How much do Doctors really get paid compared to Physician Associates?
The British Medical Association (BMA) is making a lot of noise claiming that Physician Associates (PAs) are paid more in their first year than first year foundation doctors. This is obviously a powerful argument, but it does not reflect the reality. The BMA is being “economical with the truth”. Doctors’ pay is extraordinarily complex (thanks entirely to the BMA’s previous negotiations). This article aims to set out, in an understandable way, a more truthful reflection of how PAs are paid vs Doctors.
Doctors get a basic salary and then get lots of extras on top. They get “oncall” money when they are working oncall. This is a pro-rata annual sum which gets added onto their basic pay according to how much of their work is oncall. They also get a similar sum of money for working weekends. Almost all junior/resident doctors get some degree of oncall/weekend money. If they are working on a medical ward in a hospital they will get towards the maximum amounts. If they are working in a strictly 9-5 setting then they will not.
Doctors also get very generous locum rates – and there is generally quite a bit of locum work around.
PAs are paid according to the NHS payscales called Agenda for Change. PAs typically do a preceptorship year after qualification when they get paid at band 6, after that they get paid at band 7. PAs do not get paid above band 7 unless they move into a different role, eg. Management. PAs rarely do oncalls because they cannot prescribe. If they work weekends then they get their regular pay +20%.
How the BMA twists the truth
Theoretically PAs can be paid Band 7 straight from university, in practice this never happens because why pay someone band 7 when you can pay them band 6? However the BMA twists the truth by comparing band 7 pay with a basic salary of a foundation year 1 doctor to make the case that PAs are paid more straight from university. The reality is PAs get paid Band 6 straight from university (not band 7) and year 1 doctors get significant uplift from oncalls and weekends work.
BTW, PAs are expected to be as competent as a foundation year 1 doctor during their first year and they are expected to be as effective as a SHO (year 2 onwards doctor) going forward.
The table below illustrates the comparison between doctors’ pay and PAs. The data comes from the BMA’s own website.
| Year | DOCTOR | Basic Pay | Oncall | Weekends | Total before locums | Locum rate/hr | PHYS. ASSOC | Oncall | Weekend | Locum |
| 1 | FY1 | £36,616 | £2,930 | £1,099 – £5,493 | £36,616 – £45,039 | £35-£45 | £37,338 | 4.25% | 30% | 20% |
| 2 | FY2 | £42,008 | £3,361 | £1,261 – £6,302 | £42,008 – £51,671 | £45-£55 | £46,148 | 4.25% | 30% | 20% |
| 3 | ST1 | £49,909 | £3,993 | £1,498 – £7,487 | £49,909 – £61,389 | £45-£55 | £46,148 | 4.25% | 30% | 20% |
| 4 | ST2 | £49,909 | £3,993 | £1,498 – £7,487 | £49,909 – £61,389 | £45-£55 | £48,526 | 4.25% | 30% | 20% |
| 5 | ST3 | £61,825 | £4,946 | £1,855 -£9,274 | £61,825 – £76,046 | £55-£95 | £48,526 | 4.25% | 30% | 20% |
| 6 | ST4 | £61,825 | £4,946 | £1,855 -£9,274 | £61,825 – £76,046 | £55-£95 | £48,526 | 4.25% | 30% | 20% |
| 7 | ST5 | £61,825 | £4,946 | £1,855 -£9,274 | £61,825 – £76,046 | £55-£95 | £52,809 | 4.25% | 30% | 20% |
| 8 | ST6 | £70,425 | £5,634 | £2,113 – £10,564 | £70,425 – £86,623 | £55-£95 | £52,809 | 4.25% | 30% | 20% |
| 9 | ST7 | £70,425 | £5,634 | £2,113 – £10,564 | £70,425 – £86,623 | £55-£95 | £52,809 | 4.25% | 30% | 20% |
| 10 | ST8 | £70,425 | £5,634 | £2,113 – £10,564 | £70,425 – £86,623 | £55-£95 | £52,809 | 4.25% | 30% | 20% |
| 11 | Cons | £105,504 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 12 | Cons | £105,504 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 13 | Cons | £105,504 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 14 | Cons | £111,714 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 15 | Cons | £114,894 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 16 | Cons | £114,894 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 17 | Cons | £114,894 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 18 | Cons | £114,894 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 19 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 20 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 21 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 22 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 23 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 24 | Cons | £126,018 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 25 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 26 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 27 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 28 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 29 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
| 30 | Cons | £139,882 | 3-8% | £150-£250 | £52,809 | 4.25% | 30% | 20% | ||
What this table clearly shows is that Doctors’ pay, while roughly equivalent to a PAs for the first three years of their career rapidly accelerates from year four onwards. By the time Doctors reach senior consultant level they are earning 3-5 times as much as a PA. (NB. locum consultants typically get paid £250,000 a year). And these pay scales are only for NHS work – lots of consultants work in the private sector where they earn considerably more.
This PA
This PA works in a major UK hospital and is shocked at the way the BMA is actively targeting UK PAs with an aggressive bullying campaign. This website is here to project a positive voice for Physician Associates in the UK. The views represented here are those of the author and do not represent those of any other organisation.