How Much Do Specialty Trainee Doctors Earn? Registrar Pay Rates

On this blog we want to give you the best information possible about Medical Careers. That obviously includes information about pay rates and related conditions We have already given you the low down on Interns and Residents, as well as Specialists. So its high time we discussed Specialty Trainees. Right?

In this post we are going to talk about Specialty Trainees, also referred to as Registrars and how much they earn. Specialty Trainee Registrars working full-time in the hospital system will earn between $89,649 as a first-year Registrar in Tasmania up to $161,766 per annum working at the most senior Registrar level in Western Australia. General Practice Trainee Registrars working full-time are guaranteed $75,328 per annum in their first year of training. Going up to a guaranteed $96,724 per annum in their 3rd and final year of training.

Once again it’s important to emphasize that these salaries are base salaries for full-time employees. Specialty Registrars are often required to work considerable amounts of overtime and on-call which will increase their pay rate significantly. And General Practice Registrars are able to negotiate with their employers above the guaranteed rate of pay. Often this will be on the basis of a proportion of the Medicare revenue that they generate for the practice. So, again they can possibly earn significantly more.

Specialty Trainees Can and Often Do Earn Much, Much More.

We can see evidence of the fact that Registrars do earn much more than their base rate of pay. “Other Medical Practitioners”, which is where most Registrars classify themselves for tax purposes with the Australian Tax Office earned on average $204,387 of taxable income in 2016/17 according to the ATO.

Whilst these figures are likely to be conflated by General Practitioners and other Specialists indicating this category as their profession as well they do back up the contention that most trainee doctors earn significantly more than their base salary due to working excessive hours with specialty trainees at most risk of working excessive hours and amongst these Intensive Care and Surgical trainees being at the highest risk of fatigue.

Its certainly been my observation over the years that surgical trainees in particular work long hours. This is generally a combination of rostered and unrostered overtime as well as being “on-call”. I was literally at a meeting last week where an administrator reported that the surgical trainees at her hospital were the best paid doctors last year due to their workload. Meaning that they were paid even more than the specialists.

Its easy to see why and how this would be the case. Lets take a typical situation of a medium hospital which employs 3 General Surgical trainees. Each is on the roster approximately 1 in 3 on top of their normal 40 hours per week. This means being on call around 2 weeknights per week and 1 weekend in 3.

Let’s assume one of these surgical trainees does slightly more than their share of weeknights in a month (4 weeks). 8 in total. But only one weekend. Let’s say that they get called on average 2 times per weeknight and 15 times over the course of that weekend.

In New South Wales each of these call-backs would amount to a period of 4 hours of overtime. This is initially paid at time and a half for the first two hours and thereafter double time.

So we have:

160 hours of normal time
2 callbacks X 8 = 64 hours of overtime for the weeknights
15 callbacks for the weekend = 60 hours

This gives us a total of 284 hours for that 4 week period. Which is close to double the base hours! But wait. Because those overtime hours get paid initially as time and a half and then very quickly as double time. The total amount of hours paid becomes about 400 hours!

Now this example is obviously not typical for every specialty and there are some specialties which may not have to do as much overtime and not get called in as much. But it is also not the most extreme example either as the case of Dr. Yumiko Kadota has demonstrated to us.

Breakdown By State and Territory.

We have compiled below a table that demonstrates the current base rates of pay for Intern, Resident, Senior Resident, Registrar and Senior Registrar for each State and Territory in Australia.

Please bear in mind a number of things. Once again we are talking Full-Time Annual Salary. Also, as I have pointed out above the actual take-home pay can vary considerably. Also, the Awards and agreements for each State and Territory are set independently and at different times from each other. So over time, the tendency is for there to be movement both up and down through the table.

What is apparent, however, as we have pointed out on our other blog posts about Interns and Residents is that Western Australia is clearly the best place to work if your sole interest is finances. Victoria is next best and rates a special mention as its Enterprise Agreement contains a lot of additional friendly provisions that others do not.

$31,000 in difference between the highest rate of pay between Western Australia and Tasmania is a bit hard to fathom and justify. It’s almost a 20% difference.

