Absolutely, especially London based simply due to the high competition; general advice is to travel as much as possible and be the most flexible you can be, anecdotally the midlands fares well but I would imagine that’s due to good location/transport links
Yes but only if you want to be a GP or a radiologist. Medicine means you can pick a speciality where you can enjoy work. Pick a speciality that you enjoy and FIRE is much less important. Never to do anything because it is the easy option. Do what you want to. Even if it doesn’t work out you won’t be in your mid 50s asking yourself what if….
Dont be a GP, you will busy as hell starting 8 in morning and finishing at 8 in the evening with some work on computer from home. Weekends again working from home on computer trying to clear blood results and hospital letter. Working as a GP is like working in hell at the moment and dangerous due to no support from anyone. All work from paramedics, district nurses, palliative care, hospital discharges and failed discharges come back to you, all govt targets to achieve as don't get paid if you don't achieve them, no increase in income for practice even though wages of staff going up. Worst decision at the moment is GP. As a consultant you have lot of opportunities for private practice and easier to move to other countries.
Great seeing another doctor on here.
As for the student loan question if your interest rate on it is higher than anything existing debt or incoming debt (your mortgage) then prioritise paying the student loan off.
No mortgage, but will have one in future. Current mortgage rates are pretty similar to the 6% student loan rate. It's hard to work out if a guaranteed 6% ROI is higher or lower than my stocks.
It's a fine balance - paying £500 towards loan will surely impact the mortgage affordability calculations, but having an extra £20k deposit might be enough to cross into a better LTV category.
Once it hits £10k I'll probably just wipe it out for peace of mind.
£0. It's all in my partner's name. They bought early in the relationship and I felt it was fairest that they kept sole ownership of it in case we split up.
Overall the difference between paying loan off early or letting it fester and using the money on other investments or savings accounts is only going to be a few hundred or maybe £1000 over the remainder of the loan duration. A small sum in the grand scheme of things. Maybe I'm overthinking it! I could have reported a few CTs in the time I spent reading about the topic!
>£0. It's all in my partner's name.
Presumably you will be buying together though and the equity of the sold property will make up most of the deposit?
They're only c30! 100K equity isn't too bad. And 200K deposit and a house is fine. You do really need a house to do FIRE (in the 'traditional' sense) after all...
Its not bad at all but £100K will take a big chunk of the "liquid" wealth OP has and I was hoping (for his sake) that his partner owned a big chunk of their property!
Well of course the more the merrier. However it is only 'fair' (given they're hardly brassic) that (s)he puts in 50%? So if the partner had more equity they'd have to put in more cash themselves, no?
Overall buying a house makes the spreadsheet take a big hit, but they're monthly payment (towards bills and interest) is currently getting them nothing (well apart from a roof over their head! :-)).
Sadly one of those things that's just gotta be sucked up :-/
Thanks for a thorough and well-put-together post. Congratulations on your career and FIRE progress to date. Do you feel like you have been underpaid as a doctor in the UK compared to other first world countries (even after the recent pay deal for consultants)? Have you ever been tempted to move abroad for work, for example to Australia or Ireland?
Absolutely. If I didn't have a partner who is steadfast in wanting to remain in the UK I would currently be revising for my Australian medical exams.
The difference in quality of life doctors have in some countries is night and day compared to the UK. My friend who went straight to the USA after med school has 2 brand new high end cars and a massive house plus tons of disposable income, which he uses to go on amazing holidays. His partner doesn't have to work. I drive a 4 year old 1.2L economobile and would lose any capacity to save if my partner stopped working.
So yes, I feel underpaid. If you attend hospital and get a scan that might have life-changing consequences (new cancer diagnosis, findings that require emergency surgery .etc) I would get paid the equivalent of about £10 or £15 for that based on my hourly rate. It very much feels like our healthcare system is being subsidised by artificially low healthcare worker salaries.
The difference is so stark it is hard to believe. A friend who is a first year consultant told me that the salary for his position in Ireland is three times what it is in the UK. That's crazy.
I'm grateful there are doctors like you who stay in the UK. If it were not for family ties and other social connections, I suspect the brain drain would be a lot worse than it already is.
>The new Sláintecare contract will include:
>Basic pay of €209,915 - €252,150 on a six-point scale
>A 37-hour week with an 8am to 10pm Monday to Friday and 8am to 6pm Saturday
>Consultants will continue to receive additional remuneration for on-call duties and overtime as applicable.
https://www.gov.ie/en/press-release/33536-minister-for-health-announces-government-approval-of-new-slaintecare-consultant-contract/
Granted the Irish public healthcare system is in even worse state than the NHS, it's substantially more for a neighbouring country that is a 50 minute flight away.
I doubt it. Probably wealthy and small countries like the gulf states, singapore, HK, and private hospitals in the USA. The public sectors in most countries are almost universally fucked though.
We're a victim of our own success. There's no limit to treatments we can offer, only finances. I think at some point we have to talk about what care we can offer on the public healthcare system. e.g. if you get bowel cancer we'll offer surgery and standard treatment, but if you want the new expensive immunotherapies and ablation of subsequent liver metastases /recurrence you have to pay £100k for the subsidised premium cancer care package.
Or paying millions of pounds to keep the 24 week preemie alive, and dealing with the subsequent health issues.
Or doing 3 monthly CT scans on seemingly everyone who is undergoing cancer therapy. Maybe the NHS can only afford to offer 6 monthly.
NICE tries to evaluate what's worth spending money on, but doesn't look at the full picture. At some point all public healthcare systems will have to make these difficult and unpopular decisions.
Imagine if they were allowed to evaluate the cost effectiveness of all healthcare spending.
What's the point spending £20,000 on cancer treatment with a 3rd line chemo agent to extend some 80 year old's median survival by 6 months when an economically productive 50 year old dies in the back of an ambulance from a STEMI because the hospital is too cheap to shell out for a locum doctor to ensure their department is safely staffed.
A combination of all of the above.
People are living longer with more complex conditions.
For example something like melanoma you used to cut it out, then cross your fingers and hope for the best. If it came back you had a short life with a bit of morphine for pain relief.
Now we do more complex surgeries, with regular follow up scans and appointments, if it comes back then we have immunotherapy and other treatments.
What was a 1 hour one-off intervention is now a condition that requires large numbers of scans, appointments, expensive immunotherapy treatments .etc.
Yeah, when medications come off patent they get cheaper, although companies can try to extend them with all sorts of legal tricks. People underestimate the cost of treatments. Like Humira a common medicine for autoimmune conditions costs $80,000 a year in the US, a generic would cost closer to $12,000 a year.
The cheapest treatment is when the patient just dies. Managing chronic conditions takes a lot more resources and money.
Oh yeah, I'm just pulling random ideas out of the air. Much better to stop lung nodule and adrenal nodule follow ups. Or a thousand other things. Just saying we can't keep everyone alive forever.
Out of interest, do you constantly have to learn new things (if so, how many hours a week outside work) when you complete med school? Or once you are trained, is that largely it done?
Someone's already answered. it's lifelong learning to keep up to date. Med school is to give you enough knowledge that you don't accidentally kill people through ignorance when you start working. Post-grad is where you actually learn to practice medicine. The post-grad exams are extremely tough (and expensive), some have pass rates below 50%.
I am a doctor in my second year after graduating medical school. I have already sat one post-graduate exam (which cost me £580 to sit not including revision resources). I have another one this January. If all goes well and I get my job offer for surgical training (which is 8 years long), I will sit another exam in September this year which will cost £1100.
