Doctor take-home pay in Ireland after tax, 2026
Nothing had shifted Irish hospital pay so sharply in decades until the Public-Only Consultant Contract of 2023 lifted entry-level consultant salaries beyond €200,000, an openly stated attempt to stem the flow of doctors to Australia and Britain. What each grade keeps once PAYE, USC and PRSI have been applied follows.
What each grade nets in 2026
Non-Consultant Hospital Doctors move up through intern, SHO, Registrar and Specialist Registrar grades on the HSE's consolidated scales, negotiated with the IMO. Anyone appointed as a consultant after the 2023 reform is on the Public-Only Contract, Type B, which excludes 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% |
On-call and overtime supplements are left out, though NCHDs earn them routinely and they are taxed as ordinary income. HSE Superannuation Scheme contributions have not been deducted from the table above. Source: HSE Consolidated Pay Scales 2026 and IMO pay circulars.
Why a pension leaves a consultant's USC bill untouched
Three separate charges appear on every Irish payslip, PAYE, USC and PRSI, and doctors notice the joins between them more than most because so much of their pay is pensionable. The problem lies in the order of operations: USC applies to gross income before pension contributions come out, whereas PAYE and PRSI both give full relief on those 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
Nothing catches doctors out more often on the step up from Registrar, where USC barely registers, to consultant, where it turns into a five-figure annual charge that no amount of pension planning will reduce.
Putting the 2023 contract in perspective
Until October 2023 a newly appointed HSE consultant started near €126,000 under the old contract, a number widely held responsible for the wave of doctors leaving for Australia, Canada and Britain. The Public-Only Consultant Contract raised entry pay to roughly €209,915, climbing through increments past €265,000, in return for giving up private practice rights inside public hospitals. Consultants already in post could switch across if they chose.
Most observers credit the change with pulling back part of the outflow of Irish-trained consultants. Pay reform at training grades has moved far more slowly and remains an open dispute with the IMO.
Where Irish doctors fall on the pay range
| 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 keeps around €3,156 a month. A Specialist Registrar on €90,000 keeps about €4,992, and a consultant starting on €225,000 under the new Public-Only Contract keeps roughly €10,381 before HSE pension contributions come out.
Unlike PAYE and PRSI, both of which give pension relief, USC bites on gross income before any pension contribution is deducted. A consultant sacrificing heavily into the HSE pension therefore still pays USC on the full gross salary, up to 8% on income above €70,044. The gap is worth several thousand euro a year and surprises a great many doctors on reaching consultant grade.
Entry-level consultant pay moved from roughly €126,000 to somewhere between €209,915 and €225,000 under the Public-Only Consultant Contract, reaching beyond €265,000 at the top of the scale, an increase of more than €80,000 at the point of entry. What consultants give up in return is the right to private practice inside public hospitals. Most observers credit it with slowing the flow of Irish-trained consultants to Australia and Britain.
Since 2023 the case has grown considerably stronger. Early NCHD pay remains modest against the hours worked and the length of training, and reaching consultant grade now places you well inside the top 2% to 3% of Irish earners with a defined-benefit HSE pension alongside. The friction sits in the training pipeline, seven to twelve years or more after qualification, and in the USC and PRSI drag that pension planning cannot soften the way it softens PAYE.