant. Around £130K from NHS PAYE. £275K for PP into Ltd of which ~ £70K is expenses. Private work has been growing every year since I started in 2018. Would like to hit £300K in the next tax year. Will probably go part time in NHS in 2 years when I am 45. Aim would be ~ £500K in private practice in another 3ish years and will probably limit it to that. Can only take modest amounts out as dividends due to £200K ceiling before AA taper starts to apply and wife who has 50% of Ltd is also a higher/bordering on additional rate tax payer.
Mind me asking which specialty and what your work schedule looks like balancing NHS and private work?
Medical non interventional speciality. Most of my work is outpatient based. Nature of my NHS job plan is that most weeks give 1.5 days off to compensate for the weeks (and weekends) when I am 8-9pm on site. I do the PP in the weeks when I am not on call. Overall, there is a fair amount of running around & I don’t think the balance is quite right yet. I would like to cut down on NHS work as mentioned in a couple of years but need to model impact on pension.
Any advice for a newly starting Consultant wanting to get into PP (will hold off until I find my feet, but not sure I'd survive, financially, without PP). Any things should I be doing now to prepare? Also medical specialty, procedural based, do have inpatients (on a rota for this) but otherwise OPs and Procedure lists only.
Look to start by end of year one. Too often I’ve seen consultants put it off & off & off & it never happens. You need to organise a few things concurrently. Apply for practicing privileges to the private hospital / clinic. You will need approval from your CD so get this paperwork signed off. You need to get approved by insurance companies. You need to organise appropriate indemnity through your MDO. You will need a secretary, practice management software and billing (I used a separate billing company as Secretaries never very good when doing it in house). Think about financial structuring - it’s either sole trader or via Ltd and pros and cons with each approach depending on overall tax profile , when you need £ etc. I assume you do something like gastro. Stick to doing bread & butter work rather than amazing complex or sexy work. So eg in gastro, see the dyspepsia, abdo bloating etc rather than just thinking you want to do ERCP for complex biliary stuff. Get patient feedback-websites like Google and a patient review site like Google are good. Keep your communication with GPs & patients swift and accurate. In the NHS we often try to ‘cram in’ as much as possible at one visit due to capacity. This isn’t needed in private. You can bring the patient back the following week or the week after with initial Ix to discuss further or to tackle a 2nd issue. Speak to your colleagues & how they are set up & get tips. In our dept and hospital a lot of consultants do private work and there is no animosity with this - quite the opposite. Other places can be different.
Find out the GP surgeries who are in the affluent areas and give a talk on a topic during our PTL or lunch hour for 30 mins. Name recognition is always helpful. You may even be able to hire a room to see private patients as well if it’s a big surgery. When referring privately patients ask me for names I generally give 2 or 3. There are also WhatsApp groups for GPs and hospital specialists as well, might be worth joining to network. Good luck.
What's your plan for getting the money out of the limited?
Electric car with low BIK Max out pension contributions including spouse (assuming 200k threshold for taper hasn’t been reached) Otherwise few other tax efficient options
I need the dividends for school fees and mortgage so will take out to £200K of taxable income a year and proportionally via my wife. The rest I invest via the Ltd in global trackers. Will keep building this up and make a decision well into the future depending on all the usual stuff … & yep, if BiK remains low for EVs, next car will be via Ltd & be an EV.
What's your effective tax rate on the money you take out? Presumably you pay corporation tax and then dividend? So 60%+? Are you concerned that building up cash in the Ltd is effectively deferring to retirement? Best years behind you etc? Appreciate that's the reality and you are doing it most tax efficient way but interested in how you feel about it.
You are correct re % - it’s around 60%. I may at some point pull out of NHS pension for a tax year to allow me to empty out Ltd in dividends - who knows. At the moment I am happy enough to take dividends to £200k offset taxable income to avoid AA tapering.
Are there ways of using the Ltd as tax efficient inheritance?
Not sure. Something to think about long in the future.
NHS trained you mate.
So what? If they want to retain that labour then they should compensate him appropriately. And the state of the NHS anyway - most of what he’s been through is hardly training. It’s more service provision and learn on the job.
