Doctors' pay, strikes and campaigns: what applicants should know

Why this matters at interview

Interviewers may ask about strikes, training places or how the NHS workforce is changing. You do not need a strong opinion. You do need to know the facts, explain more than one view and keep patients at the centre.

This page sets out what has happened, as of 29 October 2026, and says whose view each position is.

Who is involved

Resident doctors are qualified doctors in training, from first year foundation doctors up to senior specialty trainees. Until 2024 they were usually called junior doctors. The BMA says its members voted to replace the term at its annual meeting in June 2024, and the change took effect on 18 September 2024. The BMA says the word junior was misleading because these doctors are fully qualified. See how doctors train for the stages.

Consultants are senior doctors who have completed specialty training. SAS doctors (specialty, specialist and associate specialist) are senior doctors who are not in training posts and are not consultants. Our roles guide explains these jobs.

The main trade union in these disputes is the British Medical Association (BMA). Each group holds its own ballots.

How doctors' pay is set

Each year the government sets a remit for the Review Body on Doctors' and Dentists' Remuneration (DDRB). The DDRB takes evidence, including from government and NHS England, then publishes recommendations covering England, Scotland, Wales and Northern Ireland. Each government then decides whether to accept them.

For 2026/27, the DDRB's 54th report was published on 25 March 2026. The UK government accepted a 3.5% rise for resident doctors, SAS doctors and consultants in England from 1 April 2026. The Welsh Government announced the same 3.5% on the same day. Scotland applied 3.5% to consultants and SAS doctors in August 2026.

Resident doctors in England, 2023 to 2026

In February 2023, 98% of voting junior doctors in England backed strike action on a 77.49% turnout. In September 2024 they accepted a government offer worth an average 22.3% across 2023/24 and 2024/25. The BMA counted 44 strike days in that dispute.

A new ballot closed in July 2025, with 90% in favour on a 55% turnout. Five day strikes followed in July, November and December 2025. In February 2026 the mandate was renewed for six months. A further six day strike took place in April 2026.

On 16 June 2026 the government made a new offer and the BMA called off strikes planned for that week. The BMA says the offer, combined with the 3.5% DDRB award, gives an average 6.6% pay uplift, delivered in full by April 2027. It also includes 4,000 to 4,500 extra jobs and funding for Royal College exam fees. On 29 June 2026 members accepted it, with 52.9% voting yes on a 57.3% turnout.

• The BMA's case: the BMA argues for "pay restoration", meaning reversing the fall in real pay it says has happened since 2008. In July 2025 it put that fall at about a fifth. After the June 2026 deal it said its campaign for pay restoration was not over.
• The government's case: in July 2025 the government said the average 5.4% award for 2025/26 was the highest in the public sector, that it took the average rise over three years to 28.9%, and that it could not go further that year. In May 2026 it said pay had risen 33.4% over four years.
• A point worth noticing: the size of any real terms fall depends on the start year and method. In 2023 the Nuffield Trust found typical salaries had fallen 7.9% in real terms compared with 2010/11, while the BMA in 2023 cited a 26% fall since 2008.

Consultants and SAS doctors in England

Consultants voted for industrial action in July 2023 and took strike action several times. In April 2024 they accepted a revised offer that shortened the consultant pay scale. SAS doctors accepted their own offer in June 2024.

A new dispute has followed. The BMA says it has run since May 2025. In a ballot that closed on 6 July 2026, 75.81% of voting consultants backed industrial action on a 51.53% turnout, giving a 12 month mandate. SAS doctors voted 89.98% yes, but the BMA says turnout narrowly missed the legal threshold, so they have no mandate.

On 26 October 2026 the BMA announced a consultant strike from 06:59 on 25 November to 06:59 on 27 November 2026, with cover similar to a Christmas Day service. The BMA says it wants fully funded measures on pay and working conditions. In evidence published on 19 October 2026, DHSC and NHS England said their plans for 2027/28 assume a 2.4% pay uplift, and that anything higher would mean trade offs elsewhere in the health budget.

