What the offer includes 

Pay reform 

Pay reform is designed to make progression quicker and better aligned with the capability, experience and responsibility resident doctors build through training. 

• New pay nodes would be linked to training competencies.
• Employers would bring forward Annual Reviews of Competence Progression (ARCPs) so eligible doctors can progress sooner. 
• The new nodes would deliver rises of 6.2% for Foundation Year 1 doctors and 7.1% for Foundation Year 2 doctors in 2026/27. 
• Other resident doctors would receive between 3.5% and 5.1% in 2026/27 and between 3.5% and 9.8% by 2027/28, depending on individual circumstances. 

The offer would also support faster progression for doctors working Less Than Full Time, provide a route for Locally Employed Doctors to progress through enhanced ARCPs, and increase Clinical Academic pay premia from £5,600 to £10,000. 

Reimbursing costs 

The offer recognises that mandatory training costs can be significant and should be supported more consistently. 

• Eligible royal college membership, portfolio and exam fees would be reimbursed directly through employers. 
• Exam fee reimbursement would cover 2 attempts. 
• A BMA, Department of Health and Social Care (DHSC) and NHS England working group would agree which fees were covered. 
• Mandatory Advanced Life Support would continue to be funded locally where it is required for the role. 
• The same arrangements would also be agreed for dentists in training. 
• These reimbursements would also cover Locally Employed Doctors. 

Action on training places 

The offer would increase the number of training opportunities available and give resident doctors a role in shaping how places are distributed. 

• At least 4,000 additional training places would be created over 3 years. 
• This would include 1,000 places in 2027, with 250 with new national training numbers in February 2027. 
• A further 1,500 places would follow in each of the next 2 years. 
• Up to 500 further places may be added in years 2 and 3, depending on patient need, service requirements, training capacity and advice from the new Training Allocation and Distribution Group (TADG). 
• Resident doctors would be members of TADG. 

The offer would also support Locally Employed Doctors to gain core specialty competencies through structured support and enhanced ARCPs, helping them progress into higher training or into specialist, associate specialist, and specialty (SAS) doctor roles.  

The GP Flexible Pay Premia would become the GP Registrar Enhancement, with current contractual terms honoured in the new payments. 

Improving working lives 

The offer would build on work already under way to improve resident doctors’ working lives, including the 10 Point Plan and the Medical Education and Training Review. 

• NHS England is asking Resident Doctor Peer Leads in every trust what should be prioritised next. 
• The renewed 10 Point Plan would include further support for trusts to improve conditions for Locally Employed Doctors. 
• It would consider what should be included in a Lead Employer Model. 
• It would support Resident Doctor Peer Leads, board leads and non-executive directors focusing on this work. 
• Employers would be required to monitor and report progress in their annual accounts. 

The Medical Education and Training Review would focus on workforce needs, service integration and trainee wellbeing. The BMA Resident Doctors Committee would be formally recognised as a key stakeholder and involved in all workstreams. 

New ways of working 

The offer would establish new ways for organisations and resident doctors’ representatives to work together on delivery and future improvements. 

• A new Resident Doctor Industrial Relations Committee would bring together the BMA, DHSC, NHS England and NHS Employers. 
• The committee would monitor delivery of the offer and oversee task and finish groups where needed. 
• Resident Doctor Peer Leads would be maintained in every trust. 
• The Training Allocation and Distribution Group (TADG) would be involved in decisions on the distribution of new training places. 
• These arrangements are intended to give resident doctors a clearer role in shaping how commitments are delivered. 

What the offer could mean for you 

What the offer means in practice will depend on your grade, training pathway and personal circumstances. The summaries below set out the main benefits for each group, so you can see the detail that is most relevant to you before making your decision. 

Foundation Year 1 doctors 

For our F1 doctors, this would mean a pay increase in 2026/27, alongside support with the costs and progression points that matter early in your career. The offer also sets out changes designed to improve access to training and working life as you move through foundation training and beyond. 

• Pay would rise from £38,831 in 2025/26 to £41,226 in 2026/27. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would benefit from additional training places when you apply. 
• You would be prioritised for a specialty training place. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you became a Clinical Academic, your pay premia would increase. 