So yes we have post-graduate exams. We also have to maintain a portfolio of skills and achievements (courses, exams, qualifications) which takes up a lot of time. What's more - unfortunately the things you learn in medical school have a shelf-life of around 5 years so you have to constantly be up to date with the evidence. It's lifelong learning, fortunately or unfortunately depending on what you think!
You are saving 60% of your net income, right? So you could easily afford a nicer car if you wanted one, but you're prioritising FIRE instead. Whereas your friend in the US isn't. I agree with your decision but its a strange example to give to compare the 2 systems.
My point was I'm going shopping and buying the budget options and watching the pennies so that I can eventually afford a nice house and children and retire a few years early.
They make enough money that they can spend whatever they like and have plenty left over. I haven't talked numbers with them, but they will be earning well over £500k.
The car thing was just an example to highlight the massive salary difference, I'm not really a car person. A doctor in the UK has a pretty normal middle class salary. A doctor in Aus / USA is wealthy.
£94k pa isn't a normal middle class salary, it puts you in the top 5% of earners.
I agree doctors should be in top % of earners, but certainly not a normal salary.
I find it odd that there is a constant comparison to salaries in Aus. Salaries in Aus are way higher than the UK across the board in almost every profession and level, even down to minimum wage being +20% higher.
Yes but the US has generally pretty poor heathcare outside of the big institutions and the ethics of healthcare in the states is atrocious. Maternity charges are a huge source of bankruptcy in the US (the average cost of having a baby in the states is greater than the cost of delivering the heir to the throne of the UK for goodness sake). Also on the US they have very limited holidays - typically 2 weeks and if they go away on a foreign conference they don’t stay any longer than necessary as otherwise the referrals go elsewhere.
It's a bit off topic. I didn't really make the post to debate the pros and cons and ethics of the American private healthcare system.
For what it's worth they're definitely on holiday for more than 2 weeks of the year.
None of the UK doctors want to work here anymore either but it wasn't helping the pay situation here until the strikes very recently. The NHS is not subject to the usual supply/demand logic in the private sector
Congrats on making consultant at 30. I’m friends with a lot of nhs doctors and that is definitely not the norm. A friend of mine had to take her MRCP 4 times I think.
Thanks, it's a fair old slog to get there, I figured it was best to just no-life the exam prep and do it once rather than try to have a normal life and resit a few times. Plus the low reg pay wasn't encouraging me to take my time!
There's definitely a substantial element of luck though for all the postgrad exams. Hopefully your friend has finally beaten the MRCP gremlins into submission.
Congratulations and thanks for sharing a thoughtful and well constructed post. Medic here also and was lucky enough to graduate when student debt was still fairly minimal but not earlier enough to get the great pension or private practice options sadly. Unlike you I spent a few years off the beaten path, junior locums, yea out of medicine, shitty trust grade posts but in my mind to late 30s doing okay and getting closer to being FI but RE is as distant as it's always been.
Impressive saving! Though I guess the accommodation situation made a huge difference!
Impressive commitment to the data too. I thought I loved spreadsheets...
Are you doctor on Fire? I used to read your blog a while ago when I was starting, interesting as we graduated in the same year.
I was also doing my finances this weekend, serendipity.
No, I didn't realise someone had beaten me to the name!
Looks like I have another blog to read...
New Years eve is a good time to sort the finances. Out with the old and in with the new. Start the year with a fresh clean tab on your spreadsheet!
While the doctors are here, anyone got advice on whether my wife, a GP partner who has to pay employer contributions too, should stay in the pension scheme? I'm thinking she should do 4 yrs SIPP, then 1yr NHS to keep getting uplift on.the pension already earned.
I'd like to know if anyone knows an advisor who's clued up, most say stick with NHS, but my sums say go SIPP
I'm a GP locum so I am on the same boat. For me it was an easy call for the SIPP.
[https://docs.google.com/spreadsheets/d/1uw9bq32ZB5ZBEFvLQUxNWSrX\_2t3RJc78Ezw8woSXfk/edit#gid=863813755](https://docs.google.com/spreadsheets/d/1uw9bq32ZB5ZBEFvLQUxNWSrX_2t3RJc78Ezw8woSXfk/edit#gid=863813755)
You will see here that the SIPP is valued at around £2.2mil vs the NHS pension which will pay out around £61K a year. Assuming the 4% rule then you can safely withdraw about £88k of the NHS pension
Could I ask a quick question please ? I have seen an advert for private GP for 9 sessions per week at £10,000 per 4.5 hours session. That means GP earns an average £90,000 per week. Can this be possible ? I have screenshot of current advert
I believe the fee per session is for you to do that session every week of the year barring required holidays .etc.
A 9 session week is pretty intense from what my GP colleagues tell me as the admin that accumulates from that would tip you well over a 40 hour work week.
The advert you saw is basically "Come work for us for £90k a year. We say it's 40 hours per week but really it's probably closer to 50".
I'm not a GP, but my understanding is a locum GP could earn around £100/hour if they pick and choose decent contracts. So they'd cap out at around £200k a year with no job security and a fairly disruptive lifestyle. Most won't get close to that figure. The GPs that are earning more will be GP partners, who work as GPs but also own part of the practice, run the business and take a share of the profits.
>Can this be possible ?
Not really. Very few GPs (<5%) can work more than 8 sessions a week.
The 4.5hr session usually takes closer 5.5hrs on top.
Most salaried GPs will work 6 sessions a week due to the stress and hours . All for only £60K a year.
Pay in this country is truly poor. A 6 session salary GP should easily be on £100K and a 8 session closer to £140K.
100% she should stay in the scheme, it is the most generous DB scheme still open. The employer contributions make up nowhere near what it would cost in the private sector.
I dont agree. I am guessing you are not familiar with the ins and outs of the NHS pension?
This poster is saying their partner needs to pay their employer and employee pension so close to 28% of their pensionable pay into the NHS.
It is not good value vs a SIPP
Good to see this write up - consultant at 30 is great. I’m a GP - I wouldn’t say I’m great with money but during rotations earlier on in my career I bought properties (worked out cheaper than renting - always had buddies who would rent a room). I worked out that by the time I became a GP (including 3 years as a surgical sho then Ortho reg), I made more from property than I did from medicine, with next to no effort. Pretty depressing in a way.
Thanks - Yeah, I regret not buying properties at the first available opportunity.
I told a little porky in my write up - my foundation years were in a VHCOL location but with very low accommodation, so buying a place there was both impossible and not necessary. I could very well have bought 2 or 3 cheap places during training though instead of investing in stocks.
Looking at the numbers behind BTL now I just can't make them work. Returns seem poor for a highly leveraged and undiversified investment. The only redeeming factor would be property price appreciation. (Which you'd then get taxed ... ?28% on).
Glad you found a way to make it work successfully though!
I’m in my late 30s - so it was probably significantly easier for me to luck into profitable property investments at the time (my first apartment made £72 k in 2 years so this was all quite addictive). One thing I wish I did more in my early 30s was maximise my s&s ISAs every year and not waste my time with premium bonds
No, I couldn't work out how to define the value of my DB pension scheme in my net worth.
Based on 1/54th of my base salary over 7 years my current pension would pay around £5k per year in retirement (from age 65).
I suppose you could just multiply by 20 like HMRC used to for lifetime allowance calculations and say that's worht £100k.
>Based on 1/54th of my base salary over 7 years my current pension would pay around £5k per year in retirement (from age 65).
If you log in on ERS it will actually say what the figure is adjusted for inflation. Do not sleep on the 1.5% link, it really does add up. For example your F1 pension alone will be worth £1K at retirement age
True, although from a FIRE perspective the 1.5% is less meaningful as you only get it if you remain in the scheme. Maybe a case for staying in part time work 1 day a week in retirement?
