In February 2023 junior doctors – medics undertaking ongoing training in the role – voted for strike action, following strikes brought by nurses, midwives and ambulance staff at the end of 2022 and continuing into the new year. Some 77% of eligible junior doctors cast a vote in the BMA ballot, of which an overwhelming 98% voted in favour of strikes. This result was very similar to previous industrial action voted for by junior doctors in England in 2016.
These doctors are a vital part of the workforce, central to day-to-day medical management in and outside hospitals and at the core of the basic services the NHS offers. But many are experiencing burnout following the pandemic and record low satisfaction relating to pay, the wider job offer and standards of care.
But the reasons for the strike action are complex. To better understand the reasons doctors in training have voted to strike, we've collected a set of key facts and figures to explain the make-up of the junior doctor workforce, how they are compensated for their work and what the roots of the dispute are. Read the summary below, and download the slide pack of facts and figures.
Key points
The starting basic salary for foundation year doctors in England is £29,384 – slightly higher than the average graduate starting salary
The average annual NHS earnings of a ‘junior doctor’ in England in the year to March 2022, including those working part-time, was £55,420. The full-time equivalent average salary is around £57,118. This average has fallen £4,900 behind inflation between 2010/11 and 2021/22, and this is likely to rise to £9,500 in 2022/23 depending on how inflation changes over the year.
Even before the current financial year, typical salaries for all junior doctors had fallen by 7.9% in real terms compared to 2010/11 levels.
Pay scales differ between the four nations of the UK. In 2016, England introduced a new junior doctor contract, whereas Scotland, Wales and Northern Ireland continued with the 2002 contract
On 10 March 2023, the Secretary of State for Health and Social Care, Steve Barclay, invited the BMA to participate in formal pay discussions. The BMA declined as they did not accept the precondition of calling off strike action planned for 13–15 March.
Doctors in training roles: the basics
There were around 75,000 full-time equivalent doctors in training roles (‘junior doctors’) in the NHS in England (including GP trainees) as of September 2022, which represents a 33% increase since September 2015.
In the year to September 2022, nearly half (47%) of junior doctors who joined NHS hospital and community services in England were non-UK nationals. There were 8,728 vacancies across all doctors (not just doctors-in-training) in England as of December 2022.
When including other reasons for shortfalls, such as sickness absence, we previously estimated some 1,400 posts went unfilled on any given day. Problems retaining junior doctors have knock-on implications for the number of consultant vacancies.
A survey from the GMC found that there were an increasing number of medical trainees experiencing burnout, with one in five junior doctors at high risk of burnout in 2022, compared to one in seven in the previous year. For some specialties, such as emergency medicine, this was as high as one in three in 2022. Doctors experiencing burnout are more likely to consider leaving the profession.