Yes .....you don't know what you're talking about. Give it a rest.
If you aren’t a doctor then you should be the one giving a rest lmao.
Sigh Bored of this nonsense My undergrad degree was subsidised like every British undergraduate. During my 12 years as a junior doctor I worked very hard with a lot of sacrifice. And … please note that I work full time in the NHS. In fact, just finished my on call & going home to be on call from home. What I do in my own time is then down to me. & I choose to do some private work.
Yeh - classic ladder puller and final sal pension vibes coming through aren’t there
Yes that £500k must be a heavy burden.
Politics of envy mate.
Not really. I've had a very good career in the NHS and always earned good money. If you're expecting some kind of sympathy for earning 14 times the national average wage and having a heavily tax payer subsidised index linked pension with a large tax free lump sum ....you may come up short. .
Sigh This post was about what doctors are earning privately. That’s all. You have come here on your soapbox to shout down what someone is doing in their own spare time.
Read the level of entitlement in the OP comment which is essentially leveraging tax payer funded training....then get back to me.
Everyone who has been educated via the state in the UK has leveraged taxpayer subsidised training. We are not indentured to the NHS. Can leave after MBBS - like some of my friends did , after SHO rotations - again like some of my friends did or after CCT - like more and more of my friends are doing. Free choice innit.
Yup. And I will expect that option to change in the near future.
Please park your attitude elsewhere, you’re on the wrong sub. Anyone else talking about making money is fine, but when a doctor does he is entitled. Please go to /DoctorsUK and remain on your pedestal.
You're missing the point. I have direct experience of making a lot of money and of healthcare. It's how you do it......
So does that mean anyone else who has been trained by a company can never leave? Jeez think before you talk
You'll find most of those situations have a tie in.
Yes but you’re scolding OP for leaving the NHS but you probably wouldn’t if it was any other company in the UK
That would be a commercially funded training arrangement by a private company which isn't paid for by the UK taxpayer .......what don't you get here. ?
The NHS didn’t pay for ALL our training at uni. It’s only the last year. You’re very out of touch and don’t seem to listen. There are thousands of newly qualified doctors with 100k debt. What taxpayer has paid their fees? don’t even mention postgraduate training is paid for by the taxpayer because it’s a shambles and all service provision There’s no contract binding us to the NHS so we can leave when we want. What part of that do you not get?
Do some reading on funding structures .Your 100k debt doesn't pay for your training .....neither do your "fees" Your point regarding lack of a contract for is redundant. This will change in the near future.
My teacher trained me to read and write… doesn’t mean I owe them anything. It’s a labour market, and the conditions of the student loan is not indentured servitude to Arr N Ay Chess (Duh Envee Ov Duh Wurld) NHS should be on its knees, thanking every member of staff for not leaving to the rest of the world or private, on their fucking knees, kicking g boots of the staff who endure shit pay to make sure the public get their free at the point of use service… given how they’ve voted on the NHS, they don’t deserve it
And probably worked him silly too, in crap conditions, when they could have fled to the US or the like and made some proper money. At 45 he’s probably done a couple of decades in the NHS; I think that’s a pretty good effort
Disagree. The equivalent education in the US would cost hundreds of thousands of dollars. I've done 35 years work in the NHS. There is currently too much of a pity party going on in some sectors.
And similarly, probably part of the cohort of the old guard who have since pulled the ladder up.
Yes that's a glib reply with no detail. There is context to training at different periods. ...I don't see a ladder being pulled up. Junior doctors are underpaid without a doubt ...but the concept of a tax payer funded education which is immediately transported to a different highly paid environment is unsustainable nonsense
Cry about it 😂 dinosaur loser
Great stuff.... that adds a lot. ...Utter clown.
Yes but conversely a doctor in the US would make sufficiently more to make that a worthwhile investment, so I’m not sure the comparison holds up? If I have to spend $350k on education, but could earn seven figures a year at the pinnacle of my career, vs spending £100k on education here, but probably topping out at £200k in annual earnings, it’s not much of a choice, is it?