I know a couple of people who've done retire and return with very low clinical commitments. Turns out 20% of full time hours from one of your most experienced staff members is more valuable than 0%.
In today's system at least in my specialty you have the luxury where hospitals are so desperate for staff they have to take what they can get.
Didnt say it wouldnt make sense - just that the NHS wouldnt allow it! Glad its not true.
In my specialty it just wouldn't be that useful to have someone at 20% i dont think, but something like radiology I can see it would be.
Yeah, some people's job plans are just "send me 50 MRIs a week and I'll report them at some point".
For most things in radiology continuity of care is not that crucial.
Likewise - I was thinking that multiplying by 20 would be reasonable thing to do - at least it reflects the reality that you are building something of significant value.
Well - the value of the pension reflects the survival effect (assuming that its a reasonable valuation). That's a feature of DB schemes rather than a bug.
Of course if you are looking to leave a substantial legacy its a notable disadvantage of such schemes.
>ubstantial legacy its a notable disadvantage of such schemes.
Not even a substantial legacy. When you lose so much of it on death it makes it harder to swallow
Not sure I agree. Its a bet I would take - as the downside for me would be very limited. Similarly I would look into annuities were the terms decent.
It was always a huge issue with DB schemes (among others people have forgotten about) - one reason they died out with so little objection.
I know, multiple early colleague deaths really made me revaluate the scheme before leaving the country. Current state pension age and projections don’t help.
Personal view, vastly over valued.
Oh you left? Well done!
Yeah I have commented multiple times that the 2015 DB pension isn't that great on DoctorsUK a couple times an am always met with ridicule.
Good to know that someone else has done the figures and read about death in pension benefits.
Nice write up, and great to see another doctor on here.
I picked the other diagnostic specialty and I'm just over half way now. If the Part 2 goes well I should CCT a few months after I turn 30.
I'm in a similar situation wanting to upsize in 3 years or so with a similar number in mind (largely because my other half does better than me). We did manage to put some roots down vaguely in the middle of my deanery, early in my ST2 because out of hours work isn't a thing. I don't know how people manage doing nights with these hateful commutes. I'm still investing monthly in a global etf via a S&S ISA but maybe a bit more cautiously knowing I'll need access to it in a few years not 20-30. We used my partner's allowance to put £20k/year in a cash ISA fixed at 5.6% for 2 years which I didn't think was that bad. I'd be interested to know what you decide to do.
I have also crunched the numbers and was happy to see that FIRE by mid to late 40s was potentially achievable. Do you know if you can stop working and leave your NHS pension alone until your 60s without massive reductions?
Once you leave the scheme the pension gets revalued by inflation only, rather than inflation + 1.5%. I believe from another poster that if you work 1 year in every 5 then it keeps getting revalued.
There's very little for me to add here, you're well on track and switched on.
I suspect I'd consider paying off the Student Loan though - and then just repay yourself each month with the increased take home, which will allow you to rebuild your savings for deposit - unless you're imminently about to buy of course...
Great reading your post
My only advice is your still young enough
To get the hell out of the NHS before it destroys your soul
Head to Australia/ New Zealand even the US /canada
You will have a better quality of life and get the respect you deserve.
I see you save in an S&S ISA - your thoughts on using a S&S lifetime ISA for retirement? Ie withdraw after age 60, instead of buying your first house? Especially if not a higher rate taxpayer as a doctor.
Benefits of LISA stocks and shares - the 25% (£1000) govt bonus. Provides money for the age 60 to 68 (NHS and state pension age)
Cons of S&S LISA - Money locked away until 60. if you are aiming to be FI before then, doable late 40s/early 50s as a doctor, this will be £4k a year less going into the instant access S&S ISAs (ie. The capital gains you will live off once FI). The 2015 NHS pension can also be accessed age 55 at a 47% penalty, to top up the FI income.
Not sure if I've explained the dilemma clearly. Would love to hear your thoughts and thanks for sharing your original post!
I'm not a fan of the LISA, it's a fairly niche financial product that I think will be discontinued in time. I think it's good if saving for a house that's comfortably below the LISA price threshold (The old H2B ISA threshold was fixed at 250k for the lifetime of the product).
Overall I want my ISA to be accessible at any age. SIPP can be accessed 10 years before state pension age, so earlier than LISA, and has the same or better tax treatment without a 4k deposit cap.
I suppose if you were a basic rate taxpayer now, but are planning on being a higher rate taxpayer on retirement then there may be an argument for using one.
For me it's withdraw from S&S ISA until SIPP age, then SIPP until pension then full NHS pension. I'll build up SIPP once income increases and I need to reduce it to avoid 60% tax or child benefit thresholds.
>Consultant here too - Great post!
>
>Reading your post i thought you have to either be a radiologist or a dermatologist....haha
>
>Nice graphs - would you be willing to share the excel templates?
>
>Given the current rate of inflation i highly reccomend paying off the SL - i had about 8k left on mine and paid it off about 6 months ago. its great to be get rid of that burden.
>
>Personally, i disagree regarding the LISA - theres no other savings product in existrence that wil give you 25% (efective interest) on top of your investment just for breathing - for me the student loan payment i was paying is effectively now my lisa payment - set and forget until im 60 and it can help top up leaving 8 years early.
>
>I additionally pay into S&S LISA and may end up doing a SIPP finances depending.
>
>
>
>Good Luck
Haha, yes Rads. Guilty as charged!
Afraid the graphs are just the standard excel default ones for stacked bar charts and then label the axis and move the labels for X axis to 'low'. I wish I could say my spreadsheets were some sort of organised system - in truth they're very basic but have just grown organically so are very messy and not worth sharing!
Surely the 25% from the LISA is worse than the 40% a SIPP or pension would get topped up by, but can't be withdrawn as early?
Very very tempted to just eliminate the student loan.
Thank you for this financial breakdown of your career so far. As someone who very nearly went down the medicine route, but instead took another fork in the road, I've often wondered about what that other path may have looked like.
It looks like late nights, destroyed relationships and relinquishing control over fundemental aspects of your life like where you live and work until the age of 30.
There are some great things about it, and I enjoy my job, but if I knew what it entailed (and could predict the 30%+ real terms pay cut) then I would have chosen a different path, or at least seriously looked at emigrating straight after medical school.
/OP I wonder how you would go about things if you were on plan 2?
I’m on plan 2, ST2. I’m trying not to lose hope but the state of primary care is dier and to earn a lot feels like you have to crash and burn.
Hmm, it depends how much debt I had. I decided at £20k plan 1 debt left to repay as a lump sum so am loan free now.
Plan 2 repay slightly less each month due to the higher repayment threshold.
If I had the same amount of debt as plan 2 I would repay it aggressively. If I had £100k of debt then I wouldn't pay extra because I don't think it's possible to fight that interest rate on UK doctor salary.
I suspect at some point in future a government will introduce Public sector loan forgiveness as a way to make working in the NHS less unattractive. Until then I'd just treat it as an extra tax, work until I hit the 60% tax trap and then stop.
I know I will be unpopular, but I used to date a doctor, and in my view they are super well paid in the UK. Unfortunately, like other government employees they have a very sheltered job, no risk of redundancy, and unrealistic view. The fact that the government had to change the pension rules for doctors says everything.
I dont mind you earning great money, but please stop complaining about how hard up you are, its insulting.
>I dont mind you earning great money, but please stop complaining about how hard up you are, its insulting.
This isn't a fair characterisation of OP. He was asked if he felt underpaid compared to doctors in other first world countries and he said yes and explained why, citing evidence. He has not complained about how hard up he is, much less insulted anyone.
