GP Trainee Pay and Finances: What You Actually Need to Know
Most GP trainees start the programme with a fairly vague sense of what they will be paid and very little idea of what they can claim back. By the time the MRCGP exam fees land in ST3, it can feel like the finances crept up without warning.
This blog gives you a practical overview of how GP trainee pay is structured, what the GP premium is, what your main training costs look like, and what you are entitled to recover through your study budget and HMRC tax relief. It is not financial advice – the figures here are a guide, and you should always verify current rates with NHS Employers, the BMA and HMRC, as these change annually.
One important note on contract: GP trainees in England are paid under the 2016 resident doctor contract, where pay is set by nodal points. Trainees in Scotland, Wales and Northern Ireland are still on the older 2002 contract, which uses annual increment-based pay points. The figures in this blog refer to England unless stated otherwise.
– Join National AKT WhatsApp teaching group here
– Join National SCA WhatsApp teaching group here
– For GP trainee update and teaching emails click here
– For MRCGP AKT Preparation click here
– For MRCGP SCA Preparation click here
Basic pay
What is the basic pay for a GP trainee in England?
Under the 2016 contract, your basic pay is determined by your stage of training rather than how long you have been in post. GP trainees in England sit on nodal point 3 (ST1 and ST2) and nodal point 4 (ST3).
From 1 April 2025, as confirmed in NHS Employers Pay and Conditions Circular (M&D) 2/2025, the basic pay figures are:
– ST1 and ST2: approximately £52,656 per year (nodal point 3, basic 40-hour week)
– ST3: approximately £65,048 per year (nodal point 4, basic 40-hour week)
These are basic salary figures only, before any additional elements. There is no automatic basic pay increase between ST1 and ST2. Pay increases when you move to ST3 and again if you progress to higher training grades.
These figures will change each April following the DDRB (Doctors’ and Dentists’ Review Body) pay award. Always check the current NHS Employers medical and dental pay circular for the figures that apply to you.
Trainees in Scotland, Wales and Northern Ireland are paid on the 2002 contract, where pay rises annually in increments based on the pay point you enter on, which in turn reflects your prior NHS experience. The figures differ from the England 2016 contract and there are slight variations between the three nations. Check with your deanery or the BMA for the relevant scale.
What affects total pay in hospital posts
Hospital posts – what goes into your total pay
During hospital placements in your GP rotation, your total pay goes beyond basic salary alone. The 2016 contract calculates total pay for hospital posts based on several elements:
– Basic pay – at your nodal point for your ST year
– Additional rostered hours – pay for any average weekly hours above the standard 40 per week
– Night duty enhancement – a 37% enhancement on your standard hourly rate for working nights
– Weekend allowance – applies if you regularly work weekends at a frequency of 1 in 8 or more
– On-call availability allowance – for non-resident on-call commitments, where applicable
– London weighting – an additional £2,162 to £3,461 per year, depending on where in London you are based
The total package therefore varies significantly between posts. A busy emergency medicine post with frequent nights and weekends will yield substantially more than a post with standard hours and minimal unsocial work. A post at the lower end – 40 hours per week, no on-call, no nights – returns basic pay only.
If you are a BMA member, the BMA has a payslip checker that can help you confirm whether your pay is being calculated correctly for your specific post.
The GP premium
What is the GP flexible pay premium?
When you are placed in a GP practice as part of your training rotation, you receive an additional payment on top of your basic salary. Under the 2016 contract this is called the Flexible Pay Premium, often simply referred to as the GP premium.
This premium is only payable during periods when you are actually based in a GP practice. It is not paid during hospital posts, and how it applies to integrated or split posts can vary between employers.
The GP premium is uplifted annually in line with the general pay award. The current rate is confirmed each year in the NHS Employers medical and dental pay circular – always check the most recent circular for the figure that applies to you.
Most GP training programmes in England now include around 24 months in general practice across the three years, though the precise split varies between programmes. For each full month you spend in a practice placement, you receive a pro-rata share of the annual premium on top of your basic salary.
MRCGP exam costs
What do the MRCGP exams cost, and can you claim anything back?
The two written components of the MRCGP carry fees that are worth knowing about well in advance.
Current fees (as confirmed by the RCGP, effective from August/October 2025):
– MRCGP AKT: £481 per sitting
– MRCGP SCA: £1,207 per sitting
Sitting both once costs roughly £1,700. Re-sits are charged at the same rate per attempt.
Study budget
Your NHS study budget can contribute towards one AKT preparation course and one SCA preparation course per training programme, up to £600 per exam. This covers revision courses and learning resources that have been approved by your educational supervisor – not the exam fees themselves.
The AKT and SCA exam fees are not claimable from the NHS study budget. Study budgets are managed locally and the detail of what is approved, and how claims are processed, varies between deaneries. Always confirm with your deanery and get educational supervisor approval before booking a course if you plan to claim.
Tax relief on exam fees
While you cannot claim exam fees from the study budget, you can reclaim the tax paid on them through HMRC. The RCGP confirms this directly: all tax paid on MRCGP examination fees can be reclaimed through normal tax returns.