Scotland, Wales and Northern Ireland

Health is devolved, so each nation has its own process. In 2023 the Nuffield Trust noted that England moved to a new resident doctor contract in 2016, while Scotland, Wales and Northern Ireland kept the 2002 contract.

• Scotland: resident doctors voted for strikes in December 2025. Strikes due from 13 January 2026 were suspended, and on 11 February 2026 members accepted a two year deal that BMA Scotland describes as an average 9.9% for 2025/26 and 9.4% for 2026/27.
• Wales: the BMA's Welsh resident doctors committee entered a formal dispute in April 2026 over the 3.5% award and a freeze on specialty training places. The BMA's campaign page, checked on 29 October 2026, lists no ballot.
• Northern Ireland: resident doctors, consultants and SAS doctors struck in June 2026. In June the Health Minister said there was no room for awards above the review body recommendations for 2026/27, and that the decision sat with the Executive. The BMA says that, as of 15 October 2026, payment of the 2026/27 uplift had not been confirmed. Further 24 hour strikes are planned for 20 and 23 November 2026.

Training places and the Prioritisation Act

Competition for specialty training has risen sharply. The government said in December 2025 that there were about 1.4 applicants per postgraduate place in 2019 and 3.5 in 2025. NHS Employers reports nearly 40,000 specialty training applications in 2026. In October 2025, first year doctors in England voted for strike action over a lack of jobs.

The Medical Training (Prioritisation) Act 2026 received Royal Assent on 5 March 2026 and applies across the UK. It requires offers for the UK Foundation Programme and specialty training to go first to UK graduates and certain other groups, such as some Irish graduates and, for specialty training, certain people with UK citizenship or settled status. The government says internationally trained doctors can still apply. The BMA welcomes the Act as a first step but says it does not fully solve the jobs problem.

Physician assistants and working conditions

Physician associates and anaesthesia associates were reviewed by Professor Gillian Leng. On 16 July 2025 the government accepted all 18 recommendations. The roles were renamed physician assistants, and they should not treat undiagnosed patients except in clearly defined cases. The government said they should support doctors and never replace them. The BMA called the review inadequate, mainly because it did not set a national scope of practice.

Working conditions also feature. Consultants' stated demands include more protected professional time and better recognition of out of hours work. The government's July 2025 statement listed a new exception reporting process and a review of training rotations.

How patients are kept safe during strikes

Unions must give employers notice of strike dates, so hospitals can plan and reorganise staff. If a safety risk appears once a strike has started, a hospital can ask for a "derogation", which asks some striking doctors to return. NHS England says this covers areas such as emergency care, major incidents, essential cancer care and time critical treatment, and that the BMA must approve the request.

The government advises patients to attend appointments unless told otherwise and to use 999 for emergencies. It says the NHS kept 94.1% of elective activity during the April 2026 strike, compared with the same period a year earlier.

The General Medical Council says it does not set pay or terms and conditions and does not take sides in disputes. It has said it is "deeply concerned" about the impact of strikes on patients.

Where things stand on 29 October 2026

• Resident doctors (England): the dispute ended with the deal accepted on 29 June 2026. No strikes are planned.
• Consultants (England): a 48 hour strike is announced for 25 to 27 November 2026. The BMA says it can be avoided if the government acts.
• SAS doctors (England): no strike mandate.
• Scotland: resident doctors accepted a deal in February 2026.
• Wales: resident doctors are in dispute, with no ballot held.
• Northern Ireland: strikes are planned for 20 and 23 November 2026.
• Pay for 2027/28: the DDRB process is under way. No award has been decided.

How to discuss this at interview

Interviewers want to see how you think, not which side you pick. A simple structure helps, and our interview handbook has more on structuring answers.

• Show you understand both sides. Explain the BMA's argument and the government's argument in a sentence each, and say who holds each view.
• Put patients first. Talk about how care is protected during action, and the effect of delays and cancellations on patients.
• Think about the team. Strikes affect nurses, consultants, managers and other staff who cover gaps. See our guide to ethics stations for weighing competing duties.
• Stay professional. Avoid party political points or loaded language. It is fine to say a question is complex.
• Use reliable sources. Mention that you have read official pages or the union's own statements, and that figures depend on the method used.