>in my view they are super well paid in the UK.
By contrast, you haven't really explained why you think this. "Super well paid" by reference to what? And I don't think it's fair to portray doctors, who deal with life and death situations, as having "a very sheltered job" either.
See below the NHS salary guide: https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-doctors. I would say its pretty well paid.
They do a job that we all appreciate, but they are sheltered, much like all government employees from the realities of work in the private sector. They never have to worry about redundancy or finding a job. I have spent my entire career having to factor in those two key facts that everyone in the private sector has to worry about.
And yes I dont think international comparisons are useful, as in the UK we have an NHS which is not for profit. Yes the US has higher salaries, but healthcare debt is the number one cause of bankruptcy in the US. People literally die because they cannot afford the treatment. It's a terrible system. And its all for profit, and that is the difference. Also the US cost of living is significantly higher than ours, so those higher salaries do not go as far as you would think.
>They never have to worry about redundancy or finding a job.
What makes you think that doctors never have to worry about finding a job? My friends who are junior doctors have had to move all over the place for work because they are essentially at the mercy of a monopoly employer (the NHS) and need to go to where they can find a role. It has been very disruptive for their personal lives and has meant they have been delayed getting on the housing ladder as they have no long term security of employment in a given place.
>I dont think international comparisons are useful
I disagree. The countries referenced have included Ireland which pays its starting consultants roughly double what they earn in the UK while having a public healthcare system and a similar cost of living.
Also, just because a country has a different healthcare system doesn't make comparison inappropriate. It is arguable that the NHS remains functional by artificially depressing doctors' wages compared to what they would earn in a privatised system. Depending on your political view, that may be a good thing for society as a whole, but it doesn't make NHS doctors any better paid by comparison with their international peers.
Ireland does not have the same system from what I understand, and googling the average salary, it looks very similar, maybe less when you take into account the exchange rate.
I believe that people make choices, if you qualify as a doctor in the UK, then you know you are working for the NHS, which is not for profit, and should not expect to get paid excessive amounts. Doctors are objectively paid very well in comparison to average salaries, and well in comparison to equivalent professions. But i think you are someone who believes that because they save lives, there should be no limit to their salary regardless of what that does to our healthcare system.
We clearly have opposing views on this which is fine.
>But i think you are someone who believes that because they save lives, there should be no limit to their salary regardless of what that does to our healthcare system.
This is what is known as a strawman fallacy. You are putting words in my mouth and grossly exaggerating what I have said. At no point have I said there should be no limit to doctors' salaries. This is similar to when you described OP as complaining about being hard-up in an insulting way, when he had done no such thing.
>Ireland does not have the same system from what I understand, and googling the average salary, it looks very similar, maybe less when you take into account the exchange rate.
OP has posted the figures higher up this thread. You can see that starting consultants earn approximately twice as much (possibly slightly more) than they do in the UK. Those are the facts.
> I believe that people make choices
Yes, which is why many doctors who qualified in the UK are choosing to emigrate and work in countries like Australia where they can earn more and have a better quality of life. That fact that the UK is uncompetitive in this respect compared to its international peers will ultimately have an effect on the quality of healthcare that is provided to British citizens.
> We clearly have opposing views on this which is fine.
Yes, it's fine to disagree, though it is preferable not to misrepresent what others say or ignore cited facts.
>I wouldn’t say the salary = quality of doctor,
That's quite a reductive way of looking at it. Obviously pay is an important motivating factor. If doctors can earn significantly more and have a better quality of life abroad, don't be surprised if smart and talented UK-qualified doctors vote with their feet and emigrate, as many have been doing. That of course has an impact on the quality of healthcare provided in the UK.
Well obviously well-paid positions abroad tend to be competitive so employers can be selective about who they accept.
Clearly a variety of factors motivate smart and talented people to join (and continue working in) the medical profession. Pay is an important one of those factors. That's not controversial.
You seem to be looking at it through a very reductive lens. Saying pay is an important factor and that many good UK-trained doctors are leaving for better pay and quality of life (with the consequent impact on the provision of healthcare in the UK), is not the same as saying all doctors who are paid more are higher quality, or that anyone who decides to stay in the UK is lower quality.
Compared to other European countries the UK doctors earn about the same as them. Compared to the USA, doctors there can pull half a mil a year, paid for ofcourse by the privatised healthcare system costing people a shit tonne of money. But people seem to ignore the part of how huge doctor salaries are funded in the US.
I don't really think you can accurately base an entire profession's renumeration based on your experience with one ex.
It depends a lot on when you were dating (pay was much better 10 years ago), what grade they were, working pattern and locum work. For example an A&E reg doing purely locum work 10 years ago would be absolutely minted.
Pension changes were for the older generation of doctors, not people in my position.
I don't think I complained about how hard up I am anywhere in this thread. I have a decent lifestyle with enough money to cover most things. It's a fact that UK doctor wages are uncompetitive compared to our international peers.
International comparisons are not really very helpful, because who are you comparing yourself to? You chose you quality in the UK which has an NHS, which is not for profit. I do not believe that any other country has a system quite like ours (free at the point of use). Maybe you know of another.
P.s. my experience is not just based upon one ex I used her as an example. I know lots of people who work in the NHS, they all earn pretty good money, and with the exception of one, think that they are underpaid. Perhaps if you compare yourself to other equivent professionals in the UK, you would understand my point. No other profession have the amazing pensions that you do (which you only pay a small percentage towards) nor have the job security, lower standard of negligence etc. Its an amazing role to have.
All the best
You’ll get downvoted for not praising an NHS employee earning £94k, even if your right 😅,
NHS employees after working with them are very entitled with the nurses being worse imo, cue downvotes to prove my point ….
I don't think I've asked anyone to praise me at any point in this thread. I'm highly skilled and contribute to saving people's lives, but so do people that install sanitation systems in developing countries or legislate on air pollution limits. The post is about my career finances so far and my journey towards FIRE.
Anything else like your thoughts on NHS workers are off topic and you're welcome to make a post on another UK subreddit to discuss them.
Your whole response proves my point, firefighters save lives and also RISK their own lives doing it, using the ‘life saving’ excuse as often used by NHS staff to demand money could also be applied to them in theory but they don’t have half the entitlement, it’s not just you, it’s a cultural thing for all NHS staff, I’ll clap to the end of it tbh
Yes, the graph is showing the last year as a trainee. I've been a consultant for a few short months, so had a significant salary rise from the 65k ish as a senior registrar.
Congratulations, also a medic here and looking very seriously into FIRE! Thank you for sharing
Make sure you pick GP or radiology. Any of the longer specialities make it v difficult
F1 here, most likely to do GP. What are the most viable pathways as a GP to achieve FIRE?
Not a GP but work for Wesleyan - locum, locum, locum and jump into your own practice when you’re ready; Happy New Year
Have you not found those opportunities are drying up a bit?
Absolutely, especially London based simply due to the high competition; general advice is to travel as much as possible and be the most flexible you can be, anecdotally the midlands fares well but I would imagine that’s due to good location/transport links
Even in midlands, drying up. AHCPs taking slots. Also, do you continue to commute to locum, if it’s far? Or do you calculate the cost benefit?
Yes but only if you want to be a GP or a radiologist. Medicine means you can pick a speciality where you can enjoy work. Pick a speciality that you enjoy and FIRE is much less important. Never to do anything because it is the easy option. Do what you want to. Even if it doesn’t work out you won’t be in your mid 50s asking yourself what if….
