Doctor salary in Ireland after tax — 2026
Irish hospital medicine went through the biggest pay shake-up in a generation when the 2023 Public-Only Consultant Contract pushed entry-level consultant pay past €200,000 — a deliberate move to stop the exodus to Australia and the UK. Here's what every grade actually keeps after PAYE, USC, and PRSI.
Take-home pay by grade — 2026
NCHDs (Non-Consultant Hospital Doctors) progress through intern, SHO, Registrar and Specialist Registrar grades under the HSE's consolidated pay scales, negotiated with the IMO. Consultants employed after the 2023 reform sit on the new Public-Only Contract (Type B, no private practice).
| Grade | Gross Salary | Monthly Net | Effective Rate |
|---|---|---|---|
| Intern (Year 1) | €46,000 | €3,156/mo | 17.7% |
| SHO / Registrar (early) | €62,000 | €3,848/mo | 25.5% |
| Senior Registrar | €78,000 | €4,513/mo | 30.6% |
| Specialist Registrar | €90,000 | €4,992/mo | 33.4% |
| Consultant (Public-Only, entry) | €225,000 | €10,381/mo | 44.6% |
| Consultant (top of scale) | €265,000 | €11,978/mo | 45.8% |
Figures exclude on-call and overtime supplements, which are common for NCHDs and taxed as ordinary income. HSE Superannuation Scheme contributions not deducted in the table above. Source: HSE Consolidated Pay Scales 2026, IMO pay circulars.
The USC gap: why a pension doesn't shield a consultant's whole salary
Every Irish payslip carries three separate deductions — PAYE, USC, and PRSI — and doctors feel the seams between them more than most professionals because of how much of their income is pensionable. The catch is that USC is charged on gross income before pension contributions are deducted, unlike PAYE and PRSI, both of which give full relief on pension contributions.
- A consultant on €225,000 who salary-sacrifices heavily into their HSE pension still pays USC (up to 8% above €70,044) on the full gross figure
- PAYE relief on pension contributions can be worth 40% back; USC gives back nothing
- At consultant level, this typically costs €3,000–€5,000/year more than a doctor would estimate from a simple "pension reduces my taxable income" assumption
This is the single most common surprise NCHDs report when they move from Registrar grade — where USC is a rounding error — to Consultant grade, where it becomes a five-figure annual line item that pension planning cannot touch.
The 2023 contract, in context
Before October 2023, a newly appointed HSE consultant on the old contract started around €126,000 — a figure widely blamed for an NCHD emigration wave to Australia, Canada, and the UK. The Public-Only Consultant Contract lifted entry pay to roughly €209,915, rising through increments to over €265,000, in exchange for consultants giving up private practice rights within public hospitals. Existing consultants could opt in voluntarily.
The policy is widely credited with reversing some of the outward flow of Irish-trained consultants, though NCHD (training-grade) pay reform has been slower and remains a live industrial relations issue with the IMO.
Salary distribution — where Irish doctors sit
| Percentile | Gross Annual | Monthly Net |
|---|---|---|
| P25 (Intern–SHO) | ~€46,000–€62,000 | ~€3,156–€3,848/mo |
| P50 Median (Registrar / Spec. Reg.) | ~€78,000–€90,000 | ~€4,513–€4,992/mo |
| P75 (Consultant entry) | ~€225,000 | ~€10,381/mo |
| P90 (Consultant top of scale) | ~€265,000+ | ~€11,978+/mo |
Private practice income excluded — relevant only to pre-2023 contract consultants who retained private rights. Source: HSE, IMO 2026 pay circulars.
Frequently asked questions
An intern on €46,000 takes home around €3,156/month. A Specialist Registrar on €90,000 takes home about €4,992/month. A consultant on the new Public-Only Contract starting at €225,000 takes home roughly €10,381/month before HSE pension contributions.
USC applies to gross income before pension contributions are deducted, unlike PAYE and PRSI which both give pension relief. This means a consultant salary-sacrificing heavily into their HSE pension still pays USC (up to 8% on income above €70,044) on their full gross salary — a gap worth several thousand euro a year that catches many doctors by surprise when they reach consultant grade.
The Public-Only Consultant Contract raised entry-level consultant pay from roughly €126,000 to approximately €209,915–€225,000, rising to over €265,000 at the top of the scale — a rise of over €80,000 at entry level. In exchange, consultants on the new contract give up private practice rights within public hospitals. It's widely credited with slowing the emigration of Irish-trained consultants to Australia and the UK.
The case has strengthened considerably since 2023. Early NCHD pay is modest relative to hours worked and training length, but reaching consultant grade now puts you well into the top 2–3% of Irish earners, with a defined-benefit HSE pension on top. The main financial friction points are the long training pipeline (7–12+ years post-qualification) and the USC/PRSI drag that doesn't ease with pension planning the way PAYE does.