by Joe Jamieson

Medical, Clinical Features

What are the highest paying medical jobs?

You're here for the answer to that question.

And we've done the research and we've laid out the answer below.

But before we jump into the details, we need to set the scene.

The year is 2015...

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— Nobody knew how things would turn out —

NHS Employers and the British Government are negotiating new contracts for junior doctors.

But there’s a problem.

The British Medical Association doesn't like what the government is proposing.

Scrapping extra pay for overtime could mean up to a 40% pay cut for doctors.

the battle begins

Jeremy Hunt, the Health Secretary, says he’s going to force the new contracts — like it or lump it.

The BMA do not like this at all. The negotiations turn into a stalemate.

The BMA decide to ballot their members. As it turns out, lots of junior doctors are considering leaving the NHS thanks to the Health Secretary's threats.

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— Many young doctors were frustrated but hopeful —

In the face of the evidence , Jeremy Hunt concedes —  junior doctors working more than 56 hours a week would face a pay cut under his new proposals.

Underhanded tactics?

Hunt’s next step is to make a new offer — an 11% increase to junior doctors’ basic pay.

This is his final offer. No more negotiating.

But, for reasons known only to him, Jeremy does not go to the BMA or to NHS employers.

Instead, he takes his offer straight to the press.

This takes everyone by surprise. Why hasn't the Health Secretary given details on the new offer?

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— Doctors were ready to stand up and fight —

The BMA ballot their members again, this time to see if members want to take industrial action in the form of a strike.

98% say yes.

The fight is on

Hours before the strike is due to start, Jeremy Hunt withdraws his threat to force the contracts. He agrees to resume negotiations.

The strike is called off and negotiations resume.

The BMA put out a deadline to reach an agreement. The deadline is missed.

Negotiations grind back to a halt and the strike is back on.

Suddenly, (and very publically), the Chair of the BMA’s Junior Doctor Committee blames the strike action on...

...The government's continued failure to address junior doctors’ concerns about the need for robust contractual safeguards on safe working, and proper recognition for those working unsocial hours.

Things are now very serious.

Strike one

We get our first general strike in 2016 — the first of its kind since the 70s.

The Health Secretary goes back to the press. He talks about how patients were put at risk and doesn’t budge one inch on the deal.

We enter February and nothing has changed. Time for another strike. Around 3000 elective operations are cancelled.

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— Only emergency procedures continued —

Jeremy Hunt still doesn't budge.

Strike two

April arrives and the negotiations have gone nowhere. Another strike.

But this one is crucially different from the last two. This time, junior doctors are withdrawing labour from both routine and emergency care.

This puts enormous pressure on the Health Secretary and he cracks.

The Deal

NHS Employers and the BMA reach a deal with the government.

The BMA once again ballots its members and 82% of them vote in favour of the deal.

No one got exactly what they wanted, but that’s the nature of negotiation.

What does the deal mean for you today?

If you’re a junior doctor today, you’re paid a basic salary of between £27,689 to £32,050 for FY1 and FY2. And if you’re starting specialist training, your basic starting salary is £37,935 to £48,075.

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— At last Jr doctors can move forward —

Why didn't Hunt just pay up to begin with?

The NHS doesn’t have a bottomless pit of money to draw from. If staff want a pay rise, it’s not as simple as it is in the private sector.

In privately-owned, for-profit companies, individual members of staff can negotiate their individual pay.

In the NHS, if one person wants a raise in basic pay, everyone in that pay band has to get a raise in basic pay. Which is why it doesn’t happen often.

So what are the highest paid medical jobs?

NHS salaries are banded, so things are pretty clear cut.

Yes, there are variables — like where you’re located and your seniority.

But by and large, it’s easy to tell what your basic pay will be, whether you’re a junior doctor or a consultant.

Surgical team in Kathmandu

— Surgeons rank at the top of the payscale —

If you’re working as a speciality doctor you earn a basic salary of between £40,037 and £74,661. And salaried GPs get between £58,808 and £88,744.

And as a consultant, your basic pay is between £79,860 and £107,668.

In 2018, the average full-time consultant earned about £127k, so there’s a bit of flexibility in the numbers above (you can choose to take on extra work in management or teaching and that will give you a pay bump).

Note: Some NHS doctors boost their earnings with private work, but here we’re focusing on basic pay.

The top five highest paid specialities in the UK are:

  • Plastic surgery
  • Trauma and orthopaedic surgery
  • Neurosurgery
  • Otolaryngology
  • Cardiology

But even up here at the top of the ladder we’re still talking about small differences in pay between each.

Let’s take a step back to look at a bigger, more global picture.

The bigger picture

Misc

— There's a whole other story in the States —

How much more do doctors in America get paid?

A lot more.

Put it this way —

If you’re an orthopaedic doctor in the UK, you’re looking at an average of £87,757 a year. So over your career, you’ll earn about £3,520,000.

If you’re an orthopedic doctor in America, you’re earning the equivalent of around £370,000 per year. Over a career, that’s about £14,000,000.

So an American orthopedic doctor earns, on average, an eye-watering £10.5 million more over a career than their British equivalent.

That’s quadruple the lifetime earnings of an equally well-qualified British doctor.

we’re not being entirely fair

A medical degree costs a lot more in America than it does in the UK. There are lots of estimates online, but the average debt of the American medical student is around $200,000 upon graduation.

PLACEMENT

— US Medical degrees cost a fortune —

Let’s be incredibly generous and say that the average med school debt is $500,000 — more than double most estimates.

Even taking that into consideration, you’d still be earning £10 million more than your UK equivalent.

Ten Million Quid! Let that sink in.

Why is there such a big difference in pay?

It’s not news that the American healthcare system is private from top to bottom.

Services aren't free at the point of care and patients have to pay for treatment before they receive it.

Healthcare costs patients a fortune as a result — the average cost of a bypass in the UK is about £20,000. In the US it’s £60,000+.

PLACEMENT

— Healthcare isn't cheap in the States —

To cover the costs, lots of people in the US opt for health insurance.

There are still hundreds of thousands of people in the States who remain uninsured for one reason or another, but let’s not wade into the political debate.

The point is that the more money there is in the system, the more money there is for doctors to make. And the more money can be invested back into the system, which improves the quality of care.

or does it?

Apparently not.

Studies show that the NHS doesn't just perform better than the US healthcare system, it's actually among the best in the world.

And that’s with the NHS spending half of what the US system spends per person.

Here’s a graph from the study above —

1.4 - BLOG IMAGES

    How does this make sense?

    The National Health Service is all about people. It has been about people since it treated Sylvia Diggory — its first ever patient — in 1948.

    It’s run by people for people and it’s publicly funded.

    And because of that, people are invested in the NHS as a public institution. Any time someone mentions privatisation, the people strongly oppose it.

    The NHS is the 5th largest employer on the planet. It employs 1.7 million people. To put that into context, the other four employers in the top five are:

    • US Department of Defence
    • People's Liberation Army (China)
    • Walmart
    • McDonalds

    The NHS works as well as it does because the people who run it believe in it.

    Being an NHS doctor is about committing yourself to serving patients. You won’t get paid as much as your American colleagues, but you will be part of one of the UK's greatest collective achievements.

    Next up:

    Overseas Electives

    Learn how you can get eye-opening medical experience while travelling Africa, Asia or Latin America.

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