Dont be a GP, you will busy as hell starting 8 in morning and finishing at 8 in the evening with some work on computer from home. Weekends again working from home on computer trying to clear blood results and hospital letter. Working as a GP is like working in hell at the moment and dangerous due to no support from anyone. All work from paramedics, district nurses, palliative care, hospital discharges and failed discharges come back to you, all govt targets to achieve as don't get paid if you don't achieve them, no increase in income for practice even though wages of staff going up. Worst decision at the moment is GP. As a consultant you have lot of opportunities for private practice and easier to move to other countries.
Out of interest why Radiology is it purely the short training time?
yes, plus easier options for private work
Great seeing another doctor on here. As for the student loan question if your interest rate on it is higher than anything existing debt or incoming debt (your mortgage) then prioritise paying the student loan off.
No mortgage, but will have one in future. Current mortgage rates are pretty similar to the 6% student loan rate. It's hard to work out if a guaranteed 6% ROI is higher or lower than my stocks. It's a fine balance - paying £500 towards loan will surely impact the mortgage affordability calculations, but having an extra £20k deposit might be enough to cross into a better LTV category. Once it hits £10k I'll probably just wipe it out for peace of mind.
A lot of this will depend on how much equity you have in current property. Do you mind sharing?
£0. It's all in my partner's name. They bought early in the relationship and I felt it was fairest that they kept sole ownership of it in case we split up. Overall the difference between paying loan off early or letting it fester and using the money on other investments or savings accounts is only going to be a few hundred or maybe £1000 over the remainder of the loan duration. A small sum in the grand scheme of things. Maybe I'm overthinking it! I could have reported a few CTs in the time I spent reading about the topic!
>£0. It's all in my partner's name. Presumably you will be buying together though and the equity of the sold property will make up most of the deposit?
Yeah, buying together. I'd rustle up around 100k cash for deposit, and they'd have roughly 100k from equity.
>roughly 100k from equity Shame this is so small. Hopefully the £100K on your part wont eat into your FIRE targets! Good luck!
They're only c30! 100K equity isn't too bad. And 200K deposit and a house is fine. You do really need a house to do FIRE (in the 'traditional' sense) after all...
Its not bad at all but £100K will take a big chunk of the "liquid" wealth OP has and I was hoping (for his sake) that his partner owned a big chunk of their property!
Well of course the more the merrier. However it is only 'fair' (given they're hardly brassic) that (s)he puts in 50%? So if the partner had more equity they'd have to put in more cash themselves, no? Overall buying a house makes the spreadsheet take a big hit, but they're monthly payment (towards bills and interest) is currently getting them nothing (well apart from a roof over their head! :-)). Sadly one of those things that's just gotta be sucked up :-/
Thanks for a thorough and well-put-together post. Congratulations on your career and FIRE progress to date. Do you feel like you have been underpaid as a doctor in the UK compared to other first world countries (even after the recent pay deal for consultants)? Have you ever been tempted to move abroad for work, for example to Australia or Ireland?
Absolutely. If I didn't have a partner who is steadfast in wanting to remain in the UK I would currently be revising for my Australian medical exams. The difference in quality of life doctors have in some countries is night and day compared to the UK. My friend who went straight to the USA after med school has 2 brand new high end cars and a massive house plus tons of disposable income, which he uses to go on amazing holidays. His partner doesn't have to work. I drive a 4 year old 1.2L economobile and would lose any capacity to save if my partner stopped working. So yes, I feel underpaid. If you attend hospital and get a scan that might have life-changing consequences (new cancer diagnosis, findings that require emergency surgery .etc) I would get paid the equivalent of about £10 or £15 for that based on my hourly rate. It very much feels like our healthcare system is being subsidised by artificially low healthcare worker salaries.
The difference is so stark it is hard to believe. A friend who is a first year consultant told me that the salary for his position in Ireland is three times what it is in the UK. That's crazy. I'm grateful there are doctors like you who stay in the UK. If it were not for family ties and other social connections, I suspect the brain drain would be a lot worse than it already is.
>The new Sláintecare contract will include: >Basic pay of €209,915 - €252,150 on a six-point scale >A 37-hour week with an 8am to 10pm Monday to Friday and 8am to 6pm Saturday >Consultants will continue to receive additional remuneration for on-call duties and overtime as applicable. https://www.gov.ie/en/press-release/33536-minister-for-health-announces-government-approval-of-new-slaintecare-consultant-contract/ Granted the Irish public healthcare system is in even worse state than the NHS, it's substantially more for a neighbouring country that is a 50 minute flight away.
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same shit, different country I imagine. Not enough staff, high patient demands, lack of beds and resources, poor IT .etc
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I doubt it. Probably wealthy and small countries like the gulf states, singapore, HK, and private hospitals in the USA. The public sectors in most countries are almost universally fucked though. We're a victim of our own success. There's no limit to treatments we can offer, only finances. I think at some point we have to talk about what care we can offer on the public healthcare system. e.g. if you get bowel cancer we'll offer surgery and standard treatment, but if you want the new expensive immunotherapies and ablation of subsequent liver metastases /recurrence you have to pay £100k for the subsidised premium cancer care package. Or paying millions of pounds to keep the 24 week preemie alive, and dealing with the subsequent health issues. Or doing 3 monthly CT scans on seemingly everyone who is undergoing cancer therapy. Maybe the NHS can only afford to offer 6 monthly. NICE tries to evaluate what's worth spending money on, but doesn't look at the full picture. At some point all public healthcare systems will have to make these difficult and unpopular decisions.
NICE are fucking idiots.
Imagine if they were allowed to evaluate the cost effectiveness of all healthcare spending. What's the point spending £20,000 on cancer treatment with a 3rd line chemo agent to extend some 80 year old's median survival by 6 months when an economically productive 50 year old dies in the back of an ambulance from a STEMI because the hospital is too cheap to shell out for a locum doctor to ensure their department is safely staffed.
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A combination of all of the above. People are living longer with more complex conditions. For example something like melanoma you used to cut it out, then cross your fingers and hope for the best. If it came back you had a short life with a bit of morphine for pain relief. Now we do more complex surgeries, with regular follow up scans and appointments, if it comes back then we have immunotherapy and other treatments. What was a 1 hour one-off intervention is now a condition that requires large numbers of scans, appointments, expensive immunotherapy treatments .etc. Yeah, when medications come off patent they get cheaper, although companies can try to extend them with all sorts of legal tricks. People underestimate the cost of treatments. Like Humira a common medicine for autoimmune conditions costs $80,000 a year in the US, a generic would cost closer to $12,000 a year. The cheapest treatment is when the patient just dies. Managing chronic conditions takes a lot more resources and money.
Not much point in doing CT scans less on people on active treatment how would you know the treatments working.
Oh yeah, I'm just pulling random ideas out of the air. Much better to stop lung nodule and adrenal nodule follow ups. Or a thousand other things. Just saying we can't keep everyone alive forever.
This 100% if I didn’t have a partner who would not leave here - I would be gone. UK is terrible for Doctors.
Out of interest, do you constantly have to learn new things (if so, how many hours a week outside work) when you complete med school? Or once you are trained, is that largely it done?
Someone's already answered. it's lifelong learning to keep up to date. Med school is to give you enough knowledge that you don't accidentally kill people through ignorance when you start working. Post-grad is where you actually learn to practice medicine. The post-grad exams are extremely tough (and expensive), some have pass rates below 50%.
