Doctor take-home pay in the Netherlands after tax, 2026
The Dutch medical ladder is unusually legible. First comes ANIOS, working in hospital either before specialty training or between posts. Then AIOS, the resident in training, paid on a nationally negotiated scale that steps up each year. Qualification brings the title of medisch specialist, held either in salaried loondienst or as a self-employed vrijgevestigd doctor. What each rung keeps after box 1 tax is set out below.
Employment income falls into box 1, and the bracket rates shown below already contain the national insurance contributions for AOW, ANW and WLZ, so no separate payroll line appears the way it does on a British or German payslip. Two credits then cut the bill again, the algemene heffingskorting and the arbeidskorting, which is why the effective rate stays well under the headline 35.82% and 49.50% through most of a career.
Net pay at each stage of a Dutch medical career, 2026
| Stage | Gross Salary | Monthly Net | Effective Rate |
|---|---|---|---|
| ANIOS (arts niet in opleiding) | €58,000 | €3,524/mo | 27.1% |
| AIOS, jaar 1 (resident, year 1) | €62,000 | €3,671/mo | 28.9% |
| AIOS, jaar 4-5 (senior resident) | €78,000 | €4,257/mo | 34.5% |
| Medisch specialist (loondienst, employed) | €135,000 | €6,400/mo | 43.1% |
| Medisch specialist (vrijgevestigd, illustrative) | €220,000 | €9,977/mo | 45.6% |
The AIOS numbers come from the nationally agreed salarisschaal under De Jonge Specialist and the CAO Ziekenhuizen, which steps up automatically with each training year whatever hospital you are in. Figures for vrijgevestigd specialists, normally organised through a maatschap, are indicative at best, since actual income depends on the goodwill and turnover arrangement and swings by specialty and region. Source: CAO Ziekenhuizen 2026, AIOS salarisschaal (De Jonge Specialist), FMS (Federatie Medisch Specialisten).
What the 30% ruling is worth to a doctor recruited from abroad
Shortages in intensive care, radiology, psychiatry and several other specialties send Dutch hospitals abroad to recruit, and a fair number of those arrivals qualify for the 30%-regeling. Under it an employer may pay up to 30% of gross salary as a tax-free allowance, leaving only the other 70% to run through the box 1 brackets above. The stated purpose is to cover the extraterritorial costs of moving here for work, and it currently runs for a maximum of five years.
Two conditions matter: you must have been hired from abroad, which in practice means living more than 150km from the Dutch border beforehand, and your taxable salary after the 30% deduction must clear a floor of roughly €46,660 for 2026, a figure indexed each year and worth checking against the current Belastingdienst table before relying on it. Be aware that this corner of the tax code keeps moving. Legislation in 2024 introduced a 30/20/10% step-down across the five years for new rulings, then the 2025 Voorjaarsnota scrapped the step-down and restored a flat rate for the whole term, while cutting that rate to 27% and lifting the salary floor from 2027. Treat what is written here as a guide to direction and confirm the detail with an adviser or the Belastingdienst.
What that does to net pay is not marginal. Look at the employed medisch specialist line above: €135,000 gross taxed normally leaves roughly €6,400 a month, an effective 43.1%. Send the same €135,000 through the ruling, with €40,500 paid tax-free and €94,500 taxed as usual, and the monthly figure climbs to about €8,237, an effective rate close to 26.8%. Same gross salary, roughly €1,800 more each month, some €22,000 across the year.
One warning worth repeating: every table on this page, and the calculator itself, assumes no ruling. A doctor recruited from abroad who holds one will bank considerably more than these figures suggest. Self-employment changes things again, because the ruling attaches to box 1 wages rather than to profit drawn from a maatschap, so a vrijgevestigd specialist rarely gains from it the way a salaried AIOS or a medisch specialist in loondienst does. It is worth remembering how the Dutch boxes divide up: box 1 takes employment and business income, which is what this page calculates, box 2 covers income from a substantial shareholding, and box 3 handles savings and investments, each under its own set of rules.
Where Dutch hospital doctors fall on the pay range
| Percentile | Gross Annual | Monthly Net |
|---|---|---|
| P25 (ANIOS / early AIOS) | ~€58,000-€65,000 | ~€3,500-€3,800/mo |
| P50 Median (AIOS, mid-training) | ~€70,000-€78,000 | ~€3,950-€4,260/mo |
| P75 (medisch specialist, loondienst) | ~€120,000-€140,000 | ~€5,750-€6,600/mo |
| P90 (vrijgevestigd specialist) | ~€200,000+ | ~€9,300+/mo |
Vrijgevestigd specialist income excludes practice costs and buy-in arrangements, which vary considerably. Source: CAO Ziekenhuizen 2026, FMS.
Frequently asked questions
An ANIOS on €58,000 keeps around €3,524 a month. A first-year AIOS on €62,000 keeps about €3,671, reaching roughly €4,257 by year four or five on €78,000. A fully qualified medisch specialist employed in loondienst on €135,000 keeps approximately €6,400.
Recruited from abroad and meeting the minimum taxable salary threshold, roughly €46,660 a year for 2026 and indexed annually, an employee can receive up to 30% of gross salary free of tax for as long as five years. Hospitals use it routinely for specialists recruited into shortage fields. On €135,000 it carries net pay from about €6,400 a month to roughly €8,237. The calculator here shows standard figures without the ruling applied, so speak to a tax adviser if you are recruited under it.
An ANIOS works in a hospital without being enrolled in specialty training, which for many is a holding position while waiting for an AIOS place. An AIOS is a resident training toward a specialty on a scale that rises automatically each year under De Jonge Specialist and the CAO Ziekenhuizen. Medisch specialist is the fully qualified stage, held either in loondienst as a hospital employee or vrijgevestigd through a maatschap, the latter paying materially more and far less predictably.
In the same specialty, a vrijgevestigd specialist normally earns considerably more than a loondienst colleague, with income that swings, follows practice revenue, carries buy-in costs and brings none of the employment protections or pension arrangements attached to salaried work. Most of it falls under box 1 as business profit rather than employment income, so the 30% ruling does not apply the way it does to an employed specialist's salary. Whether the trade works depends on the specialty, the hospital and how much variability you can live with.