Foundation Year 2 doctors 

For our F2 doctors, this would mean a pay increase in 2026/27 and further support as you take the next steps in your career. The offer also includes wider benefits on costs, working conditions and future training opportunities. 

• Pay would rise from £44,439 in 2025/26 to £47,610 in 2026/27. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You have already benefited from prioritised training places. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you became a clinical academic, your pay premia would increase from £5,600 to £10,000. 

ST/CT1 doctors 

For our ST/CT1 doctors, including those in run-through training, this would mean pay progression that better reflects the competencies you gain. The offer also includes practical support with costs and continued work to improve training and working lives. 

• Pay would rise from £52,656 in 2025/26 to £55,534 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you became a clinical academic, your pay premia would increase from £5,600 to £10,000. 

ST/CT2 doctors 

For our ST/CT2 doctors, including those in run-through training, this would mean a pay increase by 2027/28 alongside future annual pay awards. The offer also includes reimbursement of mandatory training-related costs and continued action to improve working lives. 

• Pay would rise from £52,565 in 2025/26 to £56,925 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you became a clinical academic, your pay premia would increase from £5,600 to £10,000. 

ST/CT3 doctors 

For our ST/CT3 doctors, including those in run-through training, this would mean a pay increase by 2027/28 and continued access to future annual pay award processes. The offer also includes support with costs and opportunities to influence wider training reform. 

• Pay would rise from £65,048 in 2025/26 to £67,325 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you became a clinical academic, your pay premia would increase from £5,600 to £10,000. 

ST/CT4 doctors 

For our ST/CT4 doctors, including those in run-through training, this would mean a pay increase by 2027/28 alongside continued annual pay award processes. The offer also includes support with training costs, working lives and future progression routes. 

• Pay would rise from £65,048 in 2025/26 to £69,345 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 
• If you became a Locally Employed Doctor, you would have access to a permanent contract. 
• If you become a clinical academic, your pay premia would increase from £5,600 to £10,000. 

ST5 doctors 

For our ST5 doctors, this would mean one of the larger pay increases by 2027/28. The offer also includes reimbursement of mandatory costs and continued work to improve training and working lives. 

• Pay would rise from £65,048 in 2025/26 to £71,415 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 

ST6 doctors 

For our ST6 doctors, this would mean a pay increase by 2027/28 and continued future annual pay award processes. The offer also includes reimbursement of mandatory training-related costs and continued work to improve training and working lives. 

• Pay would rise from £73,992 in 2025/26 to £76,582 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 

ST7 doctors 

For our ST7 doctors, this would mean a pay increase by 2027/28 alongside future annual pay awards. The offer also includes practical support with costs and continued involvement in wider work to improve training and working lives. 

• Pay would rise from £73,992 in 2025/26 to £78,660 in 2027/28 before future annual pay uplifts are applied.
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10-point plan. 
• You would be able to influence the Medical Education and Training Review. 

ST8 doctors 

For our ST8 doctors, this would mean a pay increase by 2027/28 and continued future annual pay award processes. The offer also includes reimbursement of mandatory costs and opportunities to influence improvements to training and working lives. 

• Pay would rise from £73,992 in 2025/26 to £80,730 in 2027/28 before future annual pay uplifts are applied. 
• You would also benefit from future annual pay awards. 
• Your lifetime earnings would be significantly enhanced. 
• Exam, membership and portfolio fees would be reimbursed. 
• You would continue to benefit from the 10 Point Plan. 
• You would be able to influence the Medical Education and Training Review. 

Locally Employed Doctors 

For our Locally Employed Doctors this would mean specific action to improve stability, access to supervision, workplace protections and career progression. It would also create a clearer route for competencies gained in Locally Employed Doctor roles to be recognised. 

• You would be offered a standardised, substantive contract unless you are specifically covering a fixed-term role. 
• This may result in a pay rise, depending on your current circumstances. 
• You would get better access to supervision and workplace protections. 
• You could use competency attainment in specialty training applications. 
• You would be able to move up new pay nodes based on competencies. 
• Exam, college and portfolio fees would be reimbursed where required. 
• Consultation will define the criteria for prioritised NHS experience, and your Locally Employed Doctor role is likely to be taken into account.