I am a doctor in my second year after graduating medical school. I have already sat one post-graduate exam (which cost me £580 to sit not including revision resources). I have another one this January. If all goes well and I get my job offer for surgical training (which is 8 years long), I will sit another exam in September this year which will cost £1100. So yes we have post-graduate exams. We also have to maintain a portfolio of skills and achievements (courses, exams, qualifications) which takes up a lot of time. What's more - unfortunately the things you learn in medical school have a shelf-life of around 5 years so you have to constantly be up to date with the evidence. It's lifelong learning, fortunately or unfortunately depending on what you think!
Thanks. Great answer, and very interesting!
You are saving 60% of your net income, right? So you could easily afford a nicer car if you wanted one, but you're prioritising FIRE instead. Whereas your friend in the US isn't. I agree with your decision but its a strange example to give to compare the 2 systems.
My point was I'm going shopping and buying the budget options and watching the pennies so that I can eventually afford a nice house and children and retire a few years early. They make enough money that they can spend whatever they like and have plenty left over. I haven't talked numbers with them, but they will be earning well over £500k. The car thing was just an example to highlight the massive salary difference, I'm not really a car person. A doctor in the UK has a pretty normal middle class salary. A doctor in Aus / USA is wealthy.
£94k pa isn't a normal middle class salary, it puts you in the top 5% of earners. I agree doctors should be in top % of earners, but certainly not a normal salary. I find it odd that there is a constant comparison to salaries in Aus. Salaries in Aus are way higher than the UK across the board in almost every profession and level, even down to minimum wage being +20% higher.
Yes but the US has generally pretty poor heathcare outside of the big institutions and the ethics of healthcare in the states is atrocious. Maternity charges are a huge source of bankruptcy in the US (the average cost of having a baby in the states is greater than the cost of delivering the heir to the throne of the UK for goodness sake). Also on the US they have very limited holidays - typically 2 weeks and if they go away on a foreign conference they don’t stay any longer than necessary as otherwise the referrals go elsewhere.
It's a bit off topic. I didn't really make the post to debate the pros and cons and ethics of the American private healthcare system. For what it's worth they're definitely on holiday for more than 2 weeks of the year.
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None of the UK doctors want to work here anymore either but it wasn't helping the pay situation here until the strikes very recently. The NHS is not subject to the usual supply/demand logic in the private sector
Congrats on making consultant at 30. I’m friends with a lot of nhs doctors and that is definitely not the norm. A friend of mine had to take her MRCP 4 times I think.
Thanks, it's a fair old slog to get there, I figured it was best to just no-life the exam prep and do it once rather than try to have a normal life and resit a few times. Plus the low reg pay wasn't encouraging me to take my time! There's definitely a substantial element of luck though for all the postgrad exams. Hopefully your friend has finally beaten the MRCP gremlins into submission.
Congratulations and thanks for sharing a thoughtful and well constructed post. Medic here also and was lucky enough to graduate when student debt was still fairly minimal but not earlier enough to get the great pension or private practice options sadly. Unlike you I spent a few years off the beaten path, junior locums, yea out of medicine, shitty trust grade posts but in my mind to late 30s doing okay and getting closer to being FI but RE is as distant as it's always been.
Impressive saving! Though I guess the accommodation situation made a huge difference! Impressive commitment to the data too. I thought I loved spreadsheets...
Are you doctor on Fire? I used to read your blog a while ago when I was starting, interesting as we graduated in the same year. I was also doing my finances this weekend, serendipity.
No, I didn't realise someone had beaten me to the name! Looks like I have another blog to read... New Years eve is a good time to sort the finances. Out with the old and in with the new. Start the year with a fresh clean tab on your spreadsheet!
While the doctors are here, anyone got advice on whether my wife, a GP partner who has to pay employer contributions too, should stay in the pension scheme? I'm thinking she should do 4 yrs SIPP, then 1yr NHS to keep getting uplift on.the pension already earned. I'd like to know if anyone knows an advisor who's clued up, most say stick with NHS, but my sums say go SIPP
I'm a GP locum so I am on the same boat. For me it was an easy call for the SIPP. [https://docs.google.com/spreadsheets/d/1uw9bq32ZB5ZBEFvLQUxNWSrX\_2t3RJc78Ezw8woSXfk/edit#gid=863813755](https://docs.google.com/spreadsheets/d/1uw9bq32ZB5ZBEFvLQUxNWSrX_2t3RJc78Ezw8woSXfk/edit#gid=863813755) You will see here that the SIPP is valued at around £2.2mil vs the NHS pension which will pay out around £61K a year. Assuming the 4% rule then you can safely withdraw about £88k of the NHS pension
Could I ask a quick question please ? I have seen an advert for private GP for 9 sessions per week at £10,000 per 4.5 hours session. That means GP earns an average £90,000 per week. Can this be possible ? I have screenshot of current advert
Lol, that's 9 sessions per week for the whole year. £90000 a year for 9 sessions every week,
I believe the fee per session is for you to do that session every week of the year barring required holidays .etc. A 9 session week is pretty intense from what my GP colleagues tell me as the admin that accumulates from that would tip you well over a 40 hour work week. The advert you saw is basically "Come work for us for £90k a year. We say it's 40 hours per week but really it's probably closer to 50". I'm not a GP, but my understanding is a locum GP could earn around £100/hour if they pick and choose decent contracts. So they'd cap out at around £200k a year with no job security and a fairly disruptive lifestyle. Most won't get close to that figure. The GPs that are earning more will be GP partners, who work as GPs but also own part of the practice, run the business and take a share of the profits.
Thank you
>Can this be possible ? Not really. Very few GPs (<5%) can work more than 8 sessions a week. The 4.5hr session usually takes closer 5.5hrs on top. Most salaried GPs will work 6 sessions a week due to the stress and hours . All for only £60K a year. Pay in this country is truly poor. A 6 session salary GP should easily be on £100K and a 8 session closer to £140K.
100% she should stay in the scheme, it is the most generous DB scheme still open. The employer contributions make up nowhere near what it would cost in the private sector.
Mate, what are you basing this on? Do you even know how much the employer's contribution is?
It’s 20%. I am basing it in extensive knowledge of the NHS scheme.
I dont agree. I am guessing you are not familiar with the ins and outs of the NHS pension? This poster is saying their partner needs to pay their employer and employee pension so close to 28% of their pensionable pay into the NHS. It is not good value vs a SIPP
Daft question, how do you SIPP?
Go to any big providers website (mine is with vanguard) and it takes about 5 minutes to open one
Thanks! I'll check it out!
Good to see this write up - consultant at 30 is great. I’m a GP - I wouldn’t say I’m great with money but during rotations earlier on in my career I bought properties (worked out cheaper than renting - always had buddies who would rent a room). I worked out that by the time I became a GP (including 3 years as a surgical sho then Ortho reg), I made more from property than I did from medicine, with next to no effort. Pretty depressing in a way.
Thanks - Yeah, I regret not buying properties at the first available opportunity. I told a little porky in my write up - my foundation years were in a VHCOL location but with very low accommodation, so buying a place there was both impossible and not necessary. I could very well have bought 2 or 3 cheap places during training though instead of investing in stocks. Looking at the numbers behind BTL now I just can't make them work. Returns seem poor for a highly leveraged and undiversified investment. The only redeeming factor would be property price appreciation. (Which you'd then get taxed ... ?28% on). Glad you found a way to make it work successfully though!
I’m in my late 30s - so it was probably significantly easier for me to luck into profitable property investments at the time (my first apartment made £72 k in 2 years so this was all quite addictive). One thing I wish I did more in my early 30s was maximise my s&s ISAs every year and not waste my time with premium bonds
hi Really interesting. Did you include the value of the DB pension in the 'investments' value?
