The 10 Financial Traps That Keep Doctors Stuck

Hi again,

It’s been a while since I last updated this corner of my life — the finance side.

The last few months have been busy: Christmas, deep dives into property investing, and securing another GP role while quietly building capital for the next 10 years. The long game is still the same: creating passive income streams and more optionality.

But enough about me.

This chapter is about something far more practical — how we navigate how much we actually get paid.

Most doctors assume salary is non-negotiable.
Rota set. Banding set. Payscale set.

But that’s not entirely true.

There is flexibility in how much you’re paid — if you know the rules.

When I moved from medical registrar to GP trainee, I assumed a pay cut was inevitable.
It wasn’t.

In Wales, there’s something called Protection of Payscale progression.

Using it protected roughly £1,200 per month of take-home pay.

The point isn’t the policy.
The point is this:

Don’t assume the system is locked.
Some levers exist — but only if you know to look for them.

(This is exactly why this chapter exists.)

1️⃣ Know What Actually Makes Up Your Pay (Known your worth)

If you’ve been in the NHS for any length of time, you’ll already know this:

Not every SHO, registrar or even consultant earns the same.

That’s partly why there’s an unspoken NHS rule: we don’t talk about pay.

During my GP training, I never shared my payslip with colleagues. Not out of secrecy — but because I knew my pay would be higher than most, due to years of prior NHS experience, protected pay progression, and consistently reclaiming what I was entitled to through HMRC.

Pay differences aren’t accidental.
They’re structural.

Your income isn’t just a single headline number. It’s made up of:

• Banding or nodal pay

• Unsocial hours

• On-calls

• Rota structure

All of these are variable.
And even locum rates can differ significantly between trusts.

When we accept jobs as junior doctors, we understandably focus on training and progression. But it doesn’t hurt — and it absolutely helps — to understand how much you’re being paid, and why.

Because knowing what makes up your pay is the first step to improving it.

2️⃣ Learn the Rules (Negotiate)

Early in my career, I didn’t think about negotiating at all.

When I landed my first UK job as a trust FY1 in Carmarthen (that was over 10 years ago), I was just grateful to be here.
Negotiating felt intimidating.

Then my aunt gave me a nudge:

So I emailed HR.

I expected nothing.

They bumped my pay by a few hundred pounds a month.

That moment taught me something important:

You don’t always get what you deserve.
You get what you ask for.

I used the same mindset years later when applying for a salaried GP role.
I spent about an hour researching going rates, tailored my CV, and asked confidently.

The result?
An offer slightly above the market rate — roughly £120 extra per month for a small upfront effort.

3️⃣ Always Check Your Payslip

You’d think doctor pay systems would be airtight.

I’ve seen (and suffered from):

• Wrong banding

• Missing enhancements

• Underpayments lasting months

All because people were too busy to check.

Don’t be that doctor.

✔ Check your payslip
✔ Match it to your contract
✔ Flag errors early

They don’t fix themselves.

If needed fixing and not getting anywhere, get the BMA to help you. (One of the reasons why I stay with BMA)

4️⃣ Make Yourself Discoverable (and Desirable)

Toward the end of my GP training, the job market wasn’t exactly generous.

In my year around Swansea, there were roughly 20–30 ST3s finishing, but only 3–4 salaried GP roles advertised within a 30-mile radius.

Waiting for the “right job” to appear online?
Not a great plan.

So I went proactive.

I:

• Researched GP practices within a reasonable distance

• Sent cold emails to around 10 GP practices a day

• Asked about vacancies, locum work, and even upcoming maternity cover

The result?

• Regular locum sessions

• Long-term locum offers

• Maternity leave cover

Why not just wait for adverts?

Because hiring isn’t free. Even NHS Jobs listings come with hidden costs — admin time, HR processing, internal approvals. And if a practice advertises on BMJ Careers, a basic listing can cost over £1,000.

Bringing in an external candidate is slower and more expensive than hiring someone already known locally.

That’s why word-of-mouth hires are so common — and why being visible and easy to say “yes” to works in your favour.

That mindset — treating yourself as an asset — doesn’t just help with jobs.
It shapes financial decisions too.

At the time of writing, I hold:

• a salaried GP role

• a long-term locum role

• regular out-of-hours work

All while staying under five working days a week.

Not because I worked harder — but because I made myself known, created options, and could be selective about roles that improved both my clinical development and my financial stability.

Final Word: A Skill for Life

This might feel most relevant during training.

But it applies at every stage of your career.

You’re already qualified.
Already employable.

What changes outcomes is being willing to:

• know your worth

• ask the right questions

• speak up when the timing is right

• make yourself visible rather than passive

When you start treating yourself as an asset, decisions change — and opportunities follow.

It’s not about being pushy all the time.
It’s about being ready when the moment arrives.

And that readiness gives you options.

Options bring flexibility.
Flexibility brings freedom.