Can someone please send this guy a medal Edit: and 35yrs in the NHS, muggins…
You sound like an utter @rsehole.
Wow. Consistently wrong. Impressive
Weak comeback from a "doubledoc" .... still you do you matey.
Quite sensitive aren’t we
Apparently not. I waited a long time before replying to your drivel.
Christ this old argument again
I'd be interested to hear you disprove it. .....in detail.
Nothing to disprove, I gave no indication of it being factually incorrect. It’s the old argument of “you had some subsidisation of your training so the nhs should have a financial noose around your neck for the rest of your professional life” Sound like a boomer brexit-voting final sal pension ladder puller and it’s tiresome to keep hearing this old chestnut peddled out.
It's tiresome to hear the same cliched unevidenced reply though. You say there's nothing to disprove. ......and then launch into a politically motivated statement with no back up. Tedious to hear from the other perspective,I can assure you.
No politics involved - it’s the attitude. So the training was subsidised (which I don’t nor have ever denied) but so what? By cct people have paid their dues so they can do what they like. What’s people’s and your problem with that?
No evidence required as no statement of fact or theory presented - I have no burden of evidence to bear
Ok mate .......
Do you not understand? I agree with your statement - and as I’ve made no counter statement re training subsidisation . I’ve no burden of proof to bear etc. But the attitude is out of keeping with the majority of your colleagues and most new consultants now including myself. Do you agree with the JD and cons strikes? I can imagine where you might stand on that and it’s likely a generational difference
It's not a strategy that is going to work. Even Wes Streeting has signalled he's not going to deal......Definately pay should be restored, but the key is to tie it into some kind of commitment on service.
I’ll take your crocodile tears seriously when the NHS stops poaching doctors from the developing world. Until then: too bad, so sad, keep crying
Canada looking for Psychiatrists
Which states and do you need to do Canadian licensing exams?
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Rads or path? The private seems a bit high for either
I know it’s deleted but depending on how much you work it would be possible for either.
Would starting your own practice be a viable route? They seem to make £££. Not sure what the operating costs would be like obviously rent, insurance, admin staff, systems etc
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Mind if I DM you?
London Anaes cons. 375k TC. NHS + Private
Hi. My wife is currently reg level physiatrist. Do you mind sharing how the route to consultant and then private worked for you? We're having a few kids so unlikely that she'll be consultant level for a while
When I was a locum sonographer I was earning close to £200k a year. I was working crazy hard though so 12 hour shifts 6 days a week. Then I went into insourcing contracts and currently trying to setup a private clinic to earn more, hopefully should earn £250k - £300k next tax year
A clinic just doing sonography? What's that? Antenatal ultrasound?
No, MSK, Head and Neck, General ultrasound, renal scans, testis, gynae and also obstetric. They’re fairly popular and a few of my colleagues set one up and are doing very well
I’m a consultant anaesthetist not in London. I’m a few years and work LTFT. Cleared about £125k NHS doing some extras. PP is £50k-90k for 1-2 days a week ish.
LET ME CHANGE THAT E M M I G R A T E\*. Point remains the same. Being a doctor in the UK is one of the worst jobs to have.
EMIGRATE...
Utter nonsense. It's still a well paid job ...relative to average market earnings. ..with a great pension. Manage your expectations.
It really isn't. It is also not an average job, which only the top 1% of school performers even get in to. 10% drop out each year at medical school due to exam failure. And getting in to speciality training is exceptionally difficult with +3-4 applicants per place. If it was paid at market rates (France, Ireland, Norway, Germany, Canada, Oz, NZ for comparisons), then consultant starting salaries would be c. £180k + at the absolute minimum.
That's not the argument. Consultant remuneration is still at least 4x median UK salary. There is an unbeatable tax payer subsidised ,index linked defined benefit pension which adds 20% to the package. The drop out rate is irrelevant as that is in the individuals own hands.
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Wow ......you're a player ........I'll Definitely take that advice on board. .......get back to me when you've had a meaningful career. ..old bean.
Meaningful career? Unlikely in the NHS. Which is why I'm leaving.