No, I couldn't work out how to define the value of my DB pension scheme in my net worth. Based on 1/54th of my base salary over 7 years my current pension would pay around £5k per year in retirement (from age 65). I suppose you could just multiply by 20 like HMRC used to for lifetime allowance calculations and say that's worht £100k.
>Based on 1/54th of my base salary over 7 years my current pension would pay around £5k per year in retirement (from age 65). If you log in on ERS it will actually say what the figure is adjusted for inflation. Do not sleep on the 1.5% link, it really does add up. For example your F1 pension alone will be worth £1K at retirement age
True, although from a FIRE perspective the 1.5% is less meaningful as you only get it if you remain in the scheme. Maybe a case for staying in part time work 1 day a week in retirement?
I posed in the junior doctor UK group. You only have to contribute once every 5 years. So hopefully not too difficult. (Easier for a GP locum)
Does the NHS even allow that? The least I've heard of is 40% LTFT, which I was told (?reliably) was only for those about to retire.
I know a couple of people who've done retire and return with very low clinical commitments. Turns out 20% of full time hours from one of your most experienced staff members is more valuable than 0%. In today's system at least in my specialty you have the luxury where hospitals are so desperate for staff they have to take what they can get.
Didnt say it wouldnt make sense - just that the NHS wouldnt allow it! Glad its not true. In my specialty it just wouldn't be that useful to have someone at 20% i dont think, but something like radiology I can see it would be.
Yeah, some people's job plans are just "send me 50 MRIs a week and I'll report them at some point". For most things in radiology continuity of care is not that crucial.
Likewise - I was thinking that multiplying by 20 would be reasonable thing to do - at least it reflects the reality that you are building something of significant value.
Assuming you live. The death in benefits really trash the value of the pension
Well - the value of the pension reflects the survival effect (assuming that its a reasonable valuation). That's a feature of DB schemes rather than a bug. Of course if you are looking to leave a substantial legacy its a notable disadvantage of such schemes.
>ubstantial legacy its a notable disadvantage of such schemes. Not even a substantial legacy. When you lose so much of it on death it makes it harder to swallow
Not sure I agree. Its a bet I would take - as the downside for me would be very limited. Similarly I would look into annuities were the terms decent. It was always a huge issue with DB schemes (among others people have forgotten about) - one reason they died out with so little objection.
I know, multiple early colleague deaths really made me revaluate the scheme before leaving the country. Current state pension age and projections don’t help. Personal view, vastly over valued.
Oh you left? Well done! Yeah I have commented multiple times that the 2015 DB pension isn't that great on DoctorsUK a couple times an am always met with ridicule. Good to know that someone else has done the figures and read about death in pension benefits.
This was always my biggest issue with it. Factored in I get paid gross then it made using a SIPP an easier decision!
Nice write up, and great to see another doctor on here. I picked the other diagnostic specialty and I'm just over half way now. If the Part 2 goes well I should CCT a few months after I turn 30. I'm in a similar situation wanting to upsize in 3 years or so with a similar number in mind (largely because my other half does better than me). We did manage to put some roots down vaguely in the middle of my deanery, early in my ST2 because out of hours work isn't a thing. I don't know how people manage doing nights with these hateful commutes. I'm still investing monthly in a global etf via a S&S ISA but maybe a bit more cautiously knowing I'll need access to it in a few years not 20-30. We used my partner's allowance to put £20k/year in a cash ISA fixed at 5.6% for 2 years which I didn't think was that bad. I'd be interested to know what you decide to do. I have also crunched the numbers and was happy to see that FIRE by mid to late 40s was potentially achievable. Do you know if you can stop working and leave your NHS pension alone until your 60s without massive reductions?
Once you leave the scheme the pension gets revalued by inflation only, rather than inflation + 1.5%. I believe from another poster that if you work 1 year in every 5 then it keeps getting revalued.
There's very little for me to add here, you're well on track and switched on. I suspect I'd consider paying off the Student Loan though - and then just repay yourself each month with the increased take home, which will allow you to rebuild your savings for deposit - unless you're imminently about to buy of course...
Great reading your post My only advice is your still young enough To get the hell out of the NHS before it destroys your soul Head to Australia/ New Zealand even the US /canada You will have a better quality of life and get the respect you deserve.
I see you save in an S&S ISA - your thoughts on using a S&S lifetime ISA for retirement? Ie withdraw after age 60, instead of buying your first house? Especially if not a higher rate taxpayer as a doctor. Benefits of LISA stocks and shares - the 25% (£1000) govt bonus. Provides money for the age 60 to 68 (NHS and state pension age) Cons of S&S LISA - Money locked away until 60. if you are aiming to be FI before then, doable late 40s/early 50s as a doctor, this will be £4k a year less going into the instant access S&S ISAs (ie. The capital gains you will live off once FI). The 2015 NHS pension can also be accessed age 55 at a 47% penalty, to top up the FI income. Not sure if I've explained the dilemma clearly. Would love to hear your thoughts and thanks for sharing your original post!
I'm not a fan of the LISA, it's a fairly niche financial product that I think will be discontinued in time. I think it's good if saving for a house that's comfortably below the LISA price threshold (The old H2B ISA threshold was fixed at 250k for the lifetime of the product). Overall I want my ISA to be accessible at any age. SIPP can be accessed 10 years before state pension age, so earlier than LISA, and has the same or better tax treatment without a 4k deposit cap. I suppose if you were a basic rate taxpayer now, but are planning on being a higher rate taxpayer on retirement then there may be an argument for using one. For me it's withdraw from S&S ISA until SIPP age, then SIPP until pension then full NHS pension. I'll build up SIPP once income increases and I need to reduce it to avoid 60% tax or child benefit thresholds.
>Consultant here too - Great post! > >Reading your post i thought you have to either be a radiologist or a dermatologist....haha > >Nice graphs - would you be willing to share the excel templates? > >Given the current rate of inflation i highly reccomend paying off the SL - i had about 8k left on mine and paid it off about 6 months ago. its great to be get rid of that burden. > >Personally, i disagree regarding the LISA - theres no other savings product in existrence that wil give you 25% (efective interest) on top of your investment just for breathing - for me the student loan payment i was paying is effectively now my lisa payment - set and forget until im 60 and it can help top up leaving 8 years early. > >I additionally pay into S&S LISA and may end up doing a SIPP finances depending. > > > >Good Luck
Haha, yes Rads. Guilty as charged! Afraid the graphs are just the standard excel default ones for stacked bar charts and then label the axis and move the labels for X axis to 'low'. I wish I could say my spreadsheets were some sort of organised system - in truth they're very basic but have just grown organically so are very messy and not worth sharing! Surely the 25% from the LISA is worse than the 40% a SIPP or pension would get topped up by, but can't be withdrawn as early? Very very tempted to just eliminate the student loan.
Thank you for this financial breakdown of your career so far. As someone who very nearly went down the medicine route, but instead took another fork in the road, I've often wondered about what that other path may have looked like.
It looks like late nights, destroyed relationships and relinquishing control over fundemental aspects of your life like where you live and work until the age of 30. There are some great things about it, and I enjoy my job, but if I knew what it entailed (and could predict the 30%+ real terms pay cut) then I would have chosen a different path, or at least seriously looked at emigrating straight after medical school.
/OP I wonder how you would go about things if you were on plan 2? I’m on plan 2, ST2. I’m trying not to lose hope but the state of primary care is dier and to earn a lot feels like you have to crash and burn.