The basis for this is a 2010 court ruling (HMRC v Dr Piu Banerjee) which established that mandatory postgraduate exam fees are an allowable employment expense for doctors on approved training contracts, because sitting the examination is a contractual duty of the training programme.
At the basic rate of tax (20%), the approximate saving is:
– AKT (£481): approximately £96 back
– SCA (£1,207): approximately £241 back
At the higher rate of tax (40%), these figures roughly double. You can claim for the current tax year and up to four previous tax years – so if you have not claimed in prior years it is worth going back.
To claim, use HMRC’s online personal tax account, or include the fees in a self-assessment return if you file one. If your total employment expense claim exceeds £2,500 in a tax year, self-assessment is required.
This blog cannot advise on your individual tax position. If you are unsure how to claim, or whether you are eligible, speak to an accountant with experience in medical finances, or use the guidance on the BMA or Medics’ Money websites.
Other professional fees and tax relief
Professional fees you can claim tax relief on
As a GP trainee, you pay a number of annual professional fees that are also allowable employment expenses for tax purposes. These include:
– GMC annual retention fee
– BMA subscription
– RCGP membership fees
– Medical indemnity fees (MPS, MDU, MDDUS)
HMRC maintains a list of approved professional bodies on the gov.uk website. Note that organisations may not appear under the name you expect – for example, the RCGP appears as “General Practitioners Royal College of.” The BMA website has clear guidance on how to navigate this and make a claim.
You can claim for the current tax year and up to four previous tax years. If any of these costs were paid for you by your employer or covered by your study budget, you cannot also claim tax relief on the same expense.
The NHS Pension
The NHS Pension during GP training
As an NHS employee, you are automatically enrolled in the NHS Pension Scheme unless you opt out. It is a defined benefit scheme, meaning the pension you receive in retirement is based on a formula linked to your career earnings, rather than depending on investment performance.
Your employee contribution rate is tiered, based on your total pensionable pay. For 2025/26, member contribution rates in England range from 5.2% at the lower end to 12.5% at the highest tier, as set out by NHS Employers. On a typical GP trainee salary the applicable tier is usually somewhere in the middle of that range, though your exact rate depends on your total pensionable pay including any supplements.
Your employer contributes 23.7% of your pensionable pay on top of your own contributions – a substantial element of the overall package.
Opting out increases your take-home pay in the short term but means you forgo both the employer contributions and the long-term value of the scheme. Whether opting out is right for you depends on your wider financial situation and goals. If you are considering this, speak to a financial adviser who has experience advising NHS doctors. Pension-related decisions can have long-term consequences that are not always obvious from the short-term numbers.
How Arora Medical Education can help in GP Training
If you want a guided path to exam preparation, our AKT resources and SCA resources help you build confidence at each step. Everything is created by UK GPs and Educators and focuses on both knowledge and technique.
Also:
– Join National AKT WhatsApp teaching group here
– Join National SCA WhatsApp teaching group here
– For GP trainee update and teaching emails click here
Summary
A few practical steps worth taking early
Training is expensive. The combination of MRCGP exam fees, preparation courses, indemnity, GMC and RCGP membership adds up to a significant sum across three years. The trainees who manage this best are usually the ones who understand the system early and keep records consistently rather than trying to untangle it later.
A few things worth doing now, whatever stage of training you are at:
– Set up a personal tax account on gov.uk and check whether you have unclaimed professional fee relief from previous years – you can go back four tax years
– Keep receipts for exam fees, indemnity, GMC, BMA and RCGP payments as you go
– Check what study budget allowances your deanery offers and confirm how to apply before booking any course
– If you are a BMA member and unsure whether your pay is correct, use the BMA payslip checker
None of this replaces proper financial advice. For pension planning, tax queries or questions about your specific situation, speak to a qualified accountant or financial adviser with experience working with NHS doctors. Medics’ Money (medicsmoney.co.uk) is run by doctors and offers free guides tailored to GP trainees.
If you are preparing for the MRCGP AKT or MRCGP SCA, Arora’s packages are built around how GP trainees actually learn – structured, practical and focused on what the exams really test.
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Author Bio — Dr Aman Arora
Hi! I’m Dr. Aman Arora, a Portfolio GP with over a decade of clinical and teaching experience, dedicated to helping doctors achieve their goals with confidence. Having had the privilege of supporting more than 50,000 doctors worldwide across exams such as MRCGP AKT, SCA, MSRA, PLAB 2 and PLAB 1, I understand the challenges you face and the strategies needed to overcome them. Through personalised face-to-face sessions, engaging online courses, mocks, audio and a vibrant social media community, we’re here to guide you every step of the way.
Whether you’re looking to pass crucial exams or take the next big step in your medical career, we’re here to help you succeed. Feel free to get in touch with any thoughts, questions, or ideas — I look forward to working with you and being part of your journey.
Author Bio — Dr Pooja Arora
Dr Pooja Arora is a GP with a background in Medical Politics, where she passionately focuses on improving the opportunities and working conditions for junior doctors. She is proud to hold FRCGP (Fellow of Royal College of General Practitioners).
You can find out more about Pooja’s previous roles and qualifications here.
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