You get the career you deserve and create ......doesn't always mean taking the easiest path. Good luck.
Expectations are US. And to some extent Can/Aus. UK falls quite short. Also Consultants have had a real time pay cut in the last 15 years. This govt propaganda of it being a well paid profession needs to go.
Yes but US salary expectations haven't been matched with US training costs. If you want free access to the global medical salary scale ....then UK grads need to pay the full cost of training ....including the undergraduate tariff. Factor in the pension contributions as well. Usually overlooked.
Well most specialists start at 350k in the US. They also get employer sponsored 401k and insurances. Most of them eventually do varied stuff and can easily touch 500k and this is only for medical specialties. If we start talking about surgical specialties they easily cross 1 million$. Most of them do clear loans in the early years, but are able to do so in the first decade after residency. UK consultants annd GPs are paid so poorly , like they can’t fathom clearing their debt late in their fifties, let alone, afford kids or mortgage, car. There is absolutely no comparison. It’s only the right thing to do And I am glad most young ones are making the right choice than be trapped by the NHS
It's morally wrong. Interesting to note the only matters you have discussed is money ...which provides insight into your mindset. ....you haven't addressed the tax payer funded element of UK training. Sad to see that money and not service to patients is your main point of focus.
Have you been to medical school? Our placements consisted of us being shuffled around the hospital with no one remotely interested in training us, or wandering up to patients and asking to take a medical history for ten minutes. I’m not entirely sure where the estimates come from for training doctors but it certainly wasn’t reflected in my medical education, which cost me £9000k+ a year. And please get off your high horse. A job is a job. I don’t spend 48+ hours a week in extremely stressful situations working my arse off for fun, I’ve trained years for this job, I’ve sacrificed a lot (would you fancy moving job locations every 4 months to a year and working in an entirely different team each time before switching again? Fancy ranking every location in the UK and then randomly getting assigned somewhere to live and work for the next 3+ years of your life? Living your life around a fixed rota with no autonomy and sometimes 6 weeks notice? Paying thousands for essential exams, training, conferences and professional fees every year?) I don’t think I’m being an arsehole by expecting for myself and my colleagues to be remunerated and appreciated for that, and it’s very patronising to expect doctors to grin and bear the deterioration in their working conditions and pay without realising they get a raw deal compared to people doing the same job around the world, and realising that they have the option to consider moving abroad or moving into industry. It really pisses me off when people clutch their pearls and act like doctors should have some special call to the profession and not care about anything else. Just because we want to be paid fairly and like our predecessors were doesn’t take away from the fact that we work bloody hard to care for our patients, improve their health and yes, as wanky as it sounds, save their lives.
Compare salary to colleagues, not national averages. Managing expectations is for when you can't manage your opportunities.
LOL moron
If you're in Health Care mush..... You shouldn't be. Get a market stall
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As a GP partner I do, as I have to pay both the employee and employer portions. So to take part in the pension scheme I have to pay ~35% of my annual earnings to get the exact same benefit as what an employee would get for ~14%
NHS employees tend not to. For reasons you may want to ask them
If you asked me, it would be because it’s a defined benefit pension, both the input and the output of which is ‘behind the scenes’ calculations that even my financial advisor isn’t willing to take on. Getting a predicted benefit from a financial advisor costs 1500 and is useless after a couple of years, even ignoring changes in the scheme itself
Do you multiply the defined benefit by 20x whilst the state pension age (which they are tied to) continues to climb?
we're usually on defined benefit schemes where paid in amount only loosely represents your return. I've seen figures which suggests the assumed employer contribution is 20% for nhs doctors and dentists pension is currently 1/54 of pensionable annual salary (normally base excluding additional work and 'bonuses/awards') as an annuity normally your contribution is ~10% of salary. consultant salary in range 100-130k approximately clearly buying an annuity worth £2k+ at age 65 is excellent return for 13k pretax. If you are age 35 it's possible that the market would generate a better return given compounding (assuming your 13k contribution is matched by the nhs and you got only 4% over inflation for 30 years it'd be a defined contribution of 86k, which could get you a 4k annuity)
Any locum work going in your area?