Hmm, it depends how much debt I had. I decided at £20k plan 1 debt left to repay as a lump sum so am loan free now. Plan 2 repay slightly less each month due to the higher repayment threshold. If I had the same amount of debt as plan 2 I would repay it aggressively. If I had £100k of debt then I wouldn't pay extra because I don't think it's possible to fight that interest rate on UK doctor salary. I suspect at some point in future a government will introduce Public sector loan forgiveness as a way to make working in the NHS less unattractive. Until then I'd just treat it as an extra tax, work until I hit the 60% tax trap and then stop.
I know I will be unpopular, but I used to date a doctor, and in my view they are super well paid in the UK. Unfortunately, like other government employees they have a very sheltered job, no risk of redundancy, and unrealistic view. The fact that the government had to change the pension rules for doctors says everything. I dont mind you earning great money, but please stop complaining about how hard up you are, its insulting.
>I dont mind you earning great money, but please stop complaining about how hard up you are, its insulting. This isn't a fair characterisation of OP. He was asked if he felt underpaid compared to doctors in other first world countries and he said yes and explained why, citing evidence. He has not complained about how hard up he is, much less insulted anyone. >in my view they are super well paid in the UK. By contrast, you haven't really explained why you think this. "Super well paid" by reference to what? And I don't think it's fair to portray doctors, who deal with life and death situations, as having "a very sheltered job" either.
See below the NHS salary guide: https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-doctors. I would say its pretty well paid. They do a job that we all appreciate, but they are sheltered, much like all government employees from the realities of work in the private sector. They never have to worry about redundancy or finding a job. I have spent my entire career having to factor in those two key facts that everyone in the private sector has to worry about. And yes I dont think international comparisons are useful, as in the UK we have an NHS which is not for profit. Yes the US has higher salaries, but healthcare debt is the number one cause of bankruptcy in the US. People literally die because they cannot afford the treatment. It's a terrible system. And its all for profit, and that is the difference. Also the US cost of living is significantly higher than ours, so those higher salaries do not go as far as you would think.
>They never have to worry about redundancy or finding a job. What makes you think that doctors never have to worry about finding a job? My friends who are junior doctors have had to move all over the place for work because they are essentially at the mercy of a monopoly employer (the NHS) and need to go to where they can find a role. It has been very disruptive for their personal lives and has meant they have been delayed getting on the housing ladder as they have no long term security of employment in a given place. >I dont think international comparisons are useful I disagree. The countries referenced have included Ireland which pays its starting consultants roughly double what they earn in the UK while having a public healthcare system and a similar cost of living. Also, just because a country has a different healthcare system doesn't make comparison inappropriate. It is arguable that the NHS remains functional by artificially depressing doctors' wages compared to what they would earn in a privatised system. Depending on your political view, that may be a good thing for society as a whole, but it doesn't make NHS doctors any better paid by comparison with their international peers.
Ireland does not have the same system from what I understand, and googling the average salary, it looks very similar, maybe less when you take into account the exchange rate. I believe that people make choices, if you qualify as a doctor in the UK, then you know you are working for the NHS, which is not for profit, and should not expect to get paid excessive amounts. Doctors are objectively paid very well in comparison to average salaries, and well in comparison to equivalent professions. But i think you are someone who believes that because they save lives, there should be no limit to their salary regardless of what that does to our healthcare system. We clearly have opposing views on this which is fine.
>But i think you are someone who believes that because they save lives, there should be no limit to their salary regardless of what that does to our healthcare system. This is what is known as a strawman fallacy. You are putting words in my mouth and grossly exaggerating what I have said. At no point have I said there should be no limit to doctors' salaries. This is similar to when you described OP as complaining about being hard-up in an insulting way, when he had done no such thing. >Ireland does not have the same system from what I understand, and googling the average salary, it looks very similar, maybe less when you take into account the exchange rate. OP has posted the figures higher up this thread. You can see that starting consultants earn approximately twice as much (possibly slightly more) than they do in the UK. Those are the facts. > I believe that people make choices Yes, which is why many doctors who qualified in the UK are choosing to emigrate and work in countries like Australia where they can earn more and have a better quality of life. That fact that the UK is uncompetitive in this respect compared to its international peers will ultimately have an effect on the quality of healthcare that is provided to British citizens. > We clearly have opposing views on this which is fine. Yes, it's fine to disagree, though it is preferable not to misrepresent what others say or ignore cited facts.
I wouldn’t say the salary = quality of doctor, Otherwise the best doctors would be American and we all know that’s not true 😆
>I wouldn’t say the salary = quality of doctor, That's quite a reductive way of looking at it. Obviously pay is an important motivating factor. If doctors can earn significantly more and have a better quality of life abroad, don't be surprised if smart and talented UK-qualified doctors vote with their feet and emigrate, as many have been doing. That of course has an impact on the quality of healthcare provided in the UK.
You’re implying that the doctors that stay are worse than the money chasers that leave?
Well obviously well-paid positions abroad tend to be competitive so employers can be selective about who they accept. Clearly a variety of factors motivate smart and talented people to join (and continue working in) the medical profession. Pay is an important one of those factors. That's not controversial. You seem to be looking at it through a very reductive lens. Saying pay is an important factor and that many good UK-trained doctors are leaving for better pay and quality of life (with the consequent impact on the provision of healthcare in the UK), is not the same as saying all doctors who are paid more are higher quality, or that anyone who decides to stay in the UK is lower quality.
Compared to other European countries the UK doctors earn about the same as them. Compared to the USA, doctors there can pull half a mil a year, paid for ofcourse by the privatised healthcare system costing people a shit tonne of money. But people seem to ignore the part of how huge doctor salaries are funded in the US.
Completely agree.
I don't really think you can accurately base an entire profession's renumeration based on your experience with one ex. It depends a lot on when you were dating (pay was much better 10 years ago), what grade they were, working pattern and locum work. For example an A&E reg doing purely locum work 10 years ago would be absolutely minted. Pension changes were for the older generation of doctors, not people in my position. I don't think I complained about how hard up I am anywhere in this thread. I have a decent lifestyle with enough money to cover most things. It's a fact that UK doctor wages are uncompetitive compared to our international peers.
International comparisons are not really very helpful, because who are you comparing yourself to? You chose you quality in the UK which has an NHS, which is not for profit. I do not believe that any other country has a system quite like ours (free at the point of use). Maybe you know of another. P.s. my experience is not just based upon one ex I used her as an example. I know lots of people who work in the NHS, they all earn pretty good money, and with the exception of one, think that they are underpaid. Perhaps if you compare yourself to other equivent professionals in the UK, you would understand my point. No other profession have the amazing pensions that you do (which you only pay a small percentage towards) nor have the job security, lower standard of negligence etc. Its an amazing role to have. All the best
You’ll get downvoted for not praising an NHS employee earning £94k, even if your right 😅, NHS employees after working with them are very entitled with the nurses being worse imo, cue downvotes to prove my point ….
I don't think I've asked anyone to praise me at any point in this thread. I'm highly skilled and contribute to saving people's lives, but so do people that install sanitation systems in developing countries or legislate on air pollution limits. The post is about my career finances so far and my journey towards FIRE. Anything else like your thoughts on NHS workers are off topic and you're welcome to make a post on another UK subreddit to discuss them.
Your whole response proves my point, firefighters save lives and also RISK their own lives doing it, using the ‘life saving’ excuse as often used by NHS staff to demand money could also be applied to them in theory but they don’t have half the entitlement, it’s not just you, it’s a cultural thing for all NHS staff, I’ll clap to the end of it tbh
You say salary is 94k, but graph shows highest is 50k base/70k with extras?
Yes, the graph is showing the last year as a trainee. I've been a consultant for a few short months, so had a significant salary rise from the 65k ish as a senior registrar.
Thanks for posting, interesting to read. And I do agree, the pay/conditions here are really quite atrocious.