State / Territory	Intern	Resident	Senior Resident*	Registrar	Senior Registrar**
Western Australia***[]	$78,479	$86,328	$94,960	$109,678	$161,766
Victoria	$74,563	$79,391	$86,060	$116,460	$155,477
New South Wales[]	$69,649	$81,639	$89,793	$101,698	$143,398
Australian Capital Territory***[]	$68,094	$79,682	$87,410	$98,704	$138,667
Queensland	$73,306	$79,413	$85,521	$105,377	$134,389
Northern Territory	$71,350	$82,731	$88,629	$98,413	$134,113
South Australia	$73,370	$80,041	$86,710	$100,717	$133,400
Tasmania	$68,936	$72,837	$89,649	$89,649	$126,854

*Being appointed to a specialty trainee position does not automatically mean appointment to a Registrar role in all States and Territories. For some, for example NSW, the entry point is the Senior Resident Medical Officer position.

**Not all States and Territories have a Senior Registrar role. We have used the maximum Registrar pay grade where there is no Senior Registrar role.

***The Australian Capital Territory Enterprise Agreement expired in July 2017. Therefore we expect that the salaries quoted here will increase significantly when there is a finalization of the new agreement. Similarly, the WA Agreement experied in 2018.

What About General Practice?

Ok. So far I have ignored General Practice. But this has not been deliberate. It’s because General Practice is a different set of circumstances to the other specialty training cases. This is because General Practice works more on a national basis. Because there is an Australia-wide minimum set of pay standards.

So, according to the General Practice Registrar Association website the current base rate of pay for a first-year General Practice Registrar is $75,328.23 per year and for a Registrar in their final year (which is either 3rd or 4th year) $96,724.43 per year. Again, this is for full-time work.

Now, whilst these rates appear to be somewhat lower than for Specialty Trainees paid as Registrars you should bear in mind four things about General Practice training.

The first is that General Practice training is a minimum of 4 years, whereas most other specialties are 5 years and possibly longer. So there is no need for higher Registrar levels in general practice.

The second is that is actually possible to enter General Practice training in your PGY2 hospital year. So when you enter your first actual GP training post you are actually in your second year of training.

The third is that the pay agreements are a minimum standard as part of an employment contract below which your employer may not go. But it is quite common for GP trainees to negotiate a better agreement with their employer, by agreeing to collect a share of their Medicare billings. So it is possible to do far better than these minimum amounts. Although, clearly this partly has to do with your own productivity as a GP trainee. And I don’t have any meaningful information to tell you how much this can increase salaries.

The fourth and final thing is that clearly, GP trainees become specialists earlier. So whilst other specialists can and do eventually earn more than GPs. You get there first as a GP and so you get a head start on the rest of the field. Also, GPs are generally working less time than other specialists. So in theory more able to enjoy their very reasonable salary.

Time To Complete Training and Other Costs.

It has been suggested to me by my readers and viewers that in order to tell the complete picture I should talk about the time it takes one to complete training as well as some of the other costs involved in getting there.

Whilst I agree that this probably does make the picture a little bit more complex for Specialty groups such as Surgeons. As I have also pointed out. Whilst one is working as a Surgical Trainee, either accredited or unaccredited you are in a group of doctors who are going to be earning quite a bit due to the amount of time worked. Now. This observation in itself is not really an attractive reason to enter Surgical training in my opinion.

But it does mean that if you are successful in getting your way through Surgical training to your FRACS you are probably going to end up earning one of the highest incomes of doctors across your medical career.

This is all pretty relative when we consider that most medical professions are in or close to the top ten occupations in terms of average income in Australia.

Some key things to observe here are:

Some specialties are somewhat easier to get into at an earlier stage of training, examples being Emergency Medicine, Psychiatry, Physician Training and Emergency Medicine.
Other specialties have long waiting lists where you might end up becoming a very, very senior Resident before you get onto the program. Examples here are Surgery, Ophthalmology and Dermatology
Costs of training fees and exam fees can also vary significantly. Annual College fees usually start at over a thousand dollars for most Colleges. Examination fees can be a few thousand dollars to over ten thousand dollars. These costs are all tax deductible.
You may also need to or find it desirable to enter a formal training course. Some Colleges make this mandatory. This will also cost you a few thousand dollars. Again. This is also tax deductible.
Depending on your specialty there may be some equipment that you need to buy. For example, some of the surgical specialties utilise special equipment (think Ear